What Medicaid and Medicare Cuts Could Mean for Dentistry — Especially If You’re Starting Out
By Maritza Duran | Startup Strategist for Dentists | Research-Lover (Not a CPA)
You know I’m not one to panic about headlines—but I do like to stay informed so I can prepare myself, and help the dentists I support prepare too.
Over the past few weeks, I’ve been digging into the tax legislation passed on July 4, 2025. While most of the headlines focus on tax brackets and deductions, there’s another ripple effect happening that we need to talk about: the impact of projected Medicaid and Medicare budget changes.
This may not seem urgent if you’re focused on building or buying your first practice—but it is. These programs affect not only your patients, but also your cash flow, your collections, and how your business survives in a tightening economy.
🧩 What’s Changing: Federal Spending Priorities Are Shifting
While the tax changes didn’t specifically rewrite Medicaid or Medicare rules, they signal a broader reality:
- Medicaid expansion incentives are ending or shrinking in many states
- Reimbursements to providers may stagnate or decline
- Budget pressures could reduce patient access or shift eligibility
And these changes don’t happen in isolation.
They happen in a climate of:
- Rising inflation
- A cooling job market
- Skyrocketing student debt among young dentists
So what does that mean for someone building their first practice—or trying to grow a small, community-based one?
🧠 What This Could Mean for Dentists
1. Lower Reimbursements = More Financial Pressure
If you accept Medicaid or plan to serve patients in lower-income communities, a reduction in reimbursement rates could mean you’re collecting less for the same amount of work.
Example:
If your Medicaid reimbursement for a cleaning drops from $60 to $50, and you see 10 patients a day, that’s a $500 loss per week — $2,000 per month — without changing a single thing.
2. More Patients = Less Profit (If You’re Not Careful)
If private practice providers pull out of Medicaid networks due to lower reimbursement, more patients will come to you. But more volume doesn’t automatically mean more profit.
Example:
You may find your schedule packed, your team overworked, and your revenue not moving. If your fee schedules aren’t optimized or your operational systems aren’t efficient, this can burn you out quickly.
✅ Tool: Review your PPO and Medicaid contracts now. Consider running a fee schedule analysis before these pressures hit hard in 2026.
3. Delayed or Denied Coverage = Unhappy Patients
If funding tightens, your patients may experience more delays, eligibility denials, or treatment limitations. This creates frustration, missed appointments, and canceled treatment plans.
Example:
A mom who previously qualified for her son’s ortho consult might lose access, and she may blame your office — even if the system is at fault.
✅ Tool: Train your front desk team on empathetic scripting for insurance changes. (If you need help, I can share a simple resource.)
🎓 For Young Dentists With Student Debt: The Stakes Are Higher
Let’s be real: Most of my clients in their 30s have six-figure student loans. They’re not just launching a practice—they’re managing:
- Personal debt
- Practice loans
- Payroll
- Family responsibilities
If economic uncertainty rises and patient payments slow down, your margin for error shrinks.
💡 This is why I always recommend building a strong operational foundation — especially around collections, insurance verification, and treatment acceptance.
🔄 What Can You Do Now?
- Run a Medicaid/PPO Reimbursement Audit
If you’ve never done one, now’s the time. Don’t wait until 2026 to find out you’re underpaid. - Clarify Your Patient Mix Strategy
Are you relying too heavily on public payers? Consider slowly rebalancing with fee-for-service options or in-house plans. - Educate Your Patients Proactively
Add a short explanation to your intake paperwork about the changing healthcare landscape and your efforts to provide quality care despite insurance shifts. - Join a Mastermind or Advisory Group
Surround yourself with dentists who are navigating the same challenges—and be willing to ask for help.
🧠 Final Thought: Be Proactive, Not Reactive
No one can control the economy or legislation. But you can control your preparation. You can build a practice that’s efficient, profitable, and resilient — even in a shifting system.
This is what I help my clients do every day.
You don’t need to panic. But you do need a plan.
Link to the resources: