DHMO

A DHMO, or Dental Health Maintenance Organization, pays a dentist a flat monthly amount (called capitation) for every patient assigned to that office, whether or not the patient ever comes in, rather than paying a fee for each procedure the way a PPO or fee-for-service plan does. Some procedures on top of the capitated basics may be reimbursed on a separate low fee schedule, but the core economics of a DHMO are built around covering a population, not billing individual visits.

DHMO patients also typically must choose the practice as their designated provider and generally cannot see an out-of-network dentist without losing coverage entirely, which is a meaningfully different relationship than a PPO patient has with a plan. That makes the volume-versus-fee tradeoff even more binary than with a PPO: the practice is either accepted into the network and receiving the capitation and assigned patients, or it isn't in the arrangement at all.

Because the payment structure is so different from fee-for-service dentistry, DHMO participation should be evaluated on its own terms (patient volume and per-member economics) rather than compared directly against a PPO's fee-schedule discount using the same math.