Managed Care vs. Indemnity Payment Forms 
Author Message
 Managed Care vs. Indemnity Payment Forms

My point is that we keep selling the public amalgam fillings and
extraction that have been the minimum standard of care for 100 years. If
we provide better than that minimum standard of clinical care, and in
doing so raise the standards, then we can demand and obtain higher income.

   We have abused the indemnity insurance formula for apyiong for dental
care and it has proven too costly for the consumer to pay for through
their insurance companies. Most large insurers now sell managed care, PPO,
and basic prepaid plans, ie Connecticutt General owns Cigna Managed Care.
CG covers 10 million people and diminishing, and Cigna Dental Health 3
Million, and growing.

   When employers are presented a selection of dental benefit programs
that range from gold plated indemnity through PPO', HMO's, hybrid managed
care (which combine elements of indemnity, PPO, and capitation plans, what
is there yard stick for making a purchasing decsion ? If the basic group
of services being paid for is the same generic set of services that appear
on all of the plans, how do they make a choice...except for the price of
the premium.

   WE cannot stick our heads in the sand and try to act like the real
world of practical economics isn't there. Pro-active solutions make more
sense than blaming "them" for trying to operate a profitable business. If
we sit back and simply complain that we are being abused by 'them' and
that 'they' are doing 'it' to us...they win.

   Proactive solutions should focus on providing dental care that can be
appeciated as better care than 'average' and presented as added value
service that may not be fully covered by whatever form of dental plan the
patient is covered by.



Tue, 20 Jan 1998 03:00:00 GMT
 Managed Care vs. Indemnity Payment Forms

The high standard of dental care available in the US is being threatened
by the proponents of mangled care.  I would invite all who are interested
in raising the public IQ in these matters to join us each and every
Sunday, at 10 PM ET in a Prodigy Chat on these issues.

We are not burying our heads in the sand.  We must take charge of the
future of dentistry before it takes charge of us.
-
  Yours for good dentistry,



Wed, 21 Jan 1998 03:00:00 GMT
 Managed Care vs. Indemnity Payment Forms
Managed Care is a form of payment for dental care.

All dental care is generic (...ie. the same) to the third parties who
develop dental payment programs to pay for these services. The same
service codes are covered benefits under any form of payment.TO the
employer benefit program managers, if all of the same services are
'covered benefits' in each of the 'plans' being offered to them, then why
should they pick a higher priced package? Because the dentists want to be
paid more money for performing the same services? The laws of economics
will eventually force the changes.

We have to offer a measureably better service program if we want to make
more money. What is the difference between a $65 occlusal amalgam filling
and an $85 occlusal amalgam filling performed by you? Do you provide a
lesser quality amalgam restoration if you get paid less? If enough
dentists are willing to provide the same filling for $65 in your local
area and the patient cannot perceive the difference between you and the
dentist down the street, why should he pay you $ 85 ?

Managed care companies are not some 'new' group of companies. Most of the
traditional insurance companies are either starting their own or buying
out existing managed care companies right now.

LEAST EXPENSIVE, ETHICALLY ACCEPTABLE dental care is in the standard
package of dental services being sold to the public by the dental
profession through the dental benefit industry. As long as it all looks
the same and only the price is different, then the reimbur{*filter*}t will be
primarily determined by cost rather than quality of care.

There are workable solutions available to our profession and right now
there is so much emotional energy being spent on 'anti managed care'
discussion that there are very few constructive ideas being discussed
about what could actually be done to earn more reimbur{*filter*}t for the
services we provide.



Wed, 21 Jan 1998 03:00:00 GMT
 
 [ 3 post ] 

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