1. Association of Managed Care Dentists (www.dentalgroup.com/amcd)
This website tells a little about the mission of the Association. It was established as a reaction to the rapid growth in the capitated and PPO insurance markets which left many dentists misinformed about changes occurring in the managed care arena. Some of their goals include influencing plan design, quality assurance procedures, and quality patient care
They ask several questions, such as, “Where is the incentive to grow ones practice with capitated managed care?” “How might the dental insurance industry respond to the dissatisfaction among both the dentists and the patients?” One of their solutions is a continuing push towards PPOs which will allow patients the freedom of choice they seek, and dentists the ability to receive payments for each service performed.
They mention that dentists would be wise to avoid dental plans that propose to reduce optional treatment revenue, begin to rethink their practices in terms of capturing the emerging PPO market, and increase their vigilance by performing a monthly RVU analysis. Their survey results show that income is down and negativity is up. 80% of respondents reported feeling increasingly more negative towards managed dental care plans. This is not a good sign for the future prosperity of managed care companies who need their providers to be positive towards their product if these companies are to achieve growth and impress Wall Street analysts.
The site also gives information on how to determine the
relative value of services of users’ practices.
(4 stars) (gives real life opinions, especially with the survey)
2. Buyers Guide to Dental Benefits (www.cda.org/buyersguide.html#dhmo)
This point of this subsidiary of the CDA website is to list the pros and cons of each of the types of dental benefits packages. The ones listed include:
- fully insured indemnity
- self-insured indemnity
- PPOs
- Dental HMOs
The site gives the characteristics, advantages, disadvantages, and purchase considerations.
The information is given in a very simplified fashion, making it very easy to understand. The site gives a dentist or a student a good idea of what to expect from each type of benefit package. It spells it out in simple English. (4.5 stars)
3. The Future of Dentistry (www.mapol.com/FutureOfDentistry.htm)
This website has information about the coming of managed care and how to position users’ practices to deal with the threat to traditional indemnity and fee-for-service dentistry
The website
includes sections on problems and solutions.
The problems include three situations:
First is when the doctor signs up for a bad managed care program, i.e., one with a compensation schedule that doesn’t adequately compensate him for the types of procedures he or she normally diagnoses and performs on patients.
The second problem occurs when the doctor or staff are
unable to promote and gain patient acceptance for upgraded or optional
treatments that would be clinically superior, or better meet the patient’s
cosmetic needs, than the basic covered benefits.
The third problem occurs when the staff is unable to cope with the paperwork
associated with managed care programs.
The website includes some solutions to the three scenarios, and has the ultimate goal of keeping dentists’ chairs filled to avoid managed care harm.
(4 stars) – due to the personal effect of the information – this is what people really feel
4. HMO insurance and Dentistry (http://www.geocities.com/HotSprings/2875/fourth.htm#managed)
This website goes into an in depth discussion on what an HMO is and how it works for the dentist. It also gives some information on how managed care reduces costs, and if the person should choose an HMO.
The information on the last two topics is very brief, but the overview on managed care and dentistry is good. There is not much to this website (2.5 stars)
5. Managed care and marketplace issues (http://www.ada.org/newdent/infopaks/mancare.html)
This website provided by the ADA allows people to gain a grand number of resources to help educate people on managed care and the change in the dental profession. To help dentists make informed choices in the changing marketplace, the ADA provides members with a comprehensive array of resources including publications, seminars and services.
ADA Catalog Publications
-links to:
Managed Care Resource Packet
A Guide for Patients: Understanding Your Dental Benefits Plan
A Guide for Employers: Selecting a Dental Benefits Plan
A Dentist's Guide to Managed Care Marketplace Information
What every dentist should know before signing a dental provider contract
Financial impact analysis of plan contracts
Access to newsletters and seminars
4.5 stars – there is a plethora of information concerning all aspects of managed care for dentists
Web articles
1. Managed medical care growth rubs off on dentistry (http://managedcaremag.com/archiveMC/9806/9806.outlook.shtml)
This short article tells of the increase of managed care in the field of dentistry in 1997. Although the charts included with the article show that the number of those enrolled is increasing, the dental HMO growth has decreased a great deal in 1997.
(2.5 stars – the article only makes one point and does not give much other information)
2. Managed Care in Dentistry (http://www.reap.com/Den-Tel-Net/Den-Tel-Net/dtn95/mancare295.html)
This article is about the concerns of an orthopedic surgeon about the role of specialists in managed care.
He feels that the big problem is that the relationships with patients can only be kept going if both the primary dentist and the specialist and under contract with the same dental managed care plan. Since managed care controls the referrals anyway, even this scenario may not allow specialists to keep their patients and the relationships that were long in the making.
The good thing about managed care in dentistry for the specialists is that reimbursement of dental specialists tends to be more accommodating than for the primary care dentist, for whom capitation is the predominant form of reimbursement.
(3 stars – the article deals with real concerns of managed care for specialists)
3. What to tell your employer about dental managed care. (http://www.nque.com/hull/choose2.htm)
This article gets right to the point and tells the reader that managed care is not what patients need or should want. The author is an advocate for fee for service. In the article, reasons are listed for why dental managed care is not as good as fee for service.
The first reason is that only a few dentists join in managed care plans, so choice is limited from the beginning. The next reason is that appointments and treatments are harder to come by than under fee for service. The final reason is that you may get different treatments because the dentist will pick the one that compensates him/her the most. The treatment chosen may not be the best one for you, but it will be the best for them.
The article ends with the author telling the reader to speak with his/her employer to get them to change to a fee for service dental plan. The author says for the reader to inform others of the information found in the article as well.
4 stars – the article has pertinent information about the negative aspects of managed care, but they are only from the viewpoint of the employee or the consumer. The employer or the provider views are not mentioned.
4. NADP strives to advance dental managed care (http://www.managedhcare.com/ben697.html)
The article starts out by stating that dental managed care is not the same as medical managed care. Reasons include that dental care is preventive by nature, which means that it will be less expensive than medical costs. Dental-benefits coverage has not yet been given the status of an “inalienable right”, as has medical.
Studies are mentioned where the level of care given under PPOs and dental HMOs is equal to that of fee for service. The article then states the goals of the organization to get this information out. One goal is for the NADP to fill in the gaps in information about dental managed care to the consumers. Their annual census will be used to give information and statistics about the rising enrollment in dental managed care compared to indemnity insurance.
The group states their claim that their studies show that the quality of care is the same with or without managed care. They also say they need more research. They conclude the article by mentioning their conference where many papers were presented on various topics in the field of dentistry and managed care.
2.5 stars – the article goes more into the goals of the NADP than anything about the pros and cons about managed care. They do mention many statistics to support their claims that the two forms of coverage offer the same level of care. There is a lack of material concerning the detail of managed care.
5. First option for dental insurance. (http://www.cent4dent.com/newslett.htm)
This article discusses the shortcomings of managed care in dentistry. The author gives three reasons why patients should stick with their indemnity insurance coverage. They are that they will have an inability to choose their provider, they should expect a drop in the quality of care, and there will be longer waits to combat the lower prices.
The article gives the side from some providers as well. There are stories that some providers could not afford to treat patients at the HMO prices. When they complained to their superiors, the answer was to drop quality of care.
A group of people has set up a program called First Option, where there is a combination of managed care and traditional insurance. They hope that this will satisfy the needs of consumers, providers, and the third party payers.
4.5 stars – the article gives the viewpoint of both consumers and providers, with concrete reasoning behind the opinions.