Cancer Awareness!

In memory of Jeanne, our Dental Assistant who sadly lost her battle with Cancer in 2010, Dr. Rafoth and staff invite you to join them in the fight to cure cancer in our lifetime. For each “Like” on the Cascadia Dentistry Facebook page received through June 5^th Dr. Rafoth will donate $1 to the American Cancer Society. The impact we can make together is much greater than what any of us could do alone!

Cascadia Dentistry thanks you in advance for your support.

ORAL CANCER SCREENING is one of the most important examinations we provide at your dental visit. We utilize the best technology, courtesy of Trimira, to uphold the highest standard of care for you. Contact our office for more information.

Washington Dental Service May Experience Significant Loss of Participating Dentists

Update for our readers:

I just spoke with Steve Hardymon of the Washington State Dental Association (WSDA). He gave me a sense of the impending crisis in the Washington Dental Service (WDS) insurance conflict. As you know, WDS has decided to abruptly reduce dental reimbursements significantly as of June 1, 2011. This action will potentially limit the access to care for thousands of patients in this difficult situation. It will also threaten the livelihood of dentists, dentistry-related employees, and businesses.

With a tone of tension, Hardymon spoke about the unprecedented activity dentists are engaging in their efforts to contend with WDS. Dentists have begun to cancel their contracts with WDS. "About 150 dentists have already decided to drop," said Hardymon, "and there are about 2000 that are absolutely considering their drop." Hardymon, along with the rest of the WSDA team have been in constant contact with dentists and have been working feverishly to come up with strategies to help dentists make informed decisions to continue serving WDS patients.

Hardymon and his team issued a press release recently in hopes of informing the public about the magnitude of WDS coverage restrictions.

It is estimated that about 4000 dentists are actively doing business with WDS. If the purported number of contracted dentists drop their relationship with WDS, it may mean real trouble for the success of the insurance company. WDS will likely have to restructure the limitations they put on their dental plans for patients.

As patients, I want to encourage you to talk with your employers and HR representatives about more effective options for dental insurance benefits. There are other companies in the marketplace that offer reimbursements to dental providers that will allow you to receive excellent care and maintain a relationship with a dentist you trust. Ask how your out-of pocket expenses may change if you switch policies. And of course, talk to us here at Cascadia Dentistry about how your WDS plan is going to change, and what differences you will expect. Ultimately, the dentistry you have done is up to you. What WDS has chosen to do is reduce their spending on dental plans for patients, and it will likely result in you spending more for care if yo have their plan. So let us help you maximize your WDS insurance benefits, and minimize your out-of-pocket spending by choosing a dental plan that fits for you.

Stay tuned.

Latex No More

We decided that 2011 would be the year we became a latex-free dental clinic.

It was interesting to take stock of what contained latex in the materials we use to keep you healthy. Gloves aren't the only item. Anesthetic carpules, rubber dams, syringe stoppers, orthodontic bands, vacuum gaskets--the list goes on. So we found alternatives to all those items and more.

We will still update your medical histories every year, checking for various allergies. We will strive to keep our office as hypo-allergenic as possible. Stay tuned for more posts regarding our commitment to managing an ever-increasing list of emerging allergies for our patients.

WDS is making some Kool-Aid

Dental insurance is a great resource for my patients. I believe is is an excellent supplement when patients are seeking the right dental care. But it is important to remember a few things about the limits of insurance and how it works for dental care.

First, insurance benefits are negotiated by employers for their employees. Employers decide what level of supplements they are willing to pay for. There are countless levels of spending, and as a result, employers give employees what they can.

Second, dental insurance is different than other insurances, like car insurance or life insurance. It has never intended to reimburse the full cost of dentistry. It is a supplement for basic dental care, such as hygiene visits; a couple of examinations per year, with some basic x-rays; and a filling or two per year, maybe a crown. In my experience, about half of the patients I have seen over the past decade have needs that go beyond their insurance reimbursement.

The challenge with using dental insurance, is that current reimbursement levels are similar to what they were decades ago. They haven't kept pace with the cost of living increases or inflation. Dentists, however, have to make annual changes to keep pace with economic changes. Dentists' costs don't have to go up astronomically each year, they just have to increase modestly with the market around them. But insurance companies have chosen to only offer limited amounts of reimbursement. So the value of an insurance dollar has decreased.

Washington Dental Service, the largest dental carrier in the state, has created a sticky situation recently. They have decided that not only are they going to freeze the levels of reimbursements to participating dentists, they also are decreasing the allowable fees that dentists can charge to the patients. You would think this is a great solution for patients. But it's creating the opposite effect.

I wanted to share a letter with you from Washington Dental Service (WDS) that is being issued to employees who receive dental policies from their employers. WDS says it's aligning costs in Washington to get closer to the national average for dental fees, and that is supposed to aid patients in getting care for less.

WDS Letter to Brokers And Employers

Let's be clear. Washington state's cost of living is greater in virtually all aspects compared to the rest of the country. The big question is whether Washington residents, business owners, and dentists can find out-of-state solutions to any of their business activities. That doesn't appear to be realistic, because small businesses like dentistry rely on local economies to support much of what they do.

I'll summarize what this fee reduction means to you as a patient:
1) Dentists have continually rising costs to do your dentistry. Periodically, dentists typically assess what business strategies they can change to keep their costs from increasing dramatically. Hiring fewer employees, using cheaper materials, working more hours, etc. Whatever the case, they have to balance how they do business with the quality of work they want to do for patients, and what they want to charge patients to do it. WDS has decided that they need to determine what the price of dentistry should be for dentists.
2) WDS-participating dentists are going to suffer an average of 15% reduction in what dentists can charge for helping you. This is simply going to put some dentists in Washington out of work. 15% reduction in revenues means a 150% increase in business has to occur to break even. That is literally impossible.
3) Your amount of benefits do not change. In fact, they may not change for a long time. Your insurance dollar is already behind the curve by many, many years of economic growth and change. You will get less dentistry for WDS dollars as time goes on.
4)You will see costs rise for dental visits as dentists decide to drop a WDS relationship. Some patients won't be able to afford the changes. And that will hurt patients who really need help.

