What Happens When Insurers Become Providers

Delta Dental’s recent purchase of 25 dental practices in Wisconsin has ignited a debate within the dental community about the consequences of allowing an insurance company to also become a care provider. While the company claims the move will help expand access, particularly in rural areas, many oral health professionals are sounding the alarm over the inherent conflict of interest when the same entity both authorizes and delivers treatment.

At the heart of the concern is a fundamental shift in control. Traditionally, oral health professionals diagnose and recommend care, and insurance companies decide what portion of that care they’ll cover. Now, with Delta Dental operating on both sides of the transaction, critics fear that financial incentives could outweigh clinical judgment. If a company stands to benefit financially by approving or denying specific treatments within its own offices, it could create pressure to prioritize cost savings over patient outcomes.

This situation is particularly complex in Wisconsin, where laws do not require dental offices to be owned by licensed dentists. That legal gap has allowed Delta Dental to quietly acquire practices without patients necessarily realizing their provider and insurer may be the same company.

Professional associations, including the Wisconsin Dental Association and the American Dental Association, are taking notice. They worry this model could limit patient choice, reduce transparency, and erode the independence of oral health professionals. While Delta Dental has stated that current operations will remain unchanged, many in the profession see this as the beginning of a larger trend, one that could reshape the delivery of dental care far beyond Wisconsin. Click here to read more.