Providers Outraged Over DentaQuest Limiting Its Network

Our story on foreign-owned DentaQuest’s limitations on dental care access for Medicaid children in Texas has sparked outrage among dental providers, leading to an outpouring of angry comments.

Many practitioners shared their frustrations and experiences, highlighting how the restrictive policies affect their ability to provide adequate care for the state’s most vulnerable children and place their practices at risk.

We received more comments on this event than any story published in the last ten years.  This reflects the dental community’s deep concerns about this incredible and surprising announcement after DentaQuest’s 12 years in Texas and their foreign master’s announcement earlier this year about the need to boost profits from their US dental operations ie. DentaQuest.

Names have been changed to protect the angry

This is absolutely ridiculous, this will hurt my business very bad, how can I be expected to pay rent, overhead, staff at my office, this will be my first practice. Took a construction loan to build an office, now they are limiting who can be a provider. Only reason I am accepting medicaid is to serve the patients in my area. With no increase in fees and now this its almost pointless to be a provider. I hope something can be done to reverse this, and to think they are going to start dropping offices from their network is even more ridiculous. – Ryan

What is embarrassing is the other states holding dentaquest accountable , and hhsc letting this foreign country come in and destroy Texas businesses and jobs. The pathetic hypocrisy would be funny if it wasn’t so sad. – Juan Z.

Texas needs to show DentaQuest how much it cares about its people and give DQ a Texas sized BOOT…!!! DentaQuest (sun life) has failed so many times already! Enough is enough!! Sun Life profits are not more important than jobs for Texans and Texan livelihoods. Let’s put Texas first and get Sun Life out of Texas !  Dr. Lisa G.

This is beyond disappointing. Dentaquest is making one terrible decision after another and on a mission to destroy Texas Medicaid. How are practices suppose to replace providers without losing continuity of care? How are new offices that are opening expected to survive when a large patient bases are being eliminated and what are busy existing practices going to tell their loyal patients that have been coming for years that they can no longer see them. These are despicable actions that I’m sure will be fought and hopefully the Texas dentists and at risk patients will become victorious. – Concerned Dentist

Recommend never work with Dentaquest. They will look for ways to limit (already low) payments to, and take back payments from, providers; and if you ask pointed questions they will punish you with an audit, make your life miserable, and take back even more monies—usually for “so called” documentation issues. A typical provider will not have the time and monies to appropriately fight the “audit” battle. If possible, stay out of the Medicaid game….it just is not provider friendly. – Zaylor T

As I read this article, several very immediate consequences to the patients served by DentaQuest are obvious. The policy that only allows for the replacement of a dentist within 30 days after one leaves will lead to service interruptions. Clinics might have to stop serving DentaQuest patients temporarily if they cannot immediately replace departing dentists, impacting patient care continuity. In addition, the large gaps of time between replacement providers, preventive dental care will suffer, leading to more severe and urgent dental issues that could have been managed or prevented with regular and uninterrupted access to care. It appears to be very clear that DentaQuest’s most recent policies regarding provider sign-ups and limitations has not been well thought out and appears to be self serving in purpose. They do not appear to be acting in the best interest of their enrollees, many of which are children. – Dr. H.

The fact that DentaQuest may end up terminating their relationship with clinics in areas deemed to have high enrollee utilization is unbelievable. It’s hard to see any other motive than to decrease utilization by their members.

 

The short-term consequences are not hard to imagine. Clinics still within the network might experience an influx of patients, leading to overburdened staff and facilities, which could compromise the quality of care provided due to high patient-to-provider ratios.

 

The damage caused is going to be lasting. Clinics that have grown to support the high utilization by enrollees will probably not survive the termination. Staffing costs continue to skyrocket, and material costs keep increasing. Clinics still within the network may be very hesitant to expand to meet the new demand due to the fear of DentaQuest pulling the rug out after member utilization becomes higher. New dental practices or those expanding might find it nearly impossible to join the DentaQuest network in time to remain financially viable. Dentists entering the workforce will likely want to steer clear of joining a clinic that accepts Medicaid patients. This will lead to the stigmatization of such clinics by emerging Texas dental professionals. This would disproportionately affect growing communities, which may already be areas of high utilization.

 

Given that these changes affect Medicaid users, they would widen the gap in dental health outcomes between different socioeconomic groups, as those who can afford private care or live in areas with more dental options will not face these restrictions. Frequent changes and limitations in provider networks could erode patient trust in DentaQuest and in Medicaid dental services overall, potentially discouraging individuals from seeking dental care. – Dr. G.

It’s time to fight back against these crooks! Of course these foreign companies don’t give a shit about dental providers in their group, and they give even less of a shit about their patients. We need to get our voices out to the state government, local news, social media. Anyone who will listen. It is criminal what is happening.  – Dr. Mc.

