Inflation is hitting dental practices hard. Rising staff wages, supply costs, and overhead expenses are squeezing profitability, yet PPO reimbursements remain stagnant. As a dentist, you may feel stuck between maintaining quality patient care and keeping your business financially healthy. So, how do you navigate these challenges? Here’s a strategic approach to managing wage inflation and overall rising costs while working within PPO constraints.

1. Optimize Your PPO Strategy

While you can’t control PPO fee schedules, you can take steps to maximize revenue:

Negotiate PPO Reimbursement Rates

• Many insurance companies will negotiate fees, especially if you have a strong production history or competing offers.

• Focus on negotiating your most common procedures (e.g., D0120, D0140, D1110, D2740) to get the most impact.

• Consider working with PPO negotiation services if you’re unsure how to approach this process.

Drop the Worst PPOs

• Identify which PPOs have the lowest reimbursements and highest write-offs.

• Gradually phase them out while strengthening your fee-for-service and out-of-network patient base.

• Offer in-house membership plans to retain patients who lose in-network benefits.

2. Adjust Fees for Non-PPO Patients

Even if your PPO reimbursements are fixed, you have control over your full-fee schedule for out-of-network patients and procedures not covered by insurance.

• Increase UCR Fees (Usual, Customary, and Reasonable Fees) – Adjust your standard fees annually to keep up with inflation.

• Focus on High-Value Procedures – Shift marketing and case acceptance strategies toward more profitable treatments like implants, clear aligners, and cosmetic dentistry.

• Charge for Non-Covered Services – Many PPOs allow for additional fees on services not covered by insurance, such as upgraded materials or advanced technology.

3. Control Wage Increases While Retaining Staff

With wage inflation, balancing staff satisfaction and financial sustainability is critical.

Strategic Wage Adjustments

• If across-the-board raises aren’t feasible, consider performance-based bonuses instead of fixed raises.

• Offer profit-sharing incentives to align staff motivation with practice success.

Boost Efficiency to Offset Wage Costs

• Invest in technology and automation (e.g., AI-powered charting, automated patient reminders) to reduce workload and increase productivity.

• Cross-train staff to improve efficiency and reduce dependency on hiring additional employees.

• Use staggered scheduling to manage peak hours while minimizing unnecessary payroll costs.

4. Reduce Overhead Without Sacrificing Quality

Supplies & Lab Costs

• Negotiate pricing with suppliers or consider group purchasing organizations (GPOs) for bulk discounts.

• Explore alternative vendors that offer quality materials at lower costs.

Office Expenses

• Review contracts with vendors and service providers (waste management, software subscriptions, etc.) to renegotiate rates.

• Switch to energy-efficient equipment to cut utility costs.

5. Improve Case Acceptance & Production Efficiency

Maximize Chair Time

• Reduce no-shows and cancellations by improving pre-appointment confirmations and implementing a cancellation policy.

• Consider extending hours on high-demand days instead of adding extra workdays.

Train Staff on Case Presentation

• Improve case acceptance by educating patients on treatment value rather than relying on insurance limitations.

• Offer financing options (CareCredit, in-house payment plans) to remove cost barriers for patients.

Final Thoughts: Adapt and Thrive

While you can’t control PPO reimbursement stagnation globally, you can take proactive steps to protect your practice’s profitability. Negotiating PPO fees, optimizing your fee structure, managing wage inflation wisely, and improving operational efficiency will help you stay ahead of rising costs.

Would you like help evaluating your PPO contracts or crafting a script for discussing fees with patients? Let me know how I can assist!