The Holiday Heist: How Insurers Are Targeting Private Practices
The Rising Threat of Insurer-Owned Dental Practices
The landscape of U.S. dentistry is undergoing a seismic shift. For decades, private practice owners have operated with relative independence, building practices, patient trust, and reputations on the foundation of personalized care. That era is now under serious threat, even beyond that of DSOs, DPO’s and private equity. Major dental insurers are beginning to acquire dental practices. Delta Dental of Wisconsin’s purchase of Cherry Tree Dental signals the emergence of a new, potentially disruptive model. For private practice owners, this trend could create an increasingly hostile business environment.
Delta Dental is the largest dental benefits organization in the U.S., covering a substantial portion of the population. In 2022, its nationwide operations reportedly generated $26.6 billion in revenue, reflecting its huge influence in the market.
Vertical integration of insurance and dental care introduces inherent conflicts of interest. When an insurer owns a practice, cost-control incentives may supersede patient care priorities. Appointment times could be shortened, treatment options limited, and clinical decisions guided more by profit than professional judgment. Private practices could suddenly find themselves competing against operations that hold both payer and provider advantages, a combination that can squeeze margins and destabilize even well-managed practices. As one Wisconsin dentist observed regarding the Delta acquisition, “It’s a system designed to reward the insurer first and the patient second. Private practices can’t compete with that level of embedded control.”
The American Dental Association reinforces this warning: “From a business standpoint, dental insurance companies seek to minimize cost and maximize profit. As a result, patients may find their treatment options limited to what is most cost-effective for the insurer, not necessarily what is most effective for their oral health.”
As insurer-owned practice models spread, market consolidation may limit exit options for retiring dentists. Practices that once could have been sold to another dentist may discover that potential buyers are unwilling or unable to compete with insurer-backed clinics, potentially depressing valuations. The practice you’ve built over decades could see its worth undermined, not by operational failure, but by structural market shifts entirely outside your control.
Regulatory oversight is uneven. Some states, like Ohio, restrict non-dentist ownership of dental practices, but laws vary widely. The financial power of large insurers may test these limits, and a single acquisition could trigger a national trend, creating an environment where independent private practice ownership becomes increasingly difficult.
For practice owners in the “back nine” of their careers, the implications are significant. The decision is no longer just about operating a profitable practice; it’s about protecting a lifetime of work from market forces designed to favor insurer-owned enterprises. Transitioning your practice to a trusted successor now, before competitive pressures intensify, may be the most effective way to preserve your practice’s value and give you peace of mind. The time to act is before the market closes the door on options that once seemed guaranteed.
Disclaimer: This white paper is intended for informational purposes only. The opinions expressed are those of the author and do not constitute legal advice.
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J. Robert “Bob” Brooks, CEPA, CBI
J. Robert “Bob” Brooks, CEPA, CBI, leads Practice Endeavors, an Ohio-based practice brokerage and dental realty company. His company provides practice owners with the tools they need to prepare well for life after practice ownership and to find the best price/best fit buyers for their seller clients. Bob was integral in starting the first of its kind dental practice broker credentialing for the International Business Brokers Association.