Why is dental care so expensive?

The system is set up to benefit insurance companies at the expense of the patient experience.
Spoiler: Because it doesn’t benefit anyone to lower prices. (Other than you, of course)

A cleaning for $250. A $500 whitening.  A filling you didn’t need? Every person on our team has had an experience like this, and thousands of other people we have spoken to have as well.

You’ve probably wondered why you need to spend 30-min on the phone to book an appointment, if that surprise bill should’ve been covered by your plan, or did you actually need that treatment you reluctantly got?  

But don’t blame the dentist.  To understand the problem we must go to the foundation of the dental care system: A patient experience that has been created and driven by billion-dollar insurance companies.

This patient experience has become unnecessarily costly to operate.  Which means we (the patients) pay the big bucks to keep it afloat, and the big winners are the insurance companies.

The insurance companies have no incentive to change, so how do we smile about the future of dental care? 

First, let’s look at how we got here, and how rebuilding the dental experience in a patient-centric way will make it both affordable and amazing.


The billion-dollar force against the patient experience

The dental care market is a $150B juggernaut. Powerful, outdated, and extremely slow to change course.

It's the classic innovator's dilemma. Being innovative requires taking a risk to do something better - that's scary for insurance companies that thrive on predictable profits. Instead, they stick with what works for them, regardless of the patient experience.  This causes:

  • A complex system that's difficult and costly for dentists to operate in
  • No incentive to focus on lower-margin preventative treatment
  • Prioritization of higher-margin specialty treatments
  • Lack of technology innovation for the patient experience


Insurance companies cripple dentists

Working with a dental insurance company is like being stuck in a bad relationship. Dentists need insurance companies to help them find new patients, but insurance companies make dentists agree to extremely low reimbursement rates (the amount insurance pays the dentist for cleanings, fillings, etc.) so that the insurance company can keep more of its members' premiums.

And because insurance companies are complicated to work with, dentists need extra staff just to deal with insurance. Insurance may delay paying a dentist for months, or reject payment altogether. The result is surprise bills for patients sometimes months after the treatment is complete.

Dentists are scrambling to run successful businesses. Most dental practices are small independent businesses run by the dentist themselves, a model that hasn't changed in 50 years. And those old school offices are becoming more expensive to operate:

  • Buying or building a dental office is capital intensive
  • Dentists are up to their eyeballs in student loans
  • Various office staff needed to run the front desk, insurance reimbursement, and other back-office needs
  • Fees for out-dated software and supplies

 

High costs and low reimbursements force dentists to de-prioritize prevention, and focus on a wide range of higher-margin complex cases to help cover their costs. 

This creates high prices for patients, who have to avoid care even if they want it

The current system is incentivized to focus on expensive, reactionary treatments. Which means patients have to spend more money to keep the system going.  

The result: dental care has the highest cost of any healthcare service, and is a barrier for too many people. For example, we've had to call 30+ dentists who accepted medicaid to find one that had an appointment available.

It’s no wonder that most of us can’t get to the dentist (even if we want to).


Wally: Taking on the $150B dental care experience

At first you might think, "can you really provide great care for less money?" Turns out, yes you can. Affordability and delight, counterintuitively, go together. By delivering what patients want (and need) we are creating a dental care experience that's not only amazing, but also far less costly to operate.

We are using technology (for more than just texting reminders or electronic bill pay) to get rid of the parts of the experience that are expensive and suck for patients. Goodbye calling to book an appointment. Adios surprise bills. Bye-bye spending excess time in the dentist office. 

It's time for an amazing patient experience that is affordable. Wally is affordable care that puts patients in control. We're excited to be launching our full experience this summer - from what you do at-home to how you visit a dentist. Ready to join us?

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