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Health Policy Institute looks at large group dental practices

April 15, 2016

By Jennifer Garvin

The ADA Health Policy Institute released a research brief April 15 that finds large group dental practices account for a slightly higher share of the total number of dental practice employees, up from 0.5 percent in 1992 to 3.9 percent in 2012.

"Considering Large Group Dental Practices as a Vehicle for Consolidation in Dentistry," authored by Dr. Albert Guay, ADA chief policy advisor emeritus, and Thomas Wall, manager of statistical research, also examines the drivers of large group medical practices. Employment of medical practice employees in large group practices grew from 15.7 percent in 1992 to 29.6 percent in 2012.

"Recently, the health care industry has undergone a series of consolidations," noted the researchers, pointing to health plans combining with other health plans and hospitals combining with various providers of care as examples. "The basic motivation for these consolidations is to respond to public demands for increased value for health care expenditures."


The benefits of consolidation go beyond improving care delivery models for patients, the researchers noted, pointing out that for physicians, consolidation's "advantages outweigh the reduction in autonomy experienced with employment." Physicians also find that employment offers better work-life balance, more efficient patient referral systems and increased market power through economics of scale.

On the other hand, large group dental practices — those with 500 or more employees — are not nearly as prevalent as medical practices. Central to the research brief are the unique aspects of dentistry such as dental care not integral to services provided by hospitals will continue to preclude the same level of consolidations seen in medicine.

Chief among these reasons, small dental offices usually correlate with the location of dental patients, facilitating strong dentist-patient relationships. Also, because the Affordable Care Act pays "relatively little attention to dentistry," there has not been as much incentive to regulate the dental care industry through consolidation.

Despite the fact that medicine and dentistry fall under the health care umbrella, the researchers concluded that "medical practice is not a good model for dental practice."

Read the entire brief here.