Dental PPO networks continue to grow significantly according to NetMinder data. The average size of the top 15 dental PPO networks has grown substantially from 2008 to 2012, as has the number of locations per dentist. However, some of the reported access points may be overstated as claims data indicates around 41% of access points have not seen patients in the last 12 months. Market penetration is also increasing, though there is still room left for network growth as contracted providers make up only around 37% of available providers. Network utilization and effective discount growth have improved but at a slower rate than network expansion.

1. NETMINDER DATA REVEALS
SIGNIFICANT DENTAL
PPO TRENDS

2. NetMinder data reveals significant dental PPO
trends
Dental PPO networks continue to grow
Market penetration is also growing, and
there is still room for more
Network utilization is improving, but at a
slower rate than network growth

3. PPO networks continue to grow in size
Average National PPO Trends
Top 15 PPO Network
180,000 2.50
2.25
And the number oflocations foreachgrowing even faster
Resulting in more contracting eachyear
More dentists are access points is dentist
160,000
2.01
1.92
Average Locations Per Dentist
1.86 2.00
Average National Network
140,000
1.75
120,000
1.50
100,000
80,000
1.00
60,000
40,000
0.50
20,000
0 0.00
Mar-08 Mar-09 Mar-10 Mar-11 Mar-12
Unique Dentists Access Points Locations Per Dentist

4. There is concern that access points may be
overstated
 Using claims data, we are
able to identify practicing Confirmed Unconfirmed
Practicing Locations Per
locations (i.e. the dentist Locations Per Dentist
has practiced there in the Dentist 0.92
1.34
last 12 months).
 41% of the access points –
Confirmed
almost 1 location per dentist Practicing
Unconfirmed
– are unconfirmed. Access Points
Access Points
66,303
96,823
0% 20% 40% 60% 80% 100%
Percent of Average National PPO Network

5. Market penetration also continues to grow
Average PPO Network Penetration
Top 15 PPO Networks
80,000 45.0%
70,000
Penetration
Penetration 40.0%
60,000 37.8%
37.2%
Universe Penetration
Penetration
35.1%
Unique Providers
50,000 Penetration 35.0%
32.7%
40,000
Penetration
28.1% 30.0%
30,000
20,000
25.0%
10,000 Contracted Contracted Contracted Contracted Contracted
Providers Providers Providers Providers Providers
49,669 54,475 60,055 66,575 72,372
0 20.0%
Mar-08 Mar-09 Mar-10 Mar-11 Mar-12

6. Because providers are joining more networks
PPO Networks Per Provider
9.0 8.4
8.0 8.1
8.5
Average Number of PPO Networks
8.0
7.2
7.5
7.0
6.5
5.9
6.0
5.5
5.0
4.5
4.0
Mar-08 Mar-09 Mar-10 Mar-11 Mar-12

7. Though there is still plenty of room for network
growth
Average National Dental PPO Network
Contracted
Providers
72,372
Available
Providers
119,148

8. Network utilization is as important as network size
Effective
9.3%
Network utilization and
Discount Growth effective discount growth are
consistent
Network Unconfirmed Suggesting overstated
8.9%
Utilization Access Points? directories
Growth
16.2% Both lag network size
Access Point Growth
growth
0.0% 5.0% 10.0% 15.0% 20.0% 25.0%
Source: Ruark Dental PPO Network Study, 2010 Edition

9. In summary, dental PPO networks continue to
evolve
Network growth continues
Market penetration is also increasing
Effective discounts continue to improve

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