The Current Crisis in Local Dental Care

There is a dental care crisis in our area. It seems that Delta Dental, who insures many of the people of the valley, is upsetting a lot of folks. The City of Salem is switching to Delta for dental insurance on Oct. 1st. 

I just saw a patient at the store who will have Delta, and now must see somebody on their provider list or dental chair pixabay pub domain free commercial -2450751 640she gets no coverage at all. 

Meanwhile I've heard that Delta reimburses dentists at different rates. I have heard that their long-term providers get reimbursed at a higher rate than new providers. I have reached out to a specialist/provider to see if they tried to negotiate with them. Due to the small number of providers, historically our specialists and many generalists haven't been providers. Delta may or may not have tried to work with them. 

I can't see a huge company like Delta Dental working with my individual practice. But I will continue my research to see what options there may be.

I tried to explain "value" to the patient I encountered in the store. Like most patients, she's only thinking about what it's going to cost her. She made it clear she doesn't want to change dentists, however, she will to save money. Of concern to me is the quality of care these patients will receive (or be denied).

The reimbursement schedule Delta presented to me for the city's plan definitely dictates volume practice, not quality. In addition, this means cutting costs where ever possible -- like lab choices. We use local labs--supporting local businesses and having complete knowledge of the product and its quality. We don't do any mail order: these are often products made outside the U.S. and we have no certainty of the quality of the product or the materials used.

All of this for "insurance" that really isn't insurance. It's a predetermined dental benefit payment plan. Clearly it doesn't insure anything like your home, car or medical insurance.

I fear that this set payment for procedure will exclude many dentists. What I fear more is what the future holds for patients who must sacrifice both quality and true value in exchange for something they think will reduce their cost.

It is important that patients understand what they are getting: most dental policies (regardless of provider) pay a set amount per procedure. The patient still must pay the remainder of the cost. And, these dental policies have a limit on the amount of money they will pay to or for a single patient within a year. When insurance refuses to pay for necessary procedures, the patient suffers because the problems only become worse. In the end, I fear that it might cost them more than having no insurance.

These programs that refuse to pay any portion of the cost of dental work if the dentist is not in their network (which applies to many dental plans). This forces patients to leave their trusted dentist or to spend extra money while still paying premiums. We all live on budgets, and we want to maximize our available benefits with freedom of choice and the ability to make our own decisions about the dentist we believe provides the best value for our dollars.

argh!!!