If you’ve been hearing more and more chatter about dentists terminating their PPO contracts, you’re not imagining it — this is a real trend. Across the country, more doctors are choosing to step away from low-paying insurance plans in favor of a more sustainable model of patient care and practice profitability.

But the big question is:

Is this the right move for you?

If you're frustrated with shrinking reimbursements, rising overhead, and feeling like you're working harder for less, this article will help you explore whether it's time to rethink your insurance participation strategy.

The Problem: PPO Plans Are Squeezing Profitability

For many dentists, the decision to drop plans stems from one major pain point:
In-network fees are no longer sustainable.

• Reimbursements haven’t kept pace with inflation or overhead

• PPO discounts often cut 30%–50% off UCR fees

• Time spent on administration, denials, and appeals continues to rise

• Some plans undervalue complex procedures like extractions, crowns, or full arch cases

In short: many plans simply don’t pay enough to cover the time, expertise, and attention required to provide quality care.

The Trend: Yes, More Dentists Are Opting Out

What used to be considered a risky move is now becoming a strategic shift for practices looking to regain control.

Nationwide, more doctors are:

• Terminating low-paying PPOs

• Going out-of-network selectively

• Offering in-house membership plans as an alternative for uninsured patients

• Building fee-for-service (FFS) models focused on patient experience and value

Organizations like the ADA and state dental associations have confirmed that there is a noticeable uptick in PPO terminations, particularly in metro areas and among established practices with loyal patient bases.

Should YOU Terminate Insurance Plans?

Here’s a framework to help you decide:

You should consider dropping plans if:

• Your in-network fees don’t cover your hourly chair cost

• You have a strong patient base that trusts your care

• You want more time with each patient without financial pressure

• You’re seeing higher collection rates from out-of-network patients

• You’re ready to invest in marketing and patient education

You may want to hold off if:

• You rely heavily on insurance for new patient flow

• Your practice is still in early growth mode

• Your demographics skew toward high PPO dependence

• You don’t yet have a strategy for transitioning patients

What Other Doctors Are Saying

Many doctors who have dropped plans report:

• Increased profitability per patient (even with fewer patients)

• Improved work-life balance, with less burnout

• Stronger patient relationships based on trust, not insurance restrictions

• A renewed sense of clinical freedom and purpose

But they also note that the transition requires:

• A clear patient communication plan

• Confident scripting from the front desk

• A commitment to ride out the transition phase

Tips If You Decide to Move Forward

1. Audit all your plans
   Identify the ones with the lowest reimbursements and highest headaches.

2. Start with one or two PPOs
   You don’t need to drop everything at once. Start by phasing out the worst performers.

3. Notify patients the right way
   Emphasize that you're still happy to see them — just not under contract with the insurer. Help them understand out-of-network benefits and how you’ll support them.

4. Train your team
   Give your front desk and treatment coordinator scripts and confidence to explain your value, not just your fees.

5. Implement a membership plan
   Offer uninsured or insurance-dropping patients a simple, affordable alternative with clear preventive care benefits.

Final Thoughts

Yes, the trend is real — and it’s growing. More dentists are deciding that the cost of staying in-network outweighs the benefits. If your PPO contracts are eating into your time, your quality of care, and your profitability, it may be time to explore life outside the network.

But don’t go in blindly. With the right plan, communication, and strategy, going out-of-network can be one of the most empowering decisions you make for your practice, your team, and your patients.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com