In recent weeks, Delta Dental of Wisconsin announced its acquisition of Cherry Tree Dental, a dental practice group with more than 25 locations across Wisconsin and additional offices in neighboring states. On the surface, this move is being positioned as a way to “improve access to care” in underserved communities. But let’s be honest—this is not business as usual. It is a seismic shift in our industry that every dentist and patient should pay close attention to.
As someone who has dedicated my career to helping practices thrive while navigating the complexities of PPO contracts, I see this development as alarming. Here’s why.
The Blurring of Lines: Payer vs. Provider
For decades, the dental industry has operated under a clear understanding: insurance companies are payers, dentists are providers. The payer’s job is to help patients afford care. The provider’s job is to deliver the best treatment plan for the patient.
Delta Dental’s entry into practice ownership blurs those lines beyond recognition. Now, the same organization that dictates reimbursement levels, sets coverage rules, and denies claims will also be in the exam room—through its ownership of the dental practice.
This is more than a business expansion. It is a fundamental conflict of interest.
Who Really Decides What Care You Get?
Delta Dental has assured the public that Cherry Tree Dental will operate with “independent leadership” and that treatment decisions will remain between patient and dentist. But let’s ask the hard question: Can a dentist employed by an insurance company ever be truly independent?
Even with promised “firewalls,” the incentives are stacked against patients and providers. When the entity paying the bill is also collecting revenue from delivering the care, cost containment can easily take precedence over clinical excellence.
This raises troubling possibilities:
– Will treatment plans lean toward what’s cheapest, rather than what’s best?
– Will innovative or higher-cost procedures be discouraged?
– Will independent dentists face increasing pressure to compete with insurer-owned practices that are subsidized by insurance profits?
An Unfair Advantage in Negotiations
Another serious concern is how this move could impact PPO fee negotiations. Independent practices already struggle to negotiate fairly with large insurance companies. Now imagine sitting across the table from an insurer who not only controls the contract but also owns a competing dental practice.
– Will insurer-owned practices be offered better reimbursement rates than independents?
– Will negotiations for independent practices be tightened to protect the insurer’s own clinics?
– Will insurers use their market power to set fees that ultimately favor their practices, while squeezing everyone else?
This dynamic threatens to tilt the playing field even further, leaving independent practices at a disadvantage and reducing competition in ways that do not serve patients or providers.
The Slippery Slope for Dentistry
This isn’t just about Delta Dental or Wisconsin. It’s about the future of dentistry nationwide. If this model succeeds, we could see a cascade of insurer acquisitions across the country. Once the payer controls the provider, independent practices could be squeezed out of the marketplace altogether.
The implications are staggering:
– Reduced patient choice as networks narrow.
– Erosion of trust as patients wonder if treatment recommendations are based on health needs or insurance savings.
– Loss of autonomy for dentists who entered this profession to serve, not to answer to an insurer’s bottom line.
– Distorted fee negotiations that favor insurer-owned practices over independents.
Where Do We Go From Here?
Dentists and patients must stand together in demanding transparency and accountability. Regulators in Wisconsin—and across the country—should be vigilant in examining these arrangements. At a minimum, safeguards must be established to ensure that clinical decision-making is never compromised by financial incentives.
For independent practices, this is a wake-up call. The lines between insurer and provider are blurring, and the competitive landscape is changing rapidly. Now more than ever, practices need to understand their PPO contracts, protect their margins, and strengthen their value proposition to patients.
At PPO Advisors, our mission has always been to advocate for dental practices in the face of complex and often lopsided insurance relationships. Delta Dental’s move only reinforces why that work is critical.
Final Thought
When insurers become providers, the very foundation of patient-centered dentistry is at risk. This is not simply about business strategy. It is about ethics, trust, and the sacred relationship between dentist and patient.
As a community, we must ask ourselves: Do we want a future where insurers not only decide what gets paid for—but also decide what care gets delivered, and at what price?
That’s not dentistry. That’s insurance care. And we cannot afford to accept it.
By Shelley DeGroff, Founder of PPO Advisors