The shifting dental payer landscape

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Here are eight updates from 2026 pointing to shifts in how dentists are interacting with insurers and other trends in the field:

1. The Trump administration has ramped up its efforts to address healthcare fraud in recent months, targeting a variety of healthcare organizations, including dental offices.

2. State lawmakers have continued advancing dental insurance reforms in 2026, with 14 states enacting 21 laws so far this year. Issues addressed in the legislation include dental loss ratios, virtual credit card payments, network leasing, assignment of benefits, retroactive claim denials and downcoding.

3. Several states have either approved or proposed legislation this year to expand Medicaid dental coverage for residents or increase reimbursements for dental providers.

4. Several states facing budget shortfalls are considering rolling back adult Medicaid coverage and implementing coverage caps.

5. About 22% of dentists have dropped out of insurance networks so far this year, according to a report from the American Dental Association.

6. Although several states have increased reimbursement rates for dental services, they are still not enough to keep up with the pace of inflation.

7. The three largest dental insurers have a median market share of 66.8%, according to a report from the U.S. Government Accountability Office.

8. Nearly 80% of dental practices have reported an increase in claim denials or payer scrutiny over the past 12 months, according to a report from Zentist.

At the Becker's 5th Annual Future of Dentistry Roundtable, taking place September 14-15 in Chicago, dental leaders and executives will gain insights into emerging technologies, practice growth strategies and the evolving landscape of dental care delivery, with a focus on innovation, patient experience and operational excellence. Apply for complimentary registration now.

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