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Dental Managed Care Survey

Delta Dental Plans Association (DDPA)

By Darrell K. Pruitt; DDS

The common sense truth about managed-care dentistry was recently confirmed by Delta Dental data mining.

Preliminary Oral Care Report

Concerning what one can do to assure the best oral care for oneself or one’s family; allow me to share some significant news about research that has not yet been formally published.

On the morning of August 14 2008, less than two weeks ago, a representative for Delta Dental Plans Association (DDPA) revealed the results of an in-house study that confirms that remaining with the same dentist for the long term prevents fillings.

The 2008 National Dental benefits Conference

It was during the first day of the 2008 National Dental Benefits Conference in ADA Headquarters in Chicago that Maxwell H. Anderson DDS, the dental affairs advisor for DDPA, located in Oak Brook Illinois, announced that by data mining their proprietary dental claims over 11 years, Delta uncovered evidence-based information revealing that clients who change dentists regularly are likely to receive more fillings than those who stay in consistent “dental homes” where they are content.

Dr. Anderson told the audience of about a hundred dentists and dental industry representatives that “The greatest hazard to teeth is changing dentists.”

A Righteous Finding

I find it remarkable, as well as noble, that a managed care insurance company like Delta, based on preferred provider lists that are valid for only 12 months at a time, would voluntarily reveal findings that can only bring harm to their business model.

However, when one thinks about it, Delta’s results clearly make sense. If a patient or family of patients is comfortable with a dental team, they are more likely to keep their check-up appointments as well as take better care of their teeth at home. And, consequently, enjoy better health.

Perhaps Delta came to the righteous conclusion that to hide such landmark findings would be unethical?

Assessment

How do preferred-provider lists cause more fillings?

When dentists can rely on a dental care broker like Delta Dental for new patients, there is an inherent absence of accountability that occurs when guided by the invisible hand of competition in the marketplace, naturally. That is an undeniable fact. Managed care dentistry is dentistry by the lowest bidder with no quality control; also an undeniable fact.

Note: Dr. Pruitt, an attendee of the 2008 National Benefits Conference on August 14 and 15 in ADA Headquarters, is the sole proprietor of a fee-for-service dental practice in Fort Worth, Texas. He represents only himself for the benefit of dental patients. His name cannot be found on any preferred provider list. Report posted with permission.

Conclusion

Your thoughts and suggestions are appreciated. Are this dentist’s “facts” and quality assessment true; please opine and comment?

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2 Responses

  1. NPs versus OPs

    I am not sure that this evidence-based report is so unique as to not be anything but heuristic. New Patients [NPs] are indeed a key economic driver to most [discounted] managed care plans. Old Patients [OPs] are not!

    In other words; As a DDS, I would take the NP’s X-ray, fill a tooth, and move on to the next NP. Old [established] Patients [OPs] just don’t generate much income for the dental provider.

    So, why else would some docs take on some managed care plans whose OP reimbursement is at a net loss? For the higher paying NPs, of course!

    Look at the Calculus:
    NP = [+] cash flow
    OP = [-] or [=] cash flow
    And, this is probably not unique to other specialties, as well.

    Now, let’s not beat up on the docs, or portray them all as money-hungry. For example, was this dental study “risk-adjusted” in terms of patient mobility?

    The census bureau here in Atlanta, a town on-the-move, tells us that the average ‘Hotlantan” moves every 2.5 years. Hence, in some cases, the NP load may be justifiably over-weighted.

    Therefore, one may rightly wonder what the patient-mobility statistics are for discounted managed care, Medicare, FFS, HAS, concierge medical practice reimbursement plans, and others etc.

    Any comments?
    Hope

    Like

  2. Dear Kate Gerlesits of Delta Dental

    On January 30, Delta Dental employee Ari Adler announced that Delta guarantees its preferred providers’ work in an article that was posted on DrBicuspid.com.

    “We put our dentists thorough a credentialing process and provide quality assurance. That means if a dentist does a filling that should last a certain amount of time and it doesn’t, they have to fix it without charging the network or the patients.”

    Link: http://www.drbicuspid.com/forum/tm.aspx?m=646&mpage=1&key=&#646

    In the last two weeks, both Dr. David Edward Marcinko, Publisher-in-Chief of this Medical Executive-Post and I have requested an explanation from Ari Adler and Delta Dental. So far, our requests have been ignored.

    Did Delta Dental authorize Ari Adler to roll out the news of Delta’s guarantee, or was the sales pitch a product of Adler’s own initiative to attract new clients for Delta?

    Please respond promptly.
    D. Kellus Pruitt; DDS

    Kate Gerlesits
    Delta Dental Plans Association
    630 574-6994
    kgerlesits@deltadental.com

    Angela Feig
    The Meyocks Group
    515 327-3425
    angelafeig@meyocks.com

    Like

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