Showing posts with label Corporate Dentistry - A History. Show all posts
Showing posts with label Corporate Dentistry - A History. Show all posts

Sunday, May 01, 2011

Corporate Dentistry–A history

One of the major birth places for corporate dentistry is Texas.  Around 1995, Texas allowed managed care programs or HMO's.  The  insurance companies quickly created and sold these dental programs to employers.  However, there was one big problem.  General dentists would not sign up to be a provider because the fees were too low and the dentist would be forced to do "managed neglect" not "managed care". 

The insurance companies, primarily Aetna, decided that they could establish needed offices by guaranteeing a monthly income to a practice in Aetna's preferred location.  There were a couple of dentists in Texas who took them up on the offer. 

They did stock offerings and corporate dentistry was born in Texas even though it was and is still illegal. This relationship continues today.

Under these corporate practices, the insurance companies lists the dental provider as the corporate entity, not a licensed dentist.  Under your HMO dental plan, if you call for your free or low fee cleaning, you are told there is a one to two year waiting list.  If you complain to the Dental Board, their response is they only control licensed dentists not corporate practices. 

If you go in for an exam, you are suddenly told you need hundreds to thousands of dollars worth of work, much of which is barely covered by insurance. The dental work may not even be needed.  Check the complaints on Monarch Dental as an example.  You would think the Dental Board would have stopped the damage by now.

The insurance companies will try to further enhance their profits by using these offices to keep costs low in this economy.  In this economy employers are dropping their PPO dental insurance for the cheaper HMO policies.  Dental insurance companies can then assign these PPO patients, who use to have freedom to chose their dentist, to these corporate offices.  Dental insurance is always beneficial to the insurance companies..  It is non catastrophic unlike health insurance.  It is rarely cost effective for the insured.

Medicaid in the corporate practice has been a recent addition.  Mainly because state and federal agencies have allowed them to see Medicaid patients when it is against many of the state laws. 

To stop the corporate practice of dentistry, you must stop the dental insurance companies from funding it.  Can you imagine the potential liability of assigning and paying insurance monies to illegal corporate practices? 

They are fully aware of the liability, however, to date no one has challenged them.  The potential liability was mentioned to one national dental director now that the public is waking up and complaining.  He is in the process of having the actuaries calculate what it will take to convert the HMO policies to in-network PPOs.
Bottom line is that the economy and media exposure like the Ortho story will cause Medicaid to begin to correct itself.  Medicaid was there before corporate dentistry and will be there after. However, the slow economy will fuel the insurance companies to want to foster more corporate dentistry. 

If litigation is contemplated, then the insurance companies have the most to lose.  There is no argument that they are guilty of paying illegal corporate practices and also have large potential antitrust violations. 
a Concerned Texas Dentist