Most independent dental and medical practices are feeling confident about their future revenue growth and dental practices are particularly bullish, according to a new study out of Citizens Bank.

According to the Citizens Bank Healthcare Outlook Study, 72 percent of small, privately held dental practices anticipated higher revenues over the next five years, compared with 37 percent of similarly sized medical practices.

“In addition to the critical roles they play in providing health care services, independent medical and dental practice groups run very sophisticated businesses with complicated cash flow dynamics and a lot of opportunities to either get it right or get it wrong when it comes to managing the bottom line,” Lisa Enright, director of the Citizens Bank’s health care practice banking group, said in a statement. “This research shows that, as they grapple with changing regulations, challenging insurance payment plans and advances in technology, medical and dental practices also are increasing their focus on operational excellence and strategies for profitability. Whatever their prospects for top-line revenue growth, health care providers increasingly recognize the importance of sharpening their focus on financial management.”

Insurance posed a particular challenge for medical practices, with about two-thirds of those surveyed reporting that current insurance plans are driving down profit margins. Three in five surveyed pinned some of the blame on cheaper, employer-sponsored health insurance plans, which cause patients to put off care and medical practices to receive less reimbursement for services. Six in 10 of those medical practices surveyed said that static or declining insurance reimbursements were compressing their profit margins.

Dental practices reported similar headaches with respect to insurance, but they also cited upgrades to technology and marketing as particular struggles.

About a third of all practices surveyed anticipated staffing levels to increase over the next five years, while 71 percent expect patient levels to increase – a potential future strain on the quality of care.

In its study, Citizens highlighted six areas of focus for health care practice group leaders who want to increase profits: cash flow management, establish a line of credit, human resource management, marketing support, technology upgrades and a better understanding of the competitive landscape.

The bank surveyed 450 medical and dental practices with fewer than 10 doctors or dentists and revenues between $500,000 and $5 million for the study.