Introduction
As a dentist, facing a slow practice can be stressful. A decline in patient volume can impact your revenue, staff morale, and long-term business sustainability. One solution many dentists consider is joining PPO (Preferred Provider Organization) plans to attract more patients. While PPO participation can increase patient flow, it also comes with lower reimbursements and contractual obligations.

Before making a decision, it’s important to weigh the pros and cons of joining PPO networks and explore alternative strategies to grow your patient base.

Pros of Joining PPO Plans

• Increased Patient Volume

  • PPO plans have large patient networks, and many people choose their dentist based on in-network providers to minimize out-of-pocket costs.

  • Being part of a PPO can help bring new patients who might not have considered your practice otherwise.

• Competitive Advantage Over Non-PPO Practices

  • Patients looking for a new dentist often search for in-network providers first.

  • If other dentists in your area are non-PPO, joining a PPO may give you an advantage in attracting those patients.

• Faster Appointment Booking for New Patients

  • Patients with insurance tend to schedule treatment faster than cash-pay patients.

  • Many PPO patients prioritize covered treatments, leading to quicker case acceptance.

• Potential for Upselling and Retention

  • While PPO fees are lower, once a patient is in your chair, you can offer:

    • Elective treatments (teeth whitening, cosmetic procedures).

    • High-value services (implants, Invisalign, sedation dentistry).

    • Membership or loyalty programs for uninsured services.

Cons of Joining PPO Plans

• Lower Reimbursement Rates

  • PPOs dictate fee schedules, which are often 30-50% lower than your standard fees.

  • Accepting reduced fees can strain profitability, especially if overhead costs are high.

• Increased Administrative Burden

  • More paperwork, claim submissions, and insurance rejections can slow down operations.

  • Some PPOs require pre-authorizations or post-op documentation that delays payments.

• Write-offs Can Hurt Profit Margins

  • If your usual crown fee is $1,200, but a PPO only reimburses $750, you’re writing off $450 per crown.

  • With high write-offs, you must see more patients to maintain the same revenue level.

• Risk of Overdependence on PPO Patients

  • If your patient base becomes PPO-dominant, you may have less control over pricing and treatment plans.

  • PPOs can change fee schedules or policies, impacting your profitability long-term.

Key Considerations Before Joining a PPO

• Evaluate Your Current Patient Base

  • Are most of your patients fee-for-service (FFS), or do they already use insurance?

  • What percentage of new patients ask about PPO participation?

  • If a majority of potential patients are PPO-dependent, joining may be beneficial.

• Analyze the PPO Fee Schedule

  • Request the fee schedule before signing a contract.

  • Compare PPO reimbursement rates vs. your UCR (Usual, Customary, and Reasonable) fees.

  • Will you profit or break even based on your current overhead costs?

• Consider Hybrid Participation Strategies

  • Instead of joining multiple PPOs, start with one or two major networks and analyze performance.

  • Explore umbrella PPO networks (e.g., Connection Dental, Zelis, Dentemax) that let you join multiple plans with one contract.

  • Negotiate better PPO reimbursement rates where possible.

Alternatives to Joining PPOs

If you’re hesitant about joining a PPO but still want to grow your practice, consider these strategies:

• Strengthen Your Marketing Efforts

  • Improve your Google My Business listing for better local search rankings.

  • Offer online scheduling to attract busy patients.

  • Run targeted social media ads promoting services like implants, Invisalign, or teeth whitening.

• Develop an In-House Membership Plan

  • Many patients without insurance still want affordable care.

  • Offer a membership plan with preventive care included and discounts on other treatments.

• Enhance the Patient Experience

  • Implement same-day dentistry (e.g., CEREC crowns) to attract patients who want fast treatment.

  • Offer financing options like CareCredit to make high-cost treatments more accessible.

  • Train staff on converting price-shoppers into loyal patients.

• Network with Local Businesses for Employee Dental Plans

  • Offer customized dental packages for small businesses that don’t provide traditional insurance.

  • This can create a steady patient base without relying on PPOs.

• Ask for PPO Fee Negotiations

  • Some PPOs allow negotiation, especially if you’re in an area with limited providers.

  • Highlight factors like:

    • Unique services (IV sedation, full-mouth reconstructions).

    • A high volume of PPO patients.

    • Your willingness to drop their network if fees are too low.

Final Verdict: Should You Join a PPO?

Join a PPO if:

• Your patient volume is low, and you need immediate growth.

• You are willing to increase efficiency to compensate for lower fees.

• You can use PPO participation as a short-term strategy while building other revenue streams.

Avoid PPOs if:

• Your practice is already financially stable with fee-for-service patients.

• You cannot handle high patient volume due to space or staffing limitations.

• PPO reimbursements do not cover your overhead costs.

Conclusion

Joining a PPO can be an effective way to increase patient flow, but it comes with financial trade-offs. Before making a decision, evaluate your practice’s financials, negotiate fee schedules, and explore alternative growth strategies.

If your practice is slow, PPOs can provide a short-term boost, but long-term success comes from strong marketing, patient retention, and high-value service offerings.

Would you like a PPO fee schedule comparison template to help analyze potential plans? Let me know!