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Delta Dental, dentists find common ground on payment rates

by Priyanka Dayal McCluskey, Boston Globe | Jun 25, 2018


A year after sparring over payment rates, Massachusetts dentists and the state’s largest dental insurer have made peace.

Delta Dental of Massachusetts is proposing changes to its coverage plans that dentists now support, even though the changes will require them to accept a pay cut.

Last year, the company introduced a lower-cost plan that dentists said would slash their reimbursement rates by up to 30 percent. The move triggered an outcry among dentists, who worried about losing significant income — and the ability to hire for and invest in their practices.

But last week Delta Dental proposed changes to the Premier plan that company officials said will allow them to continue selling the plan for years to come. (Delta will also continue offering the lower-cost PPO, or preferred provider organization).

The Massachusetts Dental Society said it supports the proposed changes even though the insurer will require dentists to take a pay cut of 9 percent or 10 percent. That is far from ideal, but it’s reasonable, said Dr. David P. Lustbader, the society’s immediate past president.

“That’s a number that I think most practices can live with,” Lustbader said. “I would like to not take a hit, but it’s not reality anymore. You have to accept this is what’s coming.”

Delta Dental’s proposal, which still needs approval from the state Division of Insurance, follows several months of discussions with the dental society. The relationship between the insurance company and dentists has improved dramatically over that time.

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Last year, dentists were so upset that they lobbied legislators, regulators, and the attorney general’s office to intervene. They hired lawyers and considered legal action against the company.

Some dentists had attacked Delta Dental for paying hefty executive salaries, and some accused it of running afoul of nonprofit rules.

General dentists in Massachusetts earn $175,580 per year, on average, according to federal government estimates.

“If you stop yelling at each other and start talking, it’s amazing what you can accomplish,” Lustbader said.

Delta Dental’s president, Dennis Leonard, also noted the improved relationship with dentists.

“This proposed methodology is the result of candid, productive conversations that we’ve had over the past year with dentists, the Massachusetts Dental Society, state lawmakers, employers and business groups about the important role that the dental community must take in addressing health care cost containment,” he said in a statement.

Delta Dental’s proposal would nix language that now allows dentists in the Premier plan to receive annual rate increases tied to dental industry inflation. Delta Dental worried the plan was becoming so expensive that, over time, employers and consumers would no longer want to buy it.

More than 5,000 Massachusetts dentists participate in the Premier plan, which remains Delta Dental’s most popular plan. The lower-cost PPO plan includes more than 4,200 dentists.

Delta said it will continue to market the PPO to small businesses and individuals looking for more affordable coverage.

“Our goal is to offer an array of innovative products so that everyone has access to quality, affordable dental care that fits their needs,” Leonard said.

The Division of Insurance is expected to hold a public hearing on the proposal this summer.

Priyanka Dayal McCluskey can be reached at priyanka.mccluskey @globe.com. Follow her on Twitter @priyanka_dayal.