capitation

[mmasurf]

Advertisement - Members don't see this ad

a few of my friends work in capitation mills where the base vs production is around $400 / 33% and they rarely see more than 5 patients a day doing minimal work. how do these mills survive, do the medicaid plans pay them a huge sum every month,?does anyone have info on how this works?

 

[Shunwei]

a few of my friends work in capitation mills where the base vs production is around $400 / 33% and they rarely see more than 5 patients a day doing minimal work. how do these mills survive, do the medicaid plans pay them a huge sum every month,?does anyone have info on how this works?

Oh, the mills can survive precisely because it is capitation (in fact, they probably like that). The dentists, however, will wallow in mediocrity.............

 

[mmasurf]

do you know on average how much these plans pay?

 

[ubdental]

Oh, the mills can survive precisely because it is capitation (in fact, they probably like that). The dentists, however, will wallow in mediocrity.............

I've worked for a capitation mill before. They expect you to see 16-20 pts per day. You do everything, including hygiene. The norm is for you to see 3-4 new pts per hour, while you are doing one major production, which could be crown preps or Endo. It is expected that you can do a molar Endo, build up, and crown prep of the same tooth in 2 hrs, while seeing all the new pts during that 2 hrs.

The reason why your friend is seeing 5 pts per day doing minimal work is b/c the office doesn't have enough pts yet. Once it picks up, then the 16-20 number will kick in. Each DMO plan would pay the office $1000-$1500 per month. There could be around 20 plans out there. Essentially the office could get $30,000 per month for staying open, but after the doctor and staff salaries, and other overhead expenses, there's not much left for profit. Therefore, the doctor needs to produce massively for the office to make $$$. I got burned out after 8 months and left.

 

[Shunwei]

I've worked for a capitation mill before. They expect you to see 16-20 pts per day. You do everything, including hygiene. The norm is for you to see 3-4 new pts per hour, while you are doing one major production, which could be crown preps or Endo. It is expected that you can do a molar Endo, build up, and crown prep of the same tooth in 2 hrs, while seeing all the new pts during that 2 hrs.

The reason why your friend is seeing 5 pts per day doing minimal work is b/c the office doesn't have enough pts yet. Once it picks up, then the 16-20 number will kick in. Each DMO plan would pay the office $1000-$1500 per month. There could be around 20 plans out there. Essentially the office could get $30,000 per month for staying open, but after the doctor and staff salaries, and other overhead expenses, there's not much left for profit. Therefore, the doctor needs to produce massively for the office to make $$$. I got burned out after 8 months and left.

Offices like capitation plans when they operate under the condition at <20% of the DMO patients actually show up and also rely on unbundling stuff. If all of the capitation patients actually showed up an office would go bankrupt and no amount of work can save it.

 

[ubdental]

Offices like capitation plans when they operate under the condition at <20% of the DMO patients actually show up and also rely on unbundling stuff. If all of the capitation patients actually showed up an office would go bankrupt and no amount of work can save it.

Actually you can survive. You just have to charge for things that others may not charge for. For example, when you do a $20 extraction, you tag on a bone graft to make another $250; a PFM crown that DMO only allows $250, you tag on a custom temp crown for $150, another $150 lab fee, $100 supply fee, then you can make $600 for a PFM. That's still much lower than PPO and FFS, but you can still survive. This is when large volumes make up for profit. However, it puts a lot of stress on the doctor. This is why DMO mills have very high turn over rates.

 

[Contach]

You just have to charge for things that others may not charge for. For example, when you do a $20 extraction, you tag on a bone graft to make another $250; a PFM crown that DMO only allows $250, you tag on a custom temp crown for $150, another $150 lab fee, $100 supply fee, then you can make $600 for a PFM. That's still much lower than PPO and FFS, but you can still survive. This is when large volumes make up for profit. However, it puts a lot of stress on the doctor. This is why DMO mills have very high turn over rates.

Sounds sketchy. Do you have tail end malpractice insurance?

 

[ubdental]

Sounds sketchy. Do you have tail end malpractice insurance?

I have occurrence based coverage, which means no tail coverage is necessary.