How stagnant reimbursements are hurting 1 dental office's bottom line

Low payer reimbursements have made it hard for dental practices in the U.S. to remain financially stable, with many viewing reimbursements as a major roadblock in the industry.

An August 2022 poll by the ADA's Health Policy Institute found insurance reimbursement rates have remained stagnant for dentists despite rising operating costs. Nearly 60 percent of dentists indicated that rates remained stagnant, while 25 percent indicated their rates decreased and only 7 percent of dentists reported an increase in the last year. 

Owen Waldman, DMD, of Waldman Dental Group in Scottsdale, Ariz., recently spoke with Becker's about how reimbursements have affected his practice.

Editor's note: Responses were lightly edited for length and clarity.

Question: How are payer reimbursements affecting your practice?

Dr. Owen Waldman: Payer reimbursements by the insurance companies are awful. While our numbers are up from last year, the rate of inflation is much higher, yet reimbursements stay the same, for the most part, as they have for the last decade or so. Therefore, with the reimbursement rate not even keeping remotely close to the pace of inflation, it has hurt our bottom line. The insurance companies only care about their stockholders and CEO profits, while they raise premiums on our patients/their clients every year, but in many cases they have had the same horrible reimbursement rates for the past decade. When they do increase reimbursement rates, it's literally only a few dollars for many procedures. It would be great if everyone would just say no to to in-network insurance and make them pay fairly, but the odds of that are slim to none, so quality offices with loyal patient bases are starting to wean off some of these plans a little at a time. I know we are and so far, so good, but still a way to go.

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