Consolidation in the dental industry: a closer look at dental payers and providers

We examine the effect of commercial dental insurance concentration on the size of dental practices, the decision of dentists to own a practice, and the choice of dentists to work at a dental management service organization—a type of corporate group practice that has become more prevalent in the United States in recent years. Using 2013–2015 dentist-level data from the American Dental Association, county-level data on firms and employment from the United States Census, and commercial dental insurance market concentration data from FAIR Health(®), we find a modest effect of dental insurance market concentration on the size of dental practices. We also find that a higher level of commercial dental insurance market concentration is associated with a dentist’s decision not to own a practice. There is inconclusive evidence that higher levels of dental insurance market concentration impact a dentist’s decision to affiliate with a dental management service organization. Overall, our findings imply that dentists consolidate in response to increases in concentration among commercial dental insurers.