Wade Banner, DDS, is taking an unconventional approach to dental practice ownership by combining a portable house call service with a custom-built brick-and-mortar clinic in Southern California. The integrated model is designed to expand access for patients with complex and special needs.
Banner’s journey began during his training at Western University of Health Sciences, College of Dental Medicine in Pomona, California, where he participated in treating patients with special needs at a regional care center. After graduation, when his supervising dentist retired, the center asked him to continue providing house call dentistry.
“I determined that having a portable practice for house calls or facility patients would be easier and provide the flexibility to offer a wide array of services in different environments,” Banner said.
Building a portable practice from the ground up
Establishing a financially sustainable mobile dental practice proved to be the most challenging stage of Banner’s career. To support the early startup phase, he worked as an associate dentist in private practices and also served as adjunct clinical faculty at his alma mater.
Building a referral network for patients with special needs added another layer of complexity. These patients often include seniors in assisted living or home care settings, requiring coordinated medical and logistical support.
He later founded In Motion Dentists in 2014, but acknowledged that early expectations for patient volume and revenue growth were overly optimistic.
“In hindsight, I would have added more cushions for the start-up phase because my initial business plan was a bit optimistic on patient volume and revenue ramp-up. Finding consistent referral sources and building trust with facility representatives was challenging,” he said.
Managing mobile care required significant coordination, including scheduling complexity, medical consultations, and handling patients with multiple health conditions.
Banner advises early-stage dentists to prepare a strong financial runway and invest in relationship-building with assisted living facilities, regional centers, and community organizations.
“Also be ready to wear a lot of hats as it is more than just clinical work,” he said.
Despite the challenges, he describes the experience as rewarding.
“It’s fun. You get to meet grateful patients in a different environment every day.”
Expanding into a purpose-built clinic
In August 2021, after seven years operating a mobile practice, Banner opened a brick-and-mortar clinic in response to growing regional demand for specialized dental care.
The clinic was designed specifically for patients with special needs, supported in part by a grant that covered roughly one-third of startup costs.
Patients include individuals with intellectual and developmental disabilities, physical limitations, and cognitive conditions such as dementia and Alzheimer’s disease, many of whom require sedation for safe treatment.
At Elevated Dentistry, approximately 70% of the caseload consists of special-needs patients. The mobile practice operates across Los Angeles, San Bernardino, Riverside, and San Diego counties, with about 95% of patients having special needs.
Due to the complexity of care, clinicians typically see fewer patients per day, with mobile appointments ranging from four to six patients daily.
Medi-Cal participation and access to care
A significant portion of Banner’s patients rely on Medi-Cal Dental coverage. At Elevated Dentistry, about half of patients are Medi-Cal beneficiaries, while others are covered by PPO plans or pay out of pocket.
In the mobile practice, funding comes from dental insurance, cash payments, and Medi-Cal reimbursement.
“Ninety-five percent of the regional center’s clientele has Medi-Cal, so to continue meeting this population’s need for care, I need to be a Medi-Cal provider,” Banner said.
He noted early reimbursement challenges, particularly with behavior management fees, but said collaboration with the Department of Health Care Services improved documentation and payment accuracy.
He also emphasized the importance of detailed clinical records, especially imaging, to avoid reimbursement downgrades commonly seen in procedures such as scaling and root planing.
“Paying close attention to documentation, especially with images, is key to receiving proper payment,” he said.
Policy concerns and advocacy
While Banner praised the accessibility of Medi-Cal billing compared to private insurance systems, he expressed concern about potential funding reductions and their impact on vulnerable populations.
He warned that proposed Medi-Cal Dental budget cuts could significantly limit access to care for seniors, disabled individuals, and children.
Banner is actively working with regional centers and advocacy groups, including submitting coalition letters to policymakers.
“As lawmakers consider these cuts, I will stress that seniors, disabled persons and children are very vulnerable and that maintaining dental care is vital to their overall health,” he said.
He also highlighted broader challenges such as rising costs and insurance reimbursement limitations, calling for systemic improvements to support providers.
A model focused on patient impact
Despite operational complexity, Banner describes his hybrid model as highly rewarding.
Family members of patients with special needs often become patients themselves, strengthening continuity of care within the community.
“I have a dedicated team who begin and end their day with a sense of fulfillment. We provide the same experience and quality of care regardless of payer type, and this brings joy to the patients and the team,” he said.
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