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Managed Care Update

Recent Changes

Over the past few years, changes in managed care plan reimbursements have left many doctors alarmed and confused, says Bill Rossi, President of Advanced Practice Management.* While managed care situations vary on a state-by-state basis, the national trend toward more PPOs and deeper discounts has obviously not been positive for doctors.

Delta Dental dominates the dental insurance marketplace, owning more than one-third of the U.S. market share. Delta has been cutting reimbursements to doctors in several states over the past few years, in response to employers seeking lower premiums. In 2011, Delta Dental cut reimbursements to participating Washington dentists by 15%, and followed up with a cut of 4-13% for Idaho dentists. In 2013, Delta cut reimbursements 4-5% for New Jersey and Connecticut dentists, and later sliced reimbursements 7% on average for participating dentists in Missouri. In 2015, Northeast Delta Dental implemented a 4% reimbursement cut for dentists in New Hampshire and Vermont. Meanwhile, California dentists are still fighting a planned 8-12% reimbursement cut.

Delta says its discount averages...

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