More than 80 dentists and dental team members have provided free of charge $47,000 worth of services to 50 disadvantaged women in Houston, Texas, an average of $938 per patient.
The patients were chosen by Dress for Success Houston, a nonprofit organization furnishing professional attire and career education to low-income women.
Dental teams provided “exams, x-rays, cleanings, extractions, fillings, and same-day crowns,” according to a May 2 press release from the Pacific Dental Services Foundation, the nonprofit affiliate of Pacific Dental Services (PDS). Smile Generation, a patient/dentist referral provider supported by PDS, helped supply the volunteer dentists, the release states.
PDS is a dental support organization (DSO) performing administrative tasks for dental practices whose owners outsource nonclinical functions.
DSO-affiliated practices cost 32 percent less per Medicaid patient to operate than standalone practices, yet in recent years, various state dental boards have “sought to restrict or limit a dentist’s ability to contract with a DSO for non-clinical support services,” the American Legislative Exchange Council reported in February.
In Search of Efficiency
Bill Head, vice president of government affairs at the Association of Dental Support Organizations, says DSOs enable dentists to treat more patients at lower costs.
“The DSO model is better in terms of attending to the myriad nonclinical administrative functions, from billing to leasing office space, so that dentists can spend more time and attention on their patients,” Head said. “This can often lead to lower patient costs and, in turn, greater access to care.”
DSOs help dentists fill the unmet demand of Medicaid patients who have difficulty accessing providers, Head says.
“DSO-supported dentists often accept insurance, including Medicaid, [that] solo or small practices do not,” Head said. “Efficiencies achieved by the DSO business model enable DSO-affiliated dentists to accept Medicaid rates and still be financially viable.”
Arthur Laffer, a former adviser to President Ronald Reagan who popularized the “Laffer Curve,” a theory stating the lowering of tax rates often increases tax revenues, says DSOs illustrate how free markets benefit patients.
“The results from the creation of DSOs—better access to high-quality services at low cost—are an excellent example of what can happen when lawmakers don’t allow special-interest groups to put barriers to entry into place,” Laffer said.
Regulating DSOs out of the dental-care market would violate a rule of thumb lawmakers should always respect, Laffer says.
“In general, lawmakers should never vote in favor of regulation that puts up barriers to entry for businesses, and, on the flip side, lawmakers should generally always vote in favor of repealing regulations that create barriers to entry for business,” Laffer said.
Head says restricting DSO operations could result in lower quality of care, higher costs, and less access.
“Most studies find quality of health care to be unaffected by regulation of business practices, and in some cases, quality actually decreases in response to the restrictions,” Head said. “In fact, several organizations, including the [Federal Trade Commission] have commented on the benefits DSOs provide dentists, often resulting in greater access and lower costs.”
In serving patients formerly unable to access providers, DSO-affiliated dentists pose no threat to mom-and-pop practices, Head says.
“DSOs are simply meeting a demand and not looking to supplant solo practices who choose to do all their own administrative functions or outsource pieces of it,” Head said.
Laffer says DSOs offer lawmakers, dentists, and underserved patients a win-win.
“We all work to make after-tax income, and by allowing DSOs to form and exist, we’re able to make it profitable to provide dental services to some of the nation’s poorest children,” Laffer said. “What more could policymakers and politicians ask for?”
David Grandouiller ([email protected]) writes from Cedarville, Ohio.
Michael T. Hamilton, “Report: State Regulations Stifle Solution to Dental Care Shortage,” Health Care News, The Heartland Institute, June 2017: https://heartland.org/news-opinion/news/report-state-regulations-stifle-solution-to-dental-care-shortage?source=policybot
Matthew Glans, “Dental Service Organizations Help Patients and Dentists,” Research & Commentary, The Heartland Institute, April 24, 2017: https://heartland.org/publications-resources/publications/research–commentary-dental-service-organizations-help-patients-and-dentists
Mia Palmieri Heck, “Overregulation Threatens Market-Driven Solutions in Dentistry,” The State Factor, American Legislative Exchange Council, February 2017: https://heartland.org/publications-resources/publications/overregulation-threatens-market-driven-solutions-in-dentistry
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