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Preferred provider organization (PPO) is one of the basic dental benefit plans that are adopted to ensure employees’ dental insurance and decreased financial barriers to care. Dental insurance plans are not universal that is why PPO is to make sure that the selected approach is the most suitable one. It is advantageous that this organization is willing to work under contracted fees with various professionals in the sphere because such an approach can provide stakeholders with a range of benefits and ensure stability. The workers have an opportunity to approach any provider they like in the framework of PPO, contracted fees prove that the decision is made not because one of them can provide cheaper treatment but because this professional really appeals to the client and satisfies one’s needs. It is also advantageous that treatment costs depend on the type of completed procedure because dentists will not consider that their work is underestimated and clients will realize the peculiarities of pricing so that there will be fewer misunderstandings and dissatisfaction. Still, it is vital to consider that some dentists may resort to additional interventions and will recommend unneeded treatment just to earn more money. That is why it is vital that PPO hires only trustworthy professionals. Except for this potential issue, the implementation of contracted fees is not likely to cause serious problems. On the contrary, it can reduce costs for both organization and its employees and provide the professionals with the opportunity to be decently paid for provided services. PPO plans are expected to meet an annual maximum of coverage, which can be an obstacle on the way to treatment for some workers. However, the limit is usually enough to meet the needs of the employees (Sherman, 2012).
Preferred provider organization (PPO) plans do not only ensure that professionals are going to provide treatment for contracted fees but also presupposes that some types of interventions will be paid lower than usual. However, it is claimed that such peculiarity does not seem to be a great problem because dentists will obtain an opportunity to increase the reimbursement rate and increase their patient pool. Even though there is evidence of such a tendency, McCluskey (2017) emphasizes that professionals in Massachusetts started to earn less under this initiative. In addition to that, the change is associated with “net income of $14 million on $186 million in revenue in the first nine months of 2016, which was down from net income of $21 million and revenue of $192 million in the same period of 2015” (McCluskey, 2017, A1). Such results presuppose that the needs of the employees and employers seem to be met as they obtain an opportunity to pay less for the received services. However, no balance regarding dentists’ needs and expectations is observed because their wages decrease. In this way, it can be presupposed that financial challenges affect dentist practice when they are poorly adapted. Thus, the benefits of PPO and contracted lower fees can be ensured only if they are properly designed. Organizations need to ensure that they hire efficient professionals and that their services are not underestimated. In addition to that, this plan does not limit the client and allows them to contact other professionals if balance billing is maintained. Thus, employees should be additionally encouraged to resort to those professionals who agreed to cooperate with PPO instead of resorting to another dentist so that those who have a contract can definitely have enough clients.
References
McCluskey, P. (2017). Insurer’s plan gnaws at dentists: Low-cost coverage may affect service, incomes. Boston Globe, 8, A1.
Sherman, G. (2012). Trend worthy of smiles: Lowering dental insurance costs. Benefits Magazine, 49(10), 38-42.
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