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5 Reasons Dental Market Forces are Causing a Shift Toward Dental Membership Plans

5 Reasons Dental Market Forces are Causing a Shift Toward Dental Membership Plans

Dental membership plans are becoming a much talked about addition to dental practices.  They are popping up in corporate offices and private practice all over the nation. If you are still wondering if being the Amazon Prime of dentistry is right for you..keep reading.

Less of the population has dental insurance

Since 2008, dentistry has been in a negative growth pattern.1 Several things are responsible for this, but a strong determinant is dental insurance. In 2002, approximately 60% of Americans had dental insurance. That number dropped to 57% in 2010 and currently sits at 54%.2 Many assume the patients losing insurance are those of low socioeconomic status, but over 50% of middle income and almost 40% of high income patients do not have a dental insurance plan.3 This is a ripe market for dental practices to offer an in-house membership plan for FFS patients.

Dental Insurance Plans are becoming less economical for the practice

Dental Insurance Types Percent Change 2004-2010
Non-Networked FFS -55%
Dental PPO +61%
Dental HMO -40%
Discount Plan +30%






The mix in the types of dental insurance and their compensation rates is changing dramatically.4  Traditional Non-Networked FFS insurance plans are disappearing at a rapid rate, primarily replaced by Dental PPO plans with much lower dental compensation rates for the top dental procedures performed.  There has also been a dramatic rise in dental “Discount Plans” designed to offer patients an extremely inexpensive price point for “insurance”. The downside for dentists again is the low compensation rates for practices that participate in those discount plans with rates as low as 40%-60% of the practices “Usual, Customary and Reasonable” (UCR) fee schedule. 5, 6

Patients without a “plan” are not visiting the dentist

Pie chart.jpg

One primary reason the insurance data is so significant to note is that 81% of patients with “dental insurance” see their dentist twice a year, while only 34% of FFS patients without dental insurance make the same number of visits.7 Without some type of “plan”, most dental patients avoid seeing their dentist and having much needed dentistry performed. Dentists offering a membership plan are also starting to see the benefit from the 19% with a membership plan that are not using their benefits. Instead of dental insurance executives pocketing millions of unused benefits the membership plan payments go directly to the practice whether the patient uses them or not.


Corporate Dentistry is starting to offer membership plans to “lock-in” FFS patients

Many large Corporate Dental office chains, such as Comfort Dental and most recently Gentle Dental, are starting to offer in-house membership plans. Whether it is the Comfort Dental Gold Plan or Gentle Dental Smile Care Plan, corporate dentistry is coming around to the key membership benefit of FFS patient retention and increased treatment plan acceptance of membership patients in an effort to capture more FFS patient market share.


A monthly membership fits today’s patient’s buying expectations

Pick a product or service and you are likely to find a rapidly growing subscription/membership business in that sector. Amazon Prime, Netflix, BarkBox, BirchBox, Dollar Shave Club.  All have disrupted entire established industries with a membership or subscription system. Membership or subscription plans have been studied extensively and not only do they make a business more valuable to a potential buyer than a standard single transactional business, but patients have demonstrated that they simply do not prefer to pay upfront for products known in the retail world as “utilitarian non-durable” such as preventive dentistry.


Article originally published here, republished with permission. For further reading and information on dental membership plans, visit KeySmile.


1. Centers for Medicare and Medicaid Services; US Census Bureau; Bureau of Labor Statistics ADA 2013
2. Delta Dental Insurance Data 2014
3. CDA Journal Vol 42 N⁰ 10 October 2014 Integration of Dentistry and Medicine and the Dentistry of the Future: The Need for the Health Care Team
4. Belle DuCharme CDPMA Dental Insurance is Changing McKenzie Management 12.24.10
7. Delta Dental Insurance Data 2014
8. Sources: V.M. Patrick, C.W. Park / Journal of Retailing 82 (3, 2006) 165-175

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