The business of running a dental practice has always been shaped by payers, but the relationship is shifting in new ways, according to one dental CEO.
According to a March 2026 report from the U.S. Government Accountability Office, the three largest dental insurers have a median market share of 66.8%. This consolidation has opened the door to vertical integration, with insurance entities acquiring DSOs and positioning themselves to compete directly with the practices they also contract with.
At the practice level, nearly 80% of dental practices have reported an increase in claim denials or payer scrutiny over the past 12 months, according to a February 2026 report from Zentist. The survey’s respondents who reported more claim denials and payer scrutiny largely attributed these increases to policy interpretations around medical necessity and frequency limitations.
Source: The ‘vertical integration’ risk dentistry keeps underestimating / Becker’s Dental