Questions Linger about Capitation and DMO RFP

We’ve heard from various dentists that they have questions about controversial issues that have come up over the last several months.  So we assume there are more out there that have the same questions or heard the same rumors.

Primarily they are concerned about DMOs moving to a capitation plan as DentaQuest was seeking to do and what is currently happening with the RFP. So we would like to help straighten things out.

Here is an update.

The RFP:

  1.  What is happening?

The current deadline for company submissions is the end of this month, November 30, as we reported at the beginning of October.  At this time, we have no idea which companies have responded to the RFP.  We have reached out to some contacts but no word as of yet.

2.  Where can I get a copy of the contract?

The RFP documents are available here.  The current Dental Services contract is available here.

Capitation:

  1.  Are DMOs required to use capitation?

No.  DMOs were required under the current contract to transition a small percentage of payments from volume-based payment methods to a quality-based payment method.  DentaQuest had meetings with several providers and floated capitation payments as a possible method for them to follow through on this contract requirement.

The TDA has also weighed in on this.

2.  Is capitation still on the table?

As far as we know, no.  We assume all bets are off until the new contractors are chosen.

3.  Did someone sign a capitation contract with DentaQuest?

Not as far as we know. These were private negotiations and DentaQuest would not say more.

Hope this helps.

Leave a Reply

Your email address will not be published.