Month: February 2011

By Markian Hawryluk
The Bulletin

Dr. Eric Cadwell could never understand why patients paying cash for their dental work paid higher rates than anyone else. In many ways they’re the least expensive patients a dental practice has.

“We don’t have to send bills, we don’t have to do paperwork,” the Bend dentist said. “It doesn’t make any sense.”

Cadwell and his brother, Dr. Josh Cadwell, of Richland, Wash., figured such patients should get at least as good a deal — maybe better — than patients with dental insurance. And if a practice could cut its administrative costs, it could make dental care much more affordable to patients without any coverage.

The brothers came up with a new membership model for their dental practices, implementing it two years ago in Richland, where Josh practices. Eric Cadwell launched the model at PureCare Dental of Bend with Dr. Adam Veitschegger in December.

For a monthly fee of $19.50, PureCare members can get two cleanings and fluoride treatments, two dental exams, two emergency visits and X-rays as needed every year.

Dental experts recommend adults get X-rays every 6 to 12 months if they show signs of decay, and every 18 to 36 months when decay is not evident. PureCare members will usually get at least X-rays of their back teeth every six months, but could get more extensive X-rays if needed.

The cost represents a 45 percent discount from what those patients would normally pay without a membership plan. According to DentalPlans.com, a site that sells discount dental plans, the cost of two routine six-month check-ups and adult cleanings averages $306 in Bend. Adult members at PureCare would pay a total of $234 a year.

Patients must first complete an initial exam, which PureCare is offering at a discounted price of $59 through March 11, and those with periodontal disease who need deeper cleanings more often may have to pay a higher rate.

Members also get 15 to 20 percent discounts off the list price for other dental work, and dependent children — including college students up to age 23 — get the same services for a monthly price of $12.50. Members must set up a monthly electronic payment via a debit, credit card or checking account, which helps to keep overhead low.

The services cover the standard preventive care that dentists recommend for all patients. For those with healthy mouths and no problems, it could represent all the dental care they need for the year.

“The lifetime cost of dental care is going to be lower if you come in every six months,” Eric Cadwell said. “I can catch something little or really minor, put a small filling in. It’s going to be 10 times more expensive if I have to do a root canal or an extraction.”

If patients put off care, whether due to fear or cost, until they notice a problem, they’re likely looking at a more expensive and more unpleasant experience.

But a large majority of Americans don’t have any insurance coverage for dental work. According to the American Dental Association, for every individual without health insurance, there are three individuals without dental coverage. If that ratio holds true in Central Oregon, more than half of local residents could be paying dentists out of their own pockets.

Since launching the membership plan in December, PureCare has had more than 30 families sign up. Linda Nolan of Bend signed up as a member earlier this year after seeing PureCare’s billboard and the $19.50 per month cost.

“I didn’t have other insurance, and dental insurance is really expensive,” she said. “I’m a widow and on a fixed income.”

She had last seen a dentist 13 years ago.

The membership plan does not constitute insurance, and the Cadwells had to work with insurance commissioners in Oregon and Washington to ensure their model didn’t violate insurance laws.

“Unlike insurance, this isn’t a use-it-or-lose-it provision,” Eric Cadwell said. “If you’re paying $19.50 per month and you only come in once that year, there’s unused benefits and you can have that credited to your account, or at the end of the year, you can have a refund.”

PureCare plans to offer membership plans to businesses as well. The four owners of Cuppa Yo, a frozen yogurt shop in Bend, recently switched from a Blue Cross/Blue Shield dental insurance plan to PureCare’s membership plan.

“We’re paying half of what we were paying and getting far better coverage, as far as I’m concerned,” said Melissa Clayton, one of the co-owners.

The membership plan can also help reduce out-of-pocket costs for patients with insurance or help plans with annual limits on benefits go further. And membership fees can be paid with pre-tax flex spending account dollars as well.