The fear that dropping a PPO means losing patients is the single biggest reason practices stay in unfavorable contracts longer than they should.
We hear it on almost every consultation call: “I’d love to drop them, but I’m afraid of losing patients.”
It’s a reasonable fear. It’s also, in most cases, an overestimated one. Dropping a PPO doesn’t have to mean losing the patient base — and in many of the practices we’ve worked with, careful drops have resulted in net patient gain, not loss.
The difference is in the strategy.
Why dropping a PPO doesn’t have to mean losing patients
Two patient groups exist within any PPO panel:
- Patients who came to the practice because of the PPO
- Patients who came to the practice and happen to be on the PPO
The first group is harder to retain after dropping. The second group, in our experience, rarely leaves. They came for the dentist, the team, the location, or a referral — and the insurance was incidental.
In most established practices, the second group is significantly larger than the first.
The data analysis that makes dropping safer
A strategic drop is preceded by data:
- How many patients are actively covered by the PPO being considered
- What percentage of total practice production those patients represent
- Of those patients, how many came in via PPO directory vs. other sources
- The carrier’s reimbursement rate compared to the practice fee schedule
- The write-off cost of remaining in network vs. the projected loss of dropping
When this analysis is done well, the actual risk profile becomes clear. Often, the risk is much smaller than the practice assumed.
Communication strategy for affected patients
Patient communication is where strategic drops succeed or fail. The patients on the affected PPO need to hear from the practice — not from their insurance carrier — and they need to hear it framed correctly.
A clear communication includes:
- Notice that the practice will no longer be in network with the carrier, effective date X
- An explanation that the practice will still see them, often at out-of-network benefits
- A practical breakdown of what their cost may look like
- An offer to walk through specific concerns by phone
Vague or apologetic communication loses patients. Clear, calm, professional communication retains them.
Out-of-network strategies that work
Being out of network doesn’t always mean lower reimbursement. In many cases, an out-of-network arrangement with the same carrier can pay better than the in-network contract did.
Strategies that produce this result:
- Direct out-of-network fee negotiations with the carrier
- Single-case agreements for high-value patients
- Strategic positioning that signals the practice’s quality without antagonizing the carrier
- Patient-side reimbursement arrangements where the carrier pays the patient directly at out-of-network rates
A dentist who is “out of network” on paper can still be receiving competitive — sometimes better — reimbursement on each claim.
Timing the drop
Timing matters. A drop announced poorly can panic patients. A drop announced well builds confidence. The right timing usually includes:
- Adequate notice to the carrier per the contract’s termination provisions
- Communication to affected patients 60–90 days before the effective date
- A calm, consistent message from the