The dental industry continues to grow, and many dental practices are reaping the benefits. Alongside the growth of DSOs and third-party networks, PPO insurance carriers blossomed, but now appear to be on the decline.  


How Many People Are Covered?

According to the National Association of Dental Plans, 77% of Americans currently have dental benefits. Of those 249.1 million people with benefits, approximately 164.2 million have a form of commercial insurance, and 90% of those individuals get those dental benefits through an employer or group program like AARP. Dental Preferred Provider Organizations (DPPOs or PPOs) make up a whopping 82% of dental policies today.

PPO Insurance Carriers

In the PPO model, the insurer will create a network of dental providers that their patients can choose from. Dentists who are enrolled in that network often experience an uptick in patients as a result, but they do so at the cost of a reduced payment rate for the services that they perform. Most PPO insurance carriers cover all in-network preventative care, like cleanings, but require the patient to pay a co-pay for restorative work, like a root canal or filling.

How Many PPO Insurance Carriers Are There?

PPO insurance carriers have been on the rise for decades now, as articles dating back to 1985 proclaim that “the number of operating PPOs has increased” and “their enrollment has risen dramatically.” However, recent reports suggest that the PPO plan count is on the decline. For the fifth straight year in 2015, the total number of PPOs operating nationally declined from 454 to 451. Over the period from 2003 to 2015, the total PPO count fell by 33.7%. Insurance company-owned PPOs are experiencing the most growth, and in 2015 they accounted for 72% of all PPO enrollment. It’s important to note that while the total number of PPO insurance carriers may be declining, enrollment continues to increase, which points to steady and growing consumer interest in enrollment.

Thrive in an Era of PPO Insurance Carriers with APEX Reimbursement Specialists

The experts at APEX Reimbursement Specialists can help you to explore the best options for your continued growth and sustained success, including PPO insurance carriers. We can assist you with ensuring that your dental practice continues to grow and thrive whether you are located in Maryland or across the country. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.