Taking the HMO Concept to a Dental Plan was obvious. Remove the ability to self-refer to a Specialist, and compensate a Dentist to keep your teeth healthy instead of paying him only when you need work, and you’ve got a Dental DMO.
Like an HMO, the biggest benefit is the financial savings… For the Insurance Company, the Employer, and the Employee. The Insurance Company has the controls in place of a “gate-keeper” who makes sure that no excessive charges are being submitted for payment. The Employer saves premium as these plans costs less and because claims are controlled, the rates don’t rise as quickly. Lastly, the Employee saves because their Payroll Deductions are less and their Copayments are more affordable.
A great idea, but finding a Dentist that you like who works in a DMO Plan is the hard part.