As a small dental office, we’re deeply concerned about DentaQuest’s recent decision to limit the number of providers in their network. With the changes they’re implementing, it’s becoming nearly impossible to keep our doors open and provide the level of care our Medicaid patients deserve. This isn’t the first time DentaQuest has made it harder for us to do our jobs, and it’s only adding fuel to the fire, pushing more providers out of the network. A friend of mine said “I’ll make their job easy, I will no longer see Medicaid patients, I’m done with Medicaid in Texas”

 

As a group we are worried that this will lead to even more shortages in access to care, especially here in Texas, where Medicaid patients are already struggling to find good dental services

 

HHS needs to step in and regulate this nonsense. Crying for help here! – Dr. Kim

Just a thought, but I bet this is Dentaquest’s first step to move towards capitation or a mixed model. Limit new docs for a while then if people do want to sign up then they can only do it through a straight capitation or mixed “value based care” model. I’m not affected by this because of my location, but my regional rep who isn’t with Dentaquest anymore stated they are trying very hard to move offices to capitation or mixed capitation models in the next 5 years. – Anonymous

This is yet another example of a company prioritizing profit over people, and it is infuriating. As providers, we work hard to keep our clinics running in a system that already underpays and overburdens us. Now, with this new restriction, we face even more uncertainty and instability. Our patients—many of whom have already struggled to access care—will bear the brunt of these changes, potentially worsening oral health outcomes in underserved communities. It’s clear that DentaQuest has little regard for the challenges we face on the ground, nor the well-being of the patients we serve. – Dr.A

DentaQuest’s potential termination of relationships with high-utilization clinics in Texas poses significant risks to local businesses. Clinics facing termination may not survive due to increased operational costs and sudden loss of patient volume. Those remaining in the network could become overwhelmed, risking care quality. This situation discourages new and expanding clinics from joining DentaQuest, fearing future instability. Consequently, Texas dental professionals might avoid Medicaid-accepting clinics, exacerbating inequalities in dental care access and outcomes among different socioeconomic groups, and damaging business prospects in underserved communities. What a shameful unmitigated disaster for providers and patients. – Exhausted Medicaid Dentist

Can’t wait for a huge legal fight. Let’s see how Sun Life and DentaQuest fair when their legal expenses go sky high and ultimately have their numbers proven wrong. Wait until the losses are felt by the big banks and asset managers who are stakeholders in Sun Life. We all know their data is wrong and the liability they took on by even acquiring DentaQuest. What they will learn is they should have made DentaQuest more efficient to drive profits, instead of penalizing healthcare providers and patients. – Jeff A.

For DentaQuest to penalize network providers, who have sacrificed their profession to provide care for underprivileged and underserved communities is horrible. A practice that has high utilization or who sees a lot of patients, simply means that they have effectively earned the trust of patients who are in desperate need of oral health education and dental care. It is horrible to allocate government funds in a way that prioritizes profits over patients – the way DentaQuest, a Sun Life company, is doing! WHO CARES ABOUT DENTAQUEST PROFITS AT THE EXPENSE OF DENTISTS AND THEIR PATIENTS. Right now, Sun Life’s leadership team is making purely tactical financial decisions that will force offices to close and throw patients into a massive backlog, all to ensure that their CEO, KEVIN STRAIN keeps earning his CA$11M annual salary. I wonder how much his bonus will be this year for limiting patient access in Texas. Furthermore, why would arguably the worst administrator of healthcare in the world (CANADA) be allowed to influence American Healthcare! – Mike P

DentaQuest’s actions are a clear conflict of interest for both patients and providers. We spend years in school, hundreds of thousands of dollars on an education, then maybe hundreds of thousands more to open a practice and when we choose to provide care to the underserved community, we get a figurative slap-in-the-face; challenging our livelihoods and the care of patients. WHO IS MAKING THESE DECISIONS!? Are these peers?! Are these decision makers just “business strategy people” or are they the same people who went to dental school with me and are truly qualified to opine and decide the best course of action for patients. I CHALLENGE THE DATA THAT IS BEING USED to make the determinations that DentaQuest and Sun Life are making. PROVE TO ME that there is “adequate” care and coverage for the communities we serve vs. the population. I WANT TO SEE IT!!! PROVE TO ME THIS ISN’T AN ATTEMPT TO LIMIT CARE TO JUST BOOST SHORT TERM PROFITS! Where is the state and HHS in this decision!? – Dr. AT

Texas went from one of the best states to practice in 15 years ago and now is slowly becoming one of the worst states. If this continues, this born and raised Texan will move to another state and go practice there. Why would I stay here to make peanuts. Maybe Colorado, Lousiana, Or Florida sound good with their fee increases. – Screw Dentaquest

The recent changes implemented by DentaQuest are not just absurd; they pose a significant threat to the access of essential dental care for children in need. By restricting the ability to add new providers and requiring a waiting period until a current dentist has left, DentaQuest is effectively limiting care options for vulnerable populations who rely on Medicaid.

