Dental Benefits and Practice Management
Michael Okuji , DDS, MPH, MBA, is the Dental Director at Delta Dental of Colorado. Prior to working for Delta Dental, Dr. Okuji maintained a solo private dental practice for 35 years in San Francisco. He was also an Assistant Clinical Professor at the University of Southern California, Ostrow School of Dentistry and a Group Practice Director at the UCLA School of Dentistry. He lectures on insurance issues and practice management. Dr. Okuji is the author of the book Dental Practice: Get in the Game .
Dental Benefits and Practice Management
Why dental benefits?
Michael M. Okuji
Delta Dental of Colorado, Denver, USA
This chapter delves into the history of dental benefits and lays the groundwork for the subsequent chapters. The story is one of the social transformations of health care in the USA and the expansion of access to care to wider segments of our society. Prepaid dental benefits available to a worker and their family did not exist, in the way we understand dental benefits, until the last half of the 20th century. From that point in the 1950s to the new millennium, dental benefits broadened in scope and depth as coverage grew to include new eligible members. Dental benefits that became available to a wide swath of consumers profoundly changed the dental profession and dental care delivery.
Dentists enjoy a great deal of professional autonomy and independence in their practice. These features attracted generations of students into the profession and shaped their dental personality to the point the dentistry is rated the number one best job in the USA. From the mid-20th century, the emergence of dental benefits fueled the demand for dental services that fostered dental practice growth and lifted the dentist into the club of well-paid professionals. This is the world into which all dentists who practiced at the turn of the 21st century were born.
But the health-care world continues to evolve into a new order from care delivered by guilds to fraternal group purchases, to industry and union-provided health care, to capitated care, to the emergence of dental benefit companies to the Affordable Care Act. Now, dentists must once again adapt to a profound change in the order of dental care delivery to continue to deliver quality care to a wider segment of the population.
This chapter sets the stage for the coming chapters. Perspective is important to understand that change in the way dental care is delivered and financed has changed over the past 150 years and will continue to change. The status quo isn't destiny.
The coming of health insurance
We all practice and thrive in a world where dental benefits are a common benefit of employment. We have always practiced where patients we targeted for care had access to dental benefits. While we sometimes struggle with the administrative requirements to bill for our services and chafe at the paper work and the rules of the road, we understand that dental benefit coverage drives patients to our offices. Without dental benefits, many people would not seek dental care on a regular basis and dentists would struggle to fill chairs. For those dentists that started dental practice in the 1960s around new housing developments in the former fruit orchards of the Santa Clara Valley (CA) that became Silicon Valley, the convergence of employer-purchased dental benefits with families moving to new homes proved to be a true golden age to start from scratch a solo private practice and grow a patient base at a lightning-fast pace. So for many dentists, dental benefits proved to be godsend for their practice and their patients.
But dental benefits are a relatively new phenomenon and health insurance didn't always exist. Can you imagine a world where all of your medical, hospital, and prescription bills are paid out of pocket? Can you imagine a world where the middle class pays a large proportion of their income for a medical bill? Can you imagine a world where the working poor are consigned to welfare infirmaries?
The manner in which health care is paid evolved slowly in the USA over the past 150 years. Historically, medical care was available to and paid by principally the upper class with the hospital portion of care taking place in their home. Only the poor went to a hospital. The middle class and the working poor were left to seek episod