Mike Cole serves as the Vice President, Insurance Plan Management at Dental Care Alliance.
As part of an ongoing series, Becker's Dental + DSO is talking to industry leaders.
To learn more about Becker's Dental + DSO event, click here.
If you could solve one challenge in the dental industry overnight, what would it be and why?
Mike Cole: Plans want our doctors to be in network, the DSO’s want their doctors to be in network, many DSO’s (DCA included) do delegated credentialing which removes the process from the plans. It takes on average a month for the doctor to be in network which creates challenges for plans (less access) and DSO’s (the doctor is delayed in starting). Retro active effective dates would be the my dream.
Where are the greatest opportunities for DSOs?
MC: We are growing which means we have the ability to add access is areas of need. I’m not talking about the U.P. in upstate Michigan where there are no dentists or Key West but rather in secondary areas. DCA for instance is in South Bend IN, Allentown PA, Flint MI, Ocala FL, Dalton GA. Access is far less than your big urban markets and those are in my opinion very serviceable areas for DSO’s.
I also think that Government business is a great opportunity as long as it doesn’t become too difficult for the doctors to enroll. Medicaid is all about kids and you see far more DSO’s participating percentage wise than free standing pediatric dentists. On the other side is Medicare Advantage and again it’s a growing population with limited access at this time. Plans has learned how to price Medicare Advantage for both their clients and the doctors which is not always true with Medicaid because it is so State specific.
What has been most successful in terms of expanding?
MC: DCA has had two significant expansions; the first one when Towncare and Main Street affiliated with us and the second one when Northeast Dental Management (NEDM) affiliated with us. There were established relationships, similar mission statements and values, as well as similar styles of practices although certainly not cookie cutter. I think what is most successful about DCA is that we are not cookie cutter and we don’t only focus on one type of practice. Values, styles, relationships and partnerships do encompass different types of practices but similar qualities. That’s what makes a new affiliate a good fit.