But at a time when HMO profit margins are sagging, most managed medical care companies aren't falling over one another to buy their way into the dental market. That may yet change if cash flow improves and if dental HMOs and preferred-provider organizations continue their stellar expansion. Managed dental plan enrollment is growing at about 15 percent a year, outstripping managed medical plans' growth. And it's not as if the medical companies haven't taken notice. HealthPartners is rare in that it has its own dental network.
Pediatricians can help the dental part of the company identify infants at high risk for caries.
But Marshall warns that medical and dental payers will offer cohesive care only after they agree on coverage of dental disease stemming from medical illness or treatment. Neither side likes to pay for what it views as the other's responsibility. Take radiation treatment for head and neck cancers. One side effect is tooth decay, but many patients have no coverage. Marshall says the ADA would be leery of any trend toward combined health and dental benefits, particularly if dental benefits provided through a health plan were limited.