I hope WDS realizes this is a catastrophic mistake. But until then, it appears that the company wants to spin these changes as positive, and send policyholders letters that make it seem as if the kool-aid is worth drinking.

Send your comments and questions to me via chris@cascadiadentistry.com

There's A Storm On The Horizon For Patients, Thanks To Insurance Carriers

A few months ago, the largest dental insurance provider in Washington, Washington Dental Service, sent me a foreboding letter. The company announced that it would soon be reducing reimbursements to participating dentists, like me, who care for patients that carry Washington Dental Service (WDS) insurance plans.

People who are aware of this upcoming WDS change may think that change is a benefit to patients everywhere. Some may believe insurance companies like WDS with buying power and large numbers of insured may be capable of controlling rising costs in the dental care market, and that must mean patient spending might be reduced. And some may feel that access to dental care could be easier to come by for would-be patients in need. I wish that were the case. On the contrary, it is detrimental to everyone in the dental care system: patients, dentists, and insurance carriers.

As a dentist who started a practice from scratch, I have grown my business of health care over the past 12 years. I have fostered some amazing relationships with many patients, and love this career because I can help people become healthier and improve their quality of life. Every year, my costs to support patients go up. And every year, my patients count on me to maximize their insurance contributions for their care.

I've been happy to do what I can in recognizing the importance of their insurance assistance. I have felt a connection with their insurance carriers has been an important facet of the doctor-patient relationship. I signed a contract to become a partner with WDS promising to offer dentistry at a specific cost to patients who have that insurance plan. This is a very popular insurance plan in the state, and it has been estimated WDS supports over 4 million insured in Washington.

Over the past several years, I have changed my business strategy so I could offer the best possible quality dental care and the best customer service in my area, even in the face of increasing limitations and restrictions insurers have made. WDS reimbursements for the dental care I provide have continually decreased relative to the cost of doing business. My expenses are not decreasing at the same rate, so my ability to provide the same excellent care is becoming harder to provide to the WDS patients and their families I love to treat.

In January, I received the aforementioned letter, which contained a shocking plan to significantly reduce reimbursements to member dentists, in some cases up to 15% for some dental treatments. In addition, WDS decided that there would be no increase in reimbursements in the foreseeable future. I have talked with dozens of dentists, and read comments from countless others, and the discussions are all the same; WDS has done something that has made Washington dentists unhappy about the future of patient care. And that includes me.

So it is obviously going to hit me hard as a dental practice owner. I care most about how it will affect the level of care I provide to my patients. But it's not just about the consequences my business and my career will suffer. This change is going to affect patients and dental insurers, notably WDS. I can't possibly cover the entire scope of the fallout this WDS decision is creating now and in the future, so I will pass on articles, stories, and broadcasts that relate to this situation as they become available. Here is are two news stories that broke recently.

http://www.seattlepi.com/local/article/WA-s-largest-dental-insurer-to-cut-reimbursements-1351909.php

http://www.king5.com/home/States-largest-dental-insurance-provider-cutting-reimbursements-120656054.html

At this point, I have to decide whether or not to pass the WDS limitations and restrictions on to my patients in certain ways. In the past, I didn't have to bill my patients for certain things associated with dental care. For example, I didn't consider charging patients for local anesthesia to have a crown or a filling done. I didn't consider charging to adjust a restoration after it was placed in or on a tooth. I didn't consider charging additional costs for medications I routinely use to treat periodontal disease. These things were included in the basic cost of the treatments. Now that WDS has significantly reduced the reimbursements for everyday fillings, crowns, and gum infection procedures, I can't make up enough of the costs in other ways within my business. What were once "bundled" services could be "unbundled"services at additional fees. These services are not typically covered by WDS or other insurers. This results in greater out-of-pocket expenses for patients.

These options are not being considered to increase profits; rather, they are measures to preserve our ability to deliver the same great care to patients. I want to let you know that I am not the only dentist who is considering these options. There are hundreds of Washington dentists who are being affected by this. And that translates into thousands of patients who may suffer this fallout.

WDS has continued to spin these changes to its member dentists as "competitively priced" insurance options for Washington companies searching for reduced-cost insurance plans for their employee benefit packages. But these changes are almost certainly going to be passed on to the patients, and patient spending will increase. Patient access to care will be restricted more and more. Because the cost of providing dental care isn't going down for any dentist who wants to do right by patients with WDS dental insurance.

WDS and other insurers are looking to cut THEIR costs, not patient costs. I believe patients will start to complain to their HR reps and employers, and search for different insurance options.

If dentists decide to break their contracts with WDS, and patients have insurance plans that require treatment by WDS contracted dentists in order to receive reimbursement for dentistry, patient access to care will be restricted further. Fewer available dentists will result in more patients waiting for solutions to their infections, pain, and inability to function. Without a certain level of participation by dentists and employers, carriers like WDS will succumb to losses and not be capable of offering insurance products.

Patients will have fewer options for support and reimbursement. And that possibility, created by insurance companies like WDS, makes me sad and embarrassed as a dentist, as a patient, and as a business owner.

I want you all to remember that you have a voice in this matter. Talk with your employers and HR representatives. Call Washington Dental Service. Let any and all know that these changes are not creating excellence in dental care.

I am committed to giving you my very best as a dentist. I'll keep you posted about our efforts on this issue. Please send questions or comments to chris@cascadiadentistry.com.