 

This policy directly undermines the ability of dental practices to function effectively. Practices often need to initiate the credentialing process for new providers well before the departure of existing dentists to ensure continuity of care. DentaQuest’s approach not only disrupts this process but also jeopardizes the livelihoods of dental practices, many of which are already facing financial strain. The potential closure of clinics serving high-need communities is a direct consequence of these shortsighted rules.

 

Furthermore, if DentaQuest targets over 100 dental clinics—many of which are critical providers in urban areas—this will exacerbate the already dire situation for Medicaid patients, who will face even fewer choices and longer wait times for necessary care. The question must be raised: how does limiting the number of participating providers align with the goal of maximizing access to care for Medicaid patients?

 

This pattern of decision-making, particularly under foreign ownership prioritizing profit over patient care, raises serious concerns about the long-term implications for dental health in our communities. Providers have invested significant resources to build practices that serve these populations, and it is unfathomable that DentaQuest would choose to alienate such a vital network.

 

It is essential for stakeholders, including the HHSC, to scrutinize these changes and advocate for policies that genuinely enhance access to care rather than restrict it. We must ensure that our children receive the dental care they need and that our providers can continue to operate sustainably in this challenging environment. – Concerned Doctor

DentaQuest is about to personally impact my financial well-being and ability to care for my patients, which I have spent over a decade doing. Have any of these decision-makers gone to dental school and then become a Board Certified Pediatric Dentist, like I have. I decided to go into providing care for underprivileged and high-risk populations after first becoming an associate. There is a great deal of pride that me and my peers have for helping people who need it most. HOW DARE DENTAQUEST MAKE DECISIONS TO NEGATIVELY IMPACT THEIR CARE, ONLY TO FATTEN THEIR POCKET BOOK. I just received this notice in the middle of building a practice in an area that I factually know is underserved; QUANTIFIABLY UNDERSERVED! YET, IT IS IN AN AREA THAT DENTAQUEST STATES IS: “ADEQUATELY SERVED” – BOGUS – THIS IS FUBAR! They don’t care that I have a signed lease worth 800K and 900K in costs sunk into this project….NOW WHAT…. SCREW ME..SCREW THE PATIENTS???! – EA

DentaQuest have done the same in other states, including New Mexico, Colorado, Louisiana, Mass., Virginia and many others. what is the use of complaining if nothing is done.

 

Maybe a joint collective effort by dentists/ healthcare regulators.

 

The patient, provider and the state are the victim.

 

Any lawyers in this group that can guide the dental professionals here to have their voices and concerns heard/addressed. – Dr GH

It’s incredibly upsetting to see how these decisions impact patient care. Many individuals already face significant barriers to accessing dental services, and these new restrictions will only make things worse. Patients in underserved communities, who rely on us for essential care, will bear the brunt of this situation. It’s disheartening to witness a system that prioritizes profit over the well-being of those who need support the most. We must prioritize patient care and ensure that everyone has access to the services they deserve. – Dr. M

As a Medicaid provider in Texas, I find DentaQuest’s decision to limit dental care access for Medicaid children highly concerning. This move severely impacts our ability to provide essential services to underserved populations, leaving both providers and patients in a precarious situation. Many of us are already facing challenges with staffing shortages and financial pressures, and these restrictions could push clinics to the brink of closure. DentaQuest’s actions seem to prioritize profit over patient care, which is detrimental to the well-being of Texas’ most vulnerable populations. – Dr S

As a Medicaid provider in Texas, I’m outraged by DentaQuest’s decision to drastically limit access to dental care for 79% of Medicaid children. This is nothing short of a betrayal to the communities we serve, and it feels like an attack on both patients and providers. We already struggle with underfunding and heavy workloads, and now this decision puts our most vulnerable children at even greater risk. DentaQuest is sacrificing essential care for profits, and it’s unacceptable. This injustice cannot go unchallenged! Texas leadership must act now. – Dr. A

As a Medicaid provider in Texas, I’m appalled by DentaQuest’s decision to limit care for Medicaid children. This reckless policy change puts our most vulnerable patients at risk, cutting off critical access to dental care when they need it most. We’re left scrambling to serve these families while DentaQuest prioritizes profits over the health and well-being of children. It’s disgraceful, and it’s a direct blow to the trust that Medicaid recipients place in the system. We need immediate action to stop this harmful decision. – Dr. SF

This decision by DentaQuest is absolutely infuriating. How can they justify limiting access to critical dental care for Medicaid children, especially in such a large portion of Texas? This is a blatant profit-driven move that puts the well-being of vulnerable children at risk, all while making it harder for dentists to provide the care these kids desperately need. The state’s Medicaid system is supposed to ensure access to care, not limit it for financial gain. Texas deserves better, and DentaQuest’s actions are unacceptable! – Dr. A