What are preferred providers?

Published March 13th, 2019 by Sandy McLean

The term “preferred providers” might give the impression that these are carefully selected dental practices that undergo a rigorous examination of quality, infection control procedures, continuing education, care, and underlying technical and ethical standards that set them above other dental practices.

But, in fact, the term is mere marketing. Preferred provider practices are under no more stringent controls than any other dental practice. By controls, I mean those set by the dental board (A.H.P.R.A.) and A.D.A. guidelines. Practices named “preferred providers” sign contracts with a health fund (mostly the larger for-profit funds with big budgets). The health fund then sets the rules of the contract and actively encourages their members to use affiliated clinics ahead of other practices that may choose to stay independent .

They are contracted dentists.

Preferred providers are usually part of the vertical integration plan of larger corporate health funds: those for-profit funds that operate to create returns for shareholders, rather than the mutual funds, which return profits back into the fund itself.

Consequently, the premise of these corporate funds is to increase their profits by lowering the cost of dentistry – by squeezing their providers, which in turn encourages them to find ways to decrease overheads and costs. This often comes at the expense of quality of materials, staffing, reinvestment in the clinic, or retaining suitably experienced dentists.

When a dentist chooses to be a preferred provider, they are allowing a third party to determine the pricing structure – and are likely encouraging cost cutting to counteract lowered returns.

Disclaimer: I have in the past worked both as a preferred provider and with a corporate health group that owns many dental practices. I now choose not to be involved with either of these and to remain independent . These are the opinions only of myself after many years of experience and observation.