Demystifying Dental
Capitation Plans vs. Dental Membership Plans: Insights from Jane Lelean, an
Expert in Dental Business
When it comes to balancing
patient care and practice finance, choosing the right payment plan can often be
a daunting task. With numerous options available, it's essential to understand
the key differences between various dental plans to make an informed decision.
In this blog post, we'll explore the disparities between dental capitation
plans and dental membership plans, with insights from Jane Lelean, a highly
regarded expert in dental business and a leading figure at the Institute of
Dental Business. www.iodb.co.uk
Understanding Dental
Capitation Plans
Dental capitation plans,
also known as capitation schemes, are designed to provide a comprehensive range
of dental treatments in exchange for a fixed monthly fee. With a capitation
plan, patients typically register with a specific dentist or dental practice
and make regular payments, irrespective of the treatment they receive, the
monthly investment is based on a risk factor calculated by historical treatment
and disease.
According to Jane Lelean,
who has a profound understanding of the dental industry, capitation plans often
offer patients the advantage of budgeting for their dental care in a
predictable manner. They provide access to preventive treatments and routine
check-ups, ensuring that patients can maintain their oral health without
worrying about unexpected expenses. Dental capitation plans can emphasise
proactive preventive, aiming to address dental issues before they escalate into
more complex problems.
Dental capitation plans
usually cover a range of treatments, such as routine examinations, dental
cleanings, fillings, and extractions. However, they may not cover certain
specialised treatments, such as orthodontics, complex, root canals, TMJ treatment
or cosmetic procedures, which could incur additional cost, and these must be
excluded at the beginning of the contract. If you have not considered what you
are including or excluding, you are likely to have problems in the future.
Unveiling Dental
Membership Plans
On the other hand, dental
membership plans offer patients a different approach to paying monthly instalments
for routine dental care such as examinations, routine hygiene, and some
radiographs, some practices also include emergency visits. These plans are customised
to the requirement of your practice and may include discount on further fee per
item (FPI)treatment. Under dental membership plans, your patients may enjoy
reduced fees for various dental treatments, including routine examinations,
hygiene, restorations, root canals, and even specialized procedures, provided
by your practice. These plans can be particularly beneficial for individuals
without dental insurance or those seeking more affordable dental care options.
Dental membership plans
provide patients with greater flexibility to choose their treatment options because
the budget is not fixed like it is with a capitation plan.
Distinguishing Factors:
Capitation Plans vs. Membership Plans
To summarize the
differences between dental capitation plans and dental membership plans, Jane
Lelean emphasizes the following points:
Capitation plans
Advantages:
Budget-Friendly: Capitation plans can, and don’t always have, have
a lower monthly fee compared to other payment options. When the patient has a very low history of
disease, the monthly fees will be low making them appealing to individuals who
seek affordable dental care.
Preventive Focus: Capitation plans encourage regular dental
check-ups and preventive care. By offering comprehensive coverage for routine
procedures like examination and hygiene, with these plans may prioritise
maintaining good oral health utilising upskilled nurses.
Predictable Costs: With a capitation plan, patients can anticipate
their dental costs, as they pay a fixed monthly fee. This predictability can be
advantageous for individuals on a tight budget.
Registration and financial
security: Patients have the peace
of mind they are registered with you, and you have the security of a regular,
known, income.
Capitation Plan
Disadvantages:
Limited Provider
Choices: The registration is with
a specific dentist. Some of the larger providers have a network so patients can
transfer if they move. Monthly investments and what is included / excluded may
vary from provider to provider. This may cause patient dissatisfaction. he registration
with a specific dentist with no FPI charges can make complex reconciliations between
clinicians at the end of each month.
Non provider treatment: If a patient requires treatment from a dentist
with whom they are not registered additional
costs will be incurred. If the patient is not aware of their responsibility to
pay for excluded treatment or treatment on referral, it can lead to difficult
conversation and patient dissatisfaction.
Can be expensive: Because the plan is calculated on past disease it
can be expensive for patients who have historically had periodontal bone loss,
root canals, cast restorations etc and have modified their ways and have no
active disease. Patients may feel they are paying a lot and you are providing
very little.
Ceiling on income: For dentists there is a ceiling on income, capitation
fees are only increase once a year and with a highly volatile market in dental
materials and equipment this can be difficult to manage, and the practice
running at a loss.
Supervised neglect: Historically there have been incidences where
practices have embraced a capitation plan, used a monitoring of disease approach
which has resulted in supervised neglect. If you are planning to buy a practice
with a capitation plan, buyer beware. Audit the patient notes, do a comprehensive
risk assessment, and ensure that you are covered so that you are not personally
funding the treatment of the supervised neglect.
Complex to understand: Capitation plans are generally complex for
patients and team members to understand, because of exclusions. If a patient
was on a plan for a long time, there may be advances in treatment that did not
exist when they sign up, you think they should be excluded, the patient thinks
they should be included.
Limited scope for
dental improvement: the fees of a capitation
plan are generally set as a like for like. Patients often think they are paying
privately they can have anything and don’t understand the limited nature of the
capitation plan and are unhappy with exclusions.
Complicated associate
remuneration: Because the way capitation
plans works a monthly fee covering all treatment provided by all clinicians can
lead to a complex reconciliation of patient’s monthly fee. When preventative or
restorative work is being completed by upskilled nurses, hygienists, and
therapists. associates may feel they are not appropriately remunerated for the
restorative work they do.
Dentists can be blind
to pricing. Capitation is often
seen as an easy way not to discuss money with patients, avoiding an awkward
situation. This causes financial suicide when the dentist avoids the difficult conversation
about fees for excluded treatment and does not do an annual risk assessment and
discuss band recategorisation.
You only get once
change to convert: You must get
your conversion right first time, there is not much flexibility with a
capitation plan your must get your fees right first time. Be really prepared,
do your numbers, engage the team, amend associate contracts where necessary. Use our 4 steps,
·
Be self-aware.
·
Raise
standards.
·
Communicate
effectively.
·
Action and
accountability.
Membership plans
Advantages:
Simple: No bands. no exclusions, no difficult conversation,
very simple, transparent, do you want to be a patient of this practice yes or
no?
Budget-Friendly: Membership plans often have a low monthly fee depending
on what the practice wants to include in the monthly fee. This is usually 2
examinations and two or 4 hygiene visits per year and some radiographs. you can
include what you choose to and set you monthly investment accordingly.
Cost Savings: Depending on the plan, your patients can enjoy discounted rates for various
treatments, resulting in significant cost savings.
Easy to understand: Membership plans are generally very simple for
patients and team members to understand.
Improvement of dental
health: Monthly fees generally cover exams and hygiene, and all other
treatment is available FPI. You and your patient are free to discuss any and
all treatment alternatives, including cosmetic and functional improvement.
Comprehensive Coverage: Dental membership plans typically cover a wide
range of services, including preventive care, restorative procedures, and
cosmetic treatments. This comprehensive coverage can be appealing to
individuals seeking extensive dental care, especially if you offer discount on
private fees.
Preventive Focus: membership plans encourage regular dental
check-ups and preventive care. By offering comprehensive coverage for routine
procedures like examination and hygiene, patients are more likely to attend, and
you have the opportunity to prioritise building relationships, maintaining good oral
health.
Predictable Costs: With a membership, patients can anticipate their regular
dental costs, as they pay a fixed monthly fee. This ca be predictability for
them with the knowledge that any additional treatment needs to be funded.
Registration and financial
security: Patients have the peace
of mind they are registered with you, and you have the security of a regular,
known, income.
No ceiling on income: For the practice and clinicians there is no
ceiling on income. Whilst the monthly payment is only altered annually,
specific items of treatment are not and you have the flexibility to adjust your
fees to reflect the volatile marketplace, protecting your income and profitability,
Non provider treatment: If a patient requires treatment from a dentist
with whom they are not registered, where additional costs will be incurred. The
patient is aware of their responsibility to pay for treatment beyond what you
have included which makes transparent conversations about the best options easier
to have.
Simple associate
remuneration: The monthly patient fee
is based on a known outcome you can easily allocate the dentist:hygienist ratio.
any further treatment is then paid as a fee per item., avoiding any clinician
conflict.
Membership Plans
Disadvantages:
Limited Provider
Choices: Patient registration is
with a specific dentist, and can only see them for their routine care unless
otherwise specified or agreed within the practice. Some of the larger providers have a network so
patients can transfer if they move. Monthly investments and what is included /
excluded may vary from provider to provider. This may cause patient
dissatisfaction.
Non provider treatment: If a patient requires treatment from another
dentist or specialise with whom they are not registered additional costs will be incurred, which will
not be discounted.. If the patient is not aware of their responsibility to pay
for excluded treatment or treatment on referral, it can lead to difficult
conversation and patient dissatisfaction.
Can be expensive: Because the plan is calculated on routine
treatment if the patient’s disease is not stabilised, they can have on going
treatment fees. The plans are generally devised to prioritise stabilisation of
disease, so this should not be an ongoing situation.
Over treatment: Whilst capitation plans can encourage supervised
neglect , fee per item can result in over treatment by unscrupulous clinicians.
Be self-aware.
Raise standards.
Communicate effectively.
Action and accountability.
As we conclude our
exploration of dental capitation plans and dental membership plans, it becomes
clear that there is no one-size-fits-all solution. Each option presents its own
set of advantages and disadvantages. Coaching with a dental professional, such
as Jane Lelean from the Institute of Dental Business, can provide valuable
insights and help determine which plan best suits your individual needs.
Choosing the right dental
plan is a crucial decision for the long term success of a practice and must be
part of your financial offering to patients.
Jane Lelean, a respected
expert in the dental business realm, sheds light on the nuances of these two
payment models.
Jane is the expert place
to go for independence when choosing plan.
Jane assists practices,
- choosing the right plan
- getting the fees correct,
- engaging the team,
- anything and everything that ensures your conversion is successful.
If you would like Jane at
your side when making these important decisions, schedule an appointment using
our online booking system, www.iodb.co.uk
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