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Over the last four years, dentists have experienced significant changes to how they practice dentistry and the reimbursement they received for their services. These changes were experienced on a national scale.
Here at Sikka Software we collect information from dental practices across the nation to monitor trends and create benchmarks for successful practice management. Data is gathered in compliance of privacy laws and does not contain identifying patient or practice information.
The following graphics depict the most significant trends in dental practice management. Measuring and tracking trends allows dentists to understand the dental market, find new opportunities for revenue and grow their businesses. Practices can access complete national trends, as well get key reports about their own performance at https://www.sikkasoft.com/dental/sikka-apps/practice-optimizer-dental/
Year over year dentists have experienced a larger active patient load, where an active patient is defined as one seen in the practice during the previous 18 months. Starting at the end of 2014 and continuing into 2015, there was a significant increase, beyond what was seen in previous years, in the number of active patients. This may be due to higher employment rates and the affordable care act, leading to an increase in dental insurance coverage.
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Number of Patients Reappointed to Hygienists
Beginning in September 2014 and continuing into 2015, there was an increase in patients reappointed to hygienists. As hygienists are the professionals who clean and exam teeth, this leads to a greater number of opportunities to find and diagnosis dental concerns. This increase in reappointment is a chance to provide the market with increased quality of care, through identifying current and potential concerns, as well as grow revenue for the practice.
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Diagnostic Quantity by Practice
An increase in diagnostic quantity can be traced back to two key changes in dentistry: an increase in active patients and the increase in number of appointments to hygienists. This increase represents the chance for more patients to receive appropriate interventions.
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Hygiene Hours Worked
Hygienists are working, on average, an increased number of hours nationally. In 2012 hygienists worked, on average 139 hours each month, or approximately 6.6 hours each business day. By comparison, in 2014 time spent in the clinic rose to 148 hours and for the first quarter of 2015, 157 hours. This translates to approximately 7.1 and almost 7.5 daily hours, respectively. This increase in hours may be due to an increase in hygienist reappointments as well as more active patients per clinic.
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Hygiene Net Production Per Hour
Although the first half of 2014 saw the highest net production values per hour, there was a steep drop off in revenue starting in July 2014. Net income is after insurance adjustments, discounts, cost of goods, wages and other expanses. This trend has continued, with comparative low values throughout 2015.
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Doctor Hours Worked
As with hygienists, dentists are also working more hours to keep up with the increase in demand for dental services. In 2012 doctors worked on average 139 hours a month or approximately 6.6 hours each day. In comparison, doctors worked 154 hours, 7.3 hours each day, in 2014 and 164 during the first four months of 2015, or 7.8 hours each day.
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Doctors Net Production Per Hour
Just like hygienists, dentists are making significantly less net income per hour than the previous three years. The cause of this drop off in financial productivity by both dentists and hygienists, will be examined over the next few graphs.
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Fewer cash patients are being seen year over year at dental practices. In 2012 an average of 69 patients were seen on average each month. In comparison, 59 patients on average were seen in 2014 and 57 patients on average for the first four months of 2015. As cash, or fee for service, represents generally the highest payment rate for a given procedure, this is a key reason why net production is on the decline.
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Cash Patients to Insurance Patients
The number of patients seen using insurance is not only increasing but the proportion of those paying cash to insurance is steadily decreasing year over year. As with an increase in active patients, this is likely do to a larger percentage of the population having access to dental insurance either through employment or the Affordable Care Act (ACA).
An increase in adjustments is expected based on the increased use of insurance companies as payers for dental fees generated. Adjustments represent the difference between what a dentist would typically charge for a certain procedure versus what is actually paid by the insurance companies. These adjustments decrease the amount of income realized by the dental practice compared to fee for service.
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Practice Net Production to Practice Gross Production
The end result of these trends is that although the dentists and hygienists are working more hours on average each month, their net production per hour and per patient represents a smaller percentage of the gross. This is due to the increased use of insurance as payment, leading to more adjustments and a smaller percentage of net production. Unfortunately for dentists, with the ACA and increase in employment, this trend is likely to continue into the future.
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Dental practices are experiencing an increase in service demand, a decrease in fee for service patients and overall decrease in revenue per hour of work. This will likely have long term implications for how a clinic operates and how they provide clinical care to their patients.
About Sikka Software
Sikka Software provides a platform for small and medium-sized business healthcare apps. The company's products help healthcare providers and other small businesses optimize their business via a series of easy to use cloud-based applications. With over 32 apps built on Sikka Platform Utility® with over 14,300 installations, Sikka Software is the leader in the US Dental, Animal Health and Hearing Care markets. The company is now supporting a real time optimization and information network with providers, patients, consultants, manufacturers and financial service providers.
A privately-held company, Sikka Software is headquartered in Milpitas, California with offices in the United States and in India. More information including may be found at www.sikkasoftware.com.
About the Author
Alitta Boechler is a marketing manager at Sikka Software. She holds a Doctorate of Audiology from the University of Iowa and an MBA from the Jesse H. Jones Graduate School of Business at Rice University. You can contact her at firstname.lastname@example.org or (408) 359-3014. For more information about The Practice Optimizer Company® please visit https://www.sikkasoft.com/dental/sikka-apps/practice-optimizer-dental/