Dental capitation insurance provider compensation: a fair deal?

Am J Manag Care. 2010 Nov 1;16(11):e276-80.
PO Box 221347, Louisville, KY 40252. E-mail:


OBJECTIVE: To investigate the fairness of dental capitation insurance provider compensation amounts being paid by one of the nation's largest capitation insurance companies.

STUDY DESIGN: Analysis of insurance company documents.

METHODS: The article first reports and then analyzes the capitation amounts paid by one of the nation's largest capitation plans over the past 13 years as retrieved directly from the insurance company documents. The annual rates of change in the capitation amounts are then compared with the annual rates of change in the mean dental office overhead expenses across the United States, as well as with the rates of change in income and expenses of the average US worker.

RESULTS: The compensation (capitation amount) paid to participating providers decreased dramatically every year over the past 13 years, while the mean office overhead costs of participating providers increased every year.

CONCLUSIONS: Solo general dentists with office overhead costs greater than or equal to the national mean likely find that the capitation amounts paid by insurance companies are an unfair compensation or are incompatible with their income objectives. Participation by solo general practitioners in capitation plans with such compensation levels would be problematic or unlikely.

Comments said…
Thanks for the helpful interview on our 1Dental blog. We also added your link to our blogroll. All the best,

Samantha said…
Thanks for the heads up on that. I just read an interview that you did for, and am checking out your blog for the first time.Thank you for all the up to date dental information

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