1. Dental insurance Industry
– Market Revenue: $49.8bn(2012) to $65.9bn(2017)
– Profit: $2.9bn(5.9% of revenue)
– Annual Growth 2012-17: 5.8%
– Businesses: 48
Dental insurance currently makes up just 7.0% of the health and medical insurance sector. In 2012, 17.1% of Americans lack medical insurance; according to industry players, about 45.1% have no dental insurance. This drastic difference helps to illustrate the considerable distinction between the two types of healthcare coverage. Dental insurance largely focuses on covering regular maintenance and preventative oral health treatments, while medical insurance largely covers unpredictable and urgent health ailments. Consequently, dental care costs and the Dental Insurance industry are stable.
There are 3 types of dental insurance plans; Indemnity plan, Preferred provider organization plan, and Capitation plan. Dental insurance plans differ in the level of reimbursement offered for certain procedures and in annual dental spending caps. Dental insurance allows people to use dental care without incurring some of the extremely high costs.
Dental insurance plans can generally be divided into two categories: managed- care and fee-for-service. Managed-care dental plans are cost-containment systems that restrict the type, level and frequency of treatment; limit the access to care and control the level of reimbursement for services.
Dental plans can also be broken down into different categories for procedures. Preventative and diagnostic services generally include cleaning, oral exams and X-rays. Insurance plans typically cover 100.0% of these costs. Basic restorative services include fillings and extractions, among other things. Dental insurance usually covers 80.0% of the costs. Major restorative services include bridges, crowns and complete dentures. Dental insurance usually pays 50.0% for these procedures. Lastly, corrective services include services such as orthodontia, but are not directly included in most dental plans.
Exhibit: Services segmentation in 2012
(1) Indemnity plan
Indemnity plan coverage allows patients to choose their own dentist. Under this plan, limits and co-payments are set according to the level of coverage purchased. The dental indemnity insurance plan pays the dental office on a traditional fee-for-service basis.
(2) Preferred provider organization plan
Preferred provider organization (PPO) plans give patients the ability to select a dentist from a network or list of providers who have contractually agreed to discount their fees. If the patient chooses to receive treatment from a no-participating dentist, that patient may be required to pay a greater share of the fee-for-service or pay higher deductibles and co-payments. PPOs can be fully insured or self-insured. PPOs are usually less expensive than indemnity plans and are regulated by the appropriate state insurance department.
(3) Capitation plan
In capitation plans, patients are assigned to a specific dental office where contracting dentists receive a fixed monthly fee per patient or family regardless of whether treatment is performed. Under this plan, dentists agree to provide specific types of treatment to the patient at no charge, usually preventative or routine services. For other services, clients must pay premiums and co-payments per visit.
2. Dental clinical instrument manufacturing industry
– Market Revenue: $5.9bn(2014) to $7.7bn(2019)
– Profit: $450.3m(7.6% of revenue)
– Annual Growth 2014-19: 5.4%
– Businesses: 1,109
The Dental Clinical Instrument Manufacturing industry has grown steadily because of both consistent demand for routine dental procedures as well as the growing population of Americans over the age of 65 who demand significantly more dental care due to age-related conditions. Growing consumer disposable income levels have also led to increased demand for more specialized procedures, in turn driving growth in industry profitability, as more dental laboratories demand high- end, high-margin instruments. Industry performance during the past five years has further been accentuated by overall growth in demand and ability to pay for healthcare.
This industry is consisted by 4 major segmentations. Dental clinics are the primary market that dental instrument wholesaler’s target. However, many industry firms also employ sales personnel that target this market segment directly.
Exhibit: Market segmentation in 2014
3. Dental wholesalers
– Market Revenue: $12.8bn(2015) to $15.9bn(2020)
– Profit: $740.4m(5.8% of revenue)
– Annual Growth 2015-20: 4.5%
– Businesses: 872
The dental wholesalers industry distributes dental supplies and equipment to dental, orthodontic, periodontic, maxillofacial and other licensed dental practices. Demand for dental supplies and equipment is largely correlated with overall demand among individual consumers for dental work. Dental equipment dealers work as intermediaries between manufacturers of dental products and dental practitioners to help identify the specific needs of private practices, provide regular customer service and ultimately sell the latest and most advanced dental equipment that manufacturers have to offer.
Exhibit: Major segmentation in 2015
4. Dental Laboratory Industry
– Market Revenue: $5.2bn(2015) to $6.1bn(2020)
– Profit: $629.0m(12.1% of revenue)
– Annual Growth 2015-20: 3.3%
– Businesses: 9,381
During the past five years, the Dental Laboratories industry benefited from growth in the number of individuals with private health insurance, which boosted industry revenue. However, some consumers were still budget-conscious over the period, thereby limiting out-of- pocket healthcare costs by cutting elective procedures, including tooth implants and cosmetic procedures. Nevertheless, as the number of people with private health insurance increased at an annualized rate of 1.8% during the five years to 2015, this trend has provided a boon to the industry. Additionally, rapid technological changes, such as new filling, bonding and implant compounds, such as all-ceramic restorative systems; cutting edge computer-aided design and computer- aided manufacturing (CAD and CAM systems); and computer imaging, stimulated demand for industry services.
Exhibit: Market segmentation in 2015
Dentists are the primary users of dental laboratories. Dental laboratories also provide services to other industry operators. For example, industry operator Glidewell Laboratories markets industry products to dentists and laboratories, providing the former with prescription services and the latter with laboratory coping outsourcing services. Other services include providing record- keeping services.