Wade Banner, DDS, is reshaping dental practice ownership in Southern California through a hybrid care model that combines a mobile house-call service with a purpose-built dental clinic. The approach is designed to improve access to dental care for patients with complex medical, developmental, and cognitive conditions who often struggle to receive treatment in traditional clinical environments.
The system integrates two care delivery methods: portable dentistry services that bring treatment directly to patients in homes and care facilities, and a specialized brick-and-mortar clinic designed for individuals requiring advanced accommodations.
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Banner developed this model during his training at Western University of Health Sciences, College of Dental Medicine in Pomona, California, where he treated special-needs patients at a regional care center. After graduation, he continued providing house-call dentistry after his supervising dentist retired and the facility requested ongoing services.
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“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.
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Building a Mobile Dental Practice
Establishing a financially sustainable mobile dental practice proved to be one of the most challenging phases of Banner’s career. To support the early years, he worked as an associate dentist in private practice and served as adjunct clinical faculty at his alma mater.
He also worked to build referral networks for special-needs patients, many of whom reside in assisted living facilities or require coordinated care involving multiple healthcare providers.
In 2014, Banner founded In Motion Dentists, later acknowledging that his early projections 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,” he said. “Finding consistent referral sources and building trust with facility representatives was challenging.”
Operating a mobile dental practice also required complex logistics, including managing multi-site scheduling, coordinating medical consultations, and treating patients with significant health conditions.
Banner advises early-career dentists to prioritize financial preparation 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 work as highly rewarding. “It’s fun. You get to meet grateful patients in a different environment every day.”
Expansion Into a Dedicated Dental Clinic
After seven years of mobile practice, Banner expanded his model in August 2021 by opening a dedicated clinic in response to increasing regional demand for specialized dental care.
The clinic was designed specifically for patients with special needs and was partially funded through a grant that covered approximately 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 require sedation to safely complete dental treatment.
At Elevated Dentistry, around 70% of patients have special needs. The mobile practice serves patients across Los Angeles, San Bernardino, Riverside, and San Diego counties, with approximately 95% classified as special-needs cases.
Due to treatment complexity, clinicians typically see fewer patients per day, with mobile appointments averaging four to six patients daily.
Medi-Cal Coverage and Reimbursement Challenges
A significant portion of Banner’s patients are covered by Medi-Cal Dental. At Elevated Dentistry, about half of patients are Medi-Cal beneficiaries, while others are covered by PPO insurance or pay out of pocket. The mobile practice is funded through Medi-Cal reimbursement, insurance, and cash payments.
“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 challenges with reimbursement, particularly for behavior management services, but said collaboration with the California Department of Health Care Services improved documentation standards and payment accuracy.
Banner emphasized the importance of detailed clinical documentation, especially imaging, to ensure proper reimbursement for procedures such as scaling and root planing.
“Paying close attention to documentation, especially with images, is key to receiving proper payment,” he said.
Advocacy and Policy Concerns
While Banner acknowledged Medi-Cal’s relative accessibility compared to some private insurance systems, he expressed concern about potential funding reductions and their impact on vulnerable populations.
He warned that cuts to Medi-Cal Dental funding could significantly reduce access to care for seniors, children, and individuals with disabilities.
Banner has engaged with regional centers and advocacy groups and contributed to coalition letters directed at 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 systemic challenges, including rising costs and reimbursement limitations, calling for reforms to better support providers serving high-need populations.
A Patient-Centered Hybrid Model
Despite operational complexity, Banner describes the hybrid model as both impactful and rewarding for patients and staff.
In many cases, family members of special-needs patients also become patients, strengthening continuity of care within the community.
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“I have a dedicated team who begin and end their day with a sense of fulfillment,” he said. “We provide the same experience and quality of care regardless of payer type, and this brings joy to the patients and the team.”
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