Sun Life Blames “Overutilization” for U.S. Dental Income Drop While DentaQuest Squeezes Texas Dentists

Sun Life, the Canadian parent company of DentaQuest, has reported a $64 million drop in income for its U.S. dental and group benefits segment. Their explanation for the dental drop? Americans use too much dental care.

Yep.  On the Q3 earnings report on their website, Sunlife wrote, “Group – Health & Protection down US$64 million: Reflecting lower Group Benefits and Dental results. Group Benefits results were driven by unfavourable medical stop-loss insurance experience and unfavourable long-term disability experience in employee benefits. Dental results were driven by higher utilization rates and the prior year impact of a retroactive premium payment.”

Damn.  A national Medicaid dental contractor and Texas DMO is complaining that its members actually went to the dentist, exactly what is supposed to happen.  No wonder it is manufacturing credentialing delays and shrinks its network to strangle providers in Texas. Got to stop that utilization.

Conflict between foreign-ownership profits and Texas Medicaid performance?

According to Sun Life, “higher utilization” hurts their profits. To prevent this, in Texas, dentists report waiting months to get re-credentialed with DentaQuest. Some give up. Some simply stop accepting the plan.

You can’t reduce utilization by candidly telling families not to go to the dentist. However, you can reduce utilization by cutting off the dentist supply through slow credentialing, shrinking networks, endless paperwork, and radio silence. Texas dentists have been telling us for months that DentaQuest has been the worst offender. Lower income at the corporate level only adds fuel to that fire.

The real problem isn’t “overutilization”

Maybe the problem is that Sun Life expects profits that Medicaid dentistry simply cannot deliver and Texas dentists and Texas Medicaid kids are paying the price.

State intervention is needed

DentaQuest has already created avoidable access problems in Texas. Now, with Sun Life apparently tightening the screws, it appears that things could worsen unless state regulators intervene and demand basic accountability.

Dental care for Texas children should not be a collateral casualty of a foreign insurer’s earnings report.