Delta Dental to cut payments to Idaho dentists

2009 07 14 13 45 00 778 Budget Cut 70

Idaho has become the second U.S. state this year to be hit with reductions in reimbursement by Delta Dental. And the cuts will likely have much larger ramifications, according to the state dental association.

Starting in November, dentists in various parts of the state will be paid anywhere from 4% to 13% less for care they provide under Delta Dental's preferred provider organization (PPO) dental plans, according to an article in the Idaho-Statesman.

According to Delta Dental, 649 dentists in the state participate in the PPO plan. But the Idaho State Dental Association (ISDA) said the changes will affect all 825 dentists in the state, the Idaho-Statesman reported.

"This change will affect all dentists in the state, even those who don't contract with Delta in the PPO plan because they are going to be reducing the allowable for non-contracting dentists as well," Gregory Bengston, DDS, president of the ISDA, told "We all understand the need to share the pain, but there needs to be balance. This is a huge hit to what are, after all, very small businesses."

The ISDA found out about this change two weeks ago, Dr. Bengston said, and has since met with the CEO of Delta Dental of Idaho twice to get the company to reconsider or at least postpone the effective date until January 1, 2012.

"But so far we have been unsuccessful in getting them to reconsider their position or the effective date," Dr. Bengston said. "Their explanation of why they feel this is necessary is to remain viable in 'an ever-changing healthcare marketplace.'"

Earlier this year, Washington Dental Service (WDS) -- a member of the Delta Dental Plans Association -- announced that it was cutting its reimbursement rates by 15% starting in June.

WDS' decision to reduce reimbursements rates was prompted by the ongoing economic crisis and growing competition from other insurance providers, according to Ron Inge, DDS, dental director and vice president of professional services for WDS.

"This is really about big business," Dr. Bengston said. "The insurance industry, with its exemption from anti-trust regulations and its powerful position, is taking advantage of small businesses that are legally prohibited from collective bargaining. This is David versus Goliath."

The cuts will likely have much larger ramifications, he added.

"The result of this is going to be loss of profitability in the dental home and cost cutting in the dental office, which will lead to a likely reduction in dental staff, loss of jobs, and a reduction in charitable dental care for the underprivileged," Dr. Bengston said. "It will also likely result in increased fees to the uninsured. Somewhere along the line the system will break, and to remain viable a dental practice will have to shift the cost burden somewhere else."

As of press time, Delta Dental had not returned a call seeking comment.

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