A Response to Managed Care-Independent Practice Association

During the last several months, the dental profession has received a constant stream of information on managed care and related issues. We have been told repeatedly by the insurance industry, business executives and physicians that managed care is here, and, as it gains momentum, it will cause a substantial change in our dental practices. We all are monarchs of our own private kingdoms, and we are not accustomed to taking time to submit our ideas and efforts for the common good of our profession

Dr. Hugh F. Doherty, CFP, Clinical Excellence Editor

During the last several months, the dental profession has received a constant stream of information on managed care and related issues. We have been told repeatedly by the insurance industry, business executives and physicians that managed care is here, and, as it gains momentum, it will cause a substantial change in our dental practices. We all are monarchs of our own private kingdoms, and we are not accustomed to taking time to submit our ideas and efforts for the common good of our profession and colleagues. But this was not the case in Lane County, Oregon.

A true leader, whom I know personally to be one of the genuinely kind and philanthropic people in our profession, has taken his time to help his fellow dentists with the formation of an Independent Practice Association (IPA). This leader is Dr. Richard Meltebeke of Eugene, Oregon. It was my good fortune to work with Rich and his study club, which is comprised of truly outstanding and successful dentists. Here are some of his responses to my questions about the creation of the Lane County Dental Society IPA:

What is the mission of your IPA? Our mission is to organize the majority of the dentists in our local area, educate them about the various dental-care options which come into our area, and represent them from a position of strength in our numbers.

How will you achieve the mission of the IPA? The IPA will achieve this mission by implementing a two-fold strategy. First, the IPA will engage qualified negotiators with medical-/dental-insurance backgrounds to work with our board of directors to provide high-quality, contract-negotiation services between insurance companies and individual Lane County IPA members to preserve fee-for-service dental care as often as possible. Secondly, the IPA will be proactive in seeking out other market opportunities. That may be direct-reimbursement programs or modifying our organization to a "for-profit corporation" and sell dental coverage bundled with our local physician IPA services as an alternative to managed care.

What is the main benefit for your member-dentist to join the IPA? Delegation of your insurance-contract issues to a focused team that will be using trained insurance and legal professionals to work on your behalf, so you can do what you do best-dentistry. Individually, dentists have no negotiating strength, whereas collectively, we have a strong position at the bargaining table. The IPA can work with insurance companies to negotiate much more realistic fee schedules and eliminate the fine print that is causing so much trouble for individual practitioners.

Is there an alternative to forming an IPA? An IPA is the simplest form of organization a group of dentists can undertake. Due to antitrust issues, the ADA cannot become involved with contract negotiations or IPA activities. For the very same antitrust reasons, we as individual dentists cannot get together and discuss how to negotiate with a company unless we are first IPA members. Antitrust fines can amount to hundreds of thousands of dollars. Dr. Meltebeke will respond to as many inquiries as possible via fax (503) 485-0785.

Dr. Hugh F. Doherty, CFP, is a national lecturer, consultant to the health-care profession, workshop leader, author, management and financial adviser and Certified Financial Planner. For further information, contact Dr. Doherty at 14 Cherry Court, Spring Lake Heights, NJ 07762, or call (908) 449-3225.

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