RALEIGH — Across the U.S., dental practitioners and their patients are increasingly dissatisfied with the cost-benefit imbalance tilted in favor of insurance providers.
Dentists are regularly finding themselves wrapped up in the time-consuming, red tape-laden process of trying to get reimbursed for the procedures they administer. These tasks account for an overall decrease in daily productivity for dentists, borrowing from the time they could be spending interacting with patients.
At the same time, patients are having to pay the insurance companies more than the market value of their dental care.
North Raleigh dentist Dr. Brett Wells, owner of Wells Family Dental Group, is one of many practitioners experiencing the negative consequences of increased dependency on insurance.
A few years ago, motivated to find alternatives, Wells started experimenting with in-house direct primary care—a new model of healthcare delivery in which providers work with patients to set an agreed-upon fee for the services they will need. Wells says he was drawn to this model because it addressed the challenges practically, to the benefit of both the patient and provider.
Branching off the concept, he designed a platform that would help facilitate these agreements between patients and dentists with subscription-based plans. The service, called DentalHQ, acts as a sort of liaison between patients and doctors, managing the membership programs, ensuring legal compliance and even offering an online marketplace for patients to find new providers.
Wells says the idea quickly showed promise during its beta run in 2017. After making some tweaks to the software in response to pilot feedback, DentalHQ made a full public launch last October.
“We started in North Carolina and have been consistently expanding from there,” Wells said. “We’ve been signing up new offices every day.”
Dr. Brett Wells is the founder of Raleigh-based DentalHQ. Copyright: Jagg Photography
So far, DentalHQ is used by 130 offices and 1,500 members throughout the U.S., spanning from North Carolina and Georgia, to Massachusetts and Illinois, to Texas and California, and even as far as Hawaii and Alaska.
How it works
With DentalHQ, preventative care is covered for a set price in the membership package at a rate decided by the dentist. If more advanced care is needed, the dentist may offer a flat discount for a certain procedure such as a filling or crown.
DentalHQ’s plans are offered on a monthly or annual basis and cover the basic care a typical patient will need—a cleaning every six months, up to two exams per year, and an emergency exam or X-ray if necessary. The patient has control over the fees they pay and the basis on which they pay them.
Providers sign up for free and list their practice on DentalHQ’s marketplace so patients can find them. Customers can search for dentists are in their area, read customer reviews and view the affordability of each in-house membership plan. The setup is similar to that of physician directories like Healthgrades or RateMDs.
DentalHQ also handles the billing process for the dental offices through its software gateway. From his own experience, Wells knew this would be a particularly attractive selling point, as it is a more productive alternative to managing recurring payments through spreadsheets.
”When you make it easier for the providers, they’re more likely to offer these programs for their patients,” Wells notes.
Wells admits DentalHQ isn’t the only tech company offering subscription membership plans to dentists and patients in the U.S. But Wells says what makes DentalHQ stand out is its pricing model.
“As a dentist, I’ve been taken advantage of by companies that offered me the world and haven’t delivered,” Wells said. “DentalHQ has no sign up cost and we only get a small percentage of the fees; We don’t make money unless it works for the dentist. We’ve created a model that’s advantageous to dentists so that they don’t lose money if it doesn’t work for them.”
Subscription-based insurance a hot topic in the dental industry
Wells says DentalHQ is positioned to ride the wave of a new trend in the dental industry—innovative alternatives to traditional insurance are an exciting subject among dental practitioners in the U.S. He captured this new market in a piece recently published by Dental Economics.
The trend is driven by some compelling statistics, Wells says.
According to the National Association of Dental Plans, around 77 percent of the U.S. population has dental benefits—offered publicly or commercially, most likely through their employer.
But despite the high number of insured dental patients, research from the Health Policy Institute finds that 69 percent of adult patients pay more than the actual market value of their dental care, after including premiums in the total spending.
When considering the fact that more than one out of three adult beneficiaries do not use their benefits within a given year, the researchers conclude that these patients are ultimately paying for a dental plan they’re not using. Additionally, the dental care providers are receiving lower compensation than the market fees.
Wells says these statistics are why the demand for direct primary care is so high, and why DentalHQ has come at a timely moment in the healthcare industry.
Expanding the customer base, landing partnerships and planning fundraising
In the future, Wells is planning for DentalHQ to move into new markets in an effort to attract small businesses that don’t currently offer dental benefits for employees. DentalHQ would help them set up an agreement to subsidize a portion of the care to their staff.
“This allows total flexibility for the small businesses because they would only be paying for the employees who sign up and use the service,” Wells said. “They select the budgets and they only pay for the employees who actually use the insurance.”
As it expands the service to small businesses this year, DentalHQ is also seeking investors to fund the startup moving forward. So far, it has been entirely self-funded by Wells.
“One of the benefits of having enough revenue from my dental office is that I had the financial means to prove the concept and replicate it,” Wells says. “Now, we’re just waiting for the right investor. We want a true strategic partnership with someone.”
This summer, the immediate focus for DentalHQ is making its presence known to dentists across the country.
The team has attended a few national trade shows this year, including Smile Source: The Exchange 2018 in May an the Academy of General Dentistry Meeting just last weekend. They’ll also attend the American Association of Dental Office Management Conference, coming up in July.
The company is also reaching more prospects through new vendor partnerships with Smile Source and Elite Dental Alliance, two large networks of independent dentists. The partnerships enable DentalHQ to operate as an authorized vendor and engage directly with the networks’ dentists.
Wells’ goal is to have 1,000 offices signed on with DentalHQ by the end of next year. Once he has established a larger base of providers, his long-term plan is to switch gears and focus on marketing directly to consumers as the business expands.
