Franchise Dental Office Promises to Serve Low-Income Patients

KANSAS CITY, Kan. – Last year, in an attempt to bring services to underserved communities, Kansas liberalized rules against corporate ownership of dental practices.

And on Aug. 28, amid promises to serve hundreds of low-income clients, Colorado-based Comfort Dental opened its first Kansas franchise here in a strip shopping center along the busy State Avenue corridor.

The company has a simple philosophy, said founder and chief executive Dr. Rick Kushner: “Be open, make it cost less and be nice to people.”

Established more than three decades ago, Comfort Dental operates in 10 states. The Kansas City, Kan., office is its 100th clinic.

The Kansas Dental Board, which licenses and regulates the state’s dentists, has registered eight practices with a total of 13 dentists under the corporate dental legislation signed by Gov. Sam Brownback in May 2011.

It’s unclear how many of these practices started because of the dental franchising law, said dental board Executive Director Lane Hemsley.

The two dentists that own the Kansas City, Kan., franchise, Drs. Don Mardis and Matt Tingey, are new to the state. They transferred from Comfort Dental clinics in Colorado.

Dr. Anthony Callison in Olathe is the only other dentist of the 13 to have earned a Kansas license since the law took effect. He is a franchisee of Oklahoma-based Advanced Dental Implant and Denture Center.

Some of the other dentists have held licenses for more than 30 years, though Hemsley said they could’ve been practicing in another state and perhaps been drawn back because of the new law.

Under the new law, franchisors can provide support services to their dentists, such as billing and marketing. But they cannot be involved with functions like treatment decisions for patients.

Hemsley, who has been on the job since December, said the board routinely investigates fraud complaints against sole practitioners and nothing suggests that corporate-affiliated dentists are more prone to fraud “than the guy down the street working by himself.”

Comfort Dental officials were among the chief proponents of amending the state’s categorical exclusion of corporate-owned dentist offices.

The company worked with the Kansas Dental Association to overcome that group’s initial skepticism about changing the law.

In late 2010, amid early discussions of the legislation, KDA Executive Director Kevin Robertson said his members were concerned about the potential for fraud and abuse by corporate owners bent on maximizing profits instead of providing quality care.

House and Senate negotiators included the dental franchising language in an omnibus health care measure they agreed upon late in the 2011 session.

Of the 105 counties in Kansas, 93 face dental workforce shortages, according to a June report issued by the Kansas Board of Regents Oral Health Task Force.

In a typical Comfort Dental office, Mardis said about half the patients are on Medicaid.

According to Kushner, a new Comfort Dental franchise can grow by 200 patients a month before tapering off as it matures.

Comfort Dental dentists reap financial benefits from working evenings and Saturdays, Kushner said. And, he said, that additional patient volume allows franchises to offer lower prices than competitors.

He said an average Comfort Dental dentist earns about $360,000 a year (not including the consulting fees paid to corporate or collected from new dentists entering the practice).

That is nearly three times what the average dentist earns in Kansas, according to the 2012 wage survey from the Kansas Department of Labor.

Greeting the new dentists at the open house here last week were Kansas House members Tom Burroughs, a Democrat from Kansas City, Kan., and Barbara Bollier, a Mission Hills Republican, along with Sen. Vicki Schmidt of Topeka, who is chair of the health committee.

“We all know good dental health leads to quality health,” Burroughs said.

Bollier and Schmidt lauded Comfort Dental for catering to Medicaid patients.

“It’s a great model,” Bollier said. “I’m very pleased to have them here.”

Kushner, meanwhile, showed little reluctance to wade into another politically charged dental battle – that of expanding access by allowing midlevel providers to perform basic procedures.

That’s something KDA opposes, but Kushner said, “I’m desperately in favor of that.”

The Health Forward Foundation is proud to partner with the Kansas Health Institute news service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. This News Service is an editorially independent program of the Kansas Health Institute and the Health Forward Foundation and is committed to objective coverage of health issues.

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