Insurance giant’s recent acquisition of Wisconsin dental practices may be violating antitrust law

Back in July, the ADA expressed concern after insurance giant Delta Dental of Wisconsin (DDWI) purchased a chain of dental practices known as Cherry Tree Dental. According to the ADA, giving an insurance company autonomy over a health-care practice threatens both the quality and accessibility of patient care; oftentimes, business-minded companies aim to maximize profit at the cost of offering quality treatment.¹

Risks accompanying DDWI's acquisition

At the time of the acquisition, DDWI vice president and chief dental officer Greg Theis promised that Cherry Tree Dental would still be independently run, with DDWI having no influence over patient care decisions.

Now, however, the American Economic Liberties Project (AELP) and the Alliance of Independent Dentists have called for an investigation into the insurance company. On August 19, they sent a letter to the Federal Trade Commission, the Department of Justice Antitrust Division, and Wisconsin Attorney General Josh Kaul.²

Cause for investigation

According to a press release by AELP, "the letter concludes with a legal analysis showing that DDWI's acquisition of Cherry Tree Dental practices may violate Section 7 of the Clayton Act and should be flagged under the 2023 Merger Guidelines issued by the DOJ and FTC."²

The Clayton act is designed to stop monopolization and allow for equal opportunity for market competition. DDWI's acquisition may violate this act because it poses the following risks, per the AELP and Alliance of Independent Dentists' letter:

• "Likely would limit access to services that rival insurers and dental practices use to compete.

• Involves an already dominant firm-DDWI -attempting to extend its dominance to the dental practice and DSO markets in Wisconsin.

• Heightens the risk of concentration in three increasingly consolidated industries."²

In the letter, they noted that the DDWI acquisition is the first of its kind in the state; prior to the purchase, dental providers have never been owned by an insurance company in Wisconsin. Emma Freer, senior policy analyst for health care at AELP, outlined why this is dangerous, writing: "Vertical integration between major players from three increasingly consolidated health-care industries also poses serious conflicts of interest, endangers public health, and lessens competition in violation of federal antitrust laws."³

Jill Tanz, DDS, president of the Association of Independent Dentists, has echoed this concern, pointing out the incongruent scope of influence between DDWI and Cherry Tree Dental. She said: "Allowing insurance companies or private equity firms to control health-care delivery undermines clinical judgment and erodes trust. To protect patients, all states should prohibit such ownership arrangements and eliminate these conflicts of interest that are detrimental to public health."²

Power wielded by DDWI may be dangerous

DDWI is a large company and holds significant stock in more than just Cherry Tree Dental. Not only is it Wisconsin's dominant dental insurer, with a dental health plan covering more than 2.6 million residents and a provider network including more than 90% of Wisconsin dentists, but DDWI is also integrated with other dental health entities. It owns Encara (a company that markets individual dental plans), Wyssta, Inc. (a company that subsidizes a vision insurer, a health-care benefits manager, and a venture capital firm whose investments include treating antibiotic-resistant bacterial infections), and co-owns NorthWinds Technology Solutions, which offers IT services related to dental claims processing.²

AELP is behind the Break Up Big Medicine initiative to help liminate conflicts of interest and vertical integration issues that drive up costs and lower the quality of health-care.

References

1. Butkovic S. New acquisition puts ADA on edge, raises concern for patient treatment. DentistryIQ. July 7, 2025. https://www.dentistryiq.com/dentistry/research-and-news/news/55301613/new-acquisition-puts-ada-on-edge-raises-concern-for-patient-treatment

2. Economic liberties, alliance of independent dentists call for investigation of unprecedented dentistry vertical merger. American Economic Liberties Project. Press release. August 21, 2025.

3. Delta Dental of Wisconsin's recent acquisition of Cherry Tree Dental. Wisconsin Department of Justice. August 19, 2025. https://www.economicliberties.us/wp-content/uploads/2025/08/AELP-AID-Letter-Re-DDWI-Cherry-Tree-Dental-Aug-2025.pdf