Low reimbursements from insurance companies are hurting dental practices financially, making it difficult for offices to pay their expenses and for patients to access care.
Three dentists recently spoke with Becker's about how reimbursements are affecting their practices.
Editor's note: Responses were lightly edited for length and clarity.
Question: How are payer reimbursements affecting your practice?
Bill Choby, DMD. The Center for Dental Implants (Greensburg, Pa.): Payer reimbursements are a problem for the solo practitioner who doesn't know how to negotiate higher fees. As a result, the insurance companies are controlling the fees for dental care at the expense of the providers. Meanwhile, the insurance companies take their cut from the patient premiums. Most offices cannot afford to lose any patients by going to cash only. Some are able to do it, but they are the exception and not the rule. An alternative is the various discount plans that are inexpensive and yet still pay the providers a lesser fee but higher than the insurance reimbursements. By cutting out the insurance "middleman," the discount plans are a win-win for patients and providers.
Susan Dunn, DDS. Muskogee (Okla.) Dental and Implants: I built my practice in 1998. I sold it in June 2022, partly due to low reimbursement from third-party payers. We all know that these third-party payers are still paying at 1960s rates. Maximums of $1,000 or even $1,500 per year are so incredibly inadequate. Meanwhile, third-party CEOs are enjoying millions per year in profit. I am seeing DSOs and the next generation of dentists being very "creative" in how they practice in order to live a lifestyle that in the past was not at all difficult to attain. In addition, especially since COVID-19, expenses (due to increased regulations and the general effect from the pandemic) have skyrocketed. Thankfully, I am near the end of my career and have a very limited time remaining to deal with these situations.
Steven Schneider, DDS (San Diego, Calif.): Payer reimbursements are just horrible. Not only are they half office fees, but now that the insurance companies send reimbursements with credit cards, it costs all of us another 2.5+ percentage for our work. Keep in mind that the insurance companies have struck a deal with the credit card companies to get cash back rewards.
It is a real disappointment and is hurting our industry. The patients don't understand that it creates a "lesser" quality of care systemwide. It affects the supply companies since dentists can't afford to purchase as they once did.