Wisconsin Dentists Worry As Insurer Buys Dental Practices
Delta Dental buys company with 30 locations in the state. Conflict of interest?
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Dentists across the country are raising questions after one of Wisconsin’s largest dental insurance companies purchased a Madison-based dental practice with more than 30 locations.
Delta Dental of Wisconsin acquired Cherry Tree Dental about three weeks ago.
Now dentists are saying the transaction blurs the line between provider and insurer.
“When an insurance company becomes both health care provider and insurance payer, questions arise regarding potential conflict of interest,” according to a statement issued by the American Dental Association.
“From a business standpoint, dental insurance companies seek to minimize cost and maximize profit,” the statement continues. “As a result, patients may find their treatment options limited to what is most cost-effective for the insurer, not necessarily what is most effective for their oral health.”
Jed Roher, chief legal officer with Delta Dental of Wisconsin, said this type of arrangement is unique in the dental industry, but there are a number of instances where general health care providers own insurance companies.
Because of that, Roher said there are already established rules on how an insurance operation and provider can and can’t interact.
“One of the most important (rules) is that Cherry Tree Dental will have its own leadership team that is making its own kind of carrier contracting decisions, and they’ll be having their own reimbursement negotiations with those carriers,” Roher said. “Delta Dental of Wisconsin will have no visibility to those conversations. Equally, clinical care decisions will be made by the dentist and the patient.”
Roher said Delta Dental was interested in buying Cherry Tree Dental to ensure people have access to rural dentists.
Cherry Tree Dental was started in Madison as a family-owned practice in 2006 and grew to 25 locations in Wisconsin, four in Illinois, one in Michigan and one Minnesota.
Most of the Wisconsin locations are in the central part of the state, including Wausau, Eau Claire, La Crosse and Green Bay.
Mark Paget, executive director of the Wisconsin Dental Association, said the group had no advanced notice that the acquisition was happening. He said the WDA’s 3,100 members are very concerned.
Wisconsin is one of less than a dozen states that does not require dental offices to be owned by a licensed dentist.
“This is legal, but it doesn’t make it right,” Paget said. “We would never in a million years expect this to happen. Well, it has, and we want to make sure it does not interfere with the dentist relationships that they have with their patients.”
Brookfield dentist Dr. Emily Eckdahl said she was shocked to hear about the transaction.
She worries that the focus at Cherry Tree will no longer be on the patient but on making money.
But Eckdahl said this could be an opportunity for Wisconsin and the dental community to look at possible changes into laws or oversight governing ownership of practices.
“You know, this is 20 offices,” Eckdahl said. “If it turns into 2,000 offices, that could really affect the overall dental community within our state.”
Paget doesn’t think the laws will change, but he’s hoping there is more transparency going forward.
“We want to make sure there are enough safeguards, firewalls and transparency put in place to make sure that the patients aren’t harmed by this, or the treatment isn’t determined by the payer,” Paget said.
Dentists across Wisconsin worry after insurance company buys large dental practice was originally published by Wisconsin Public Radio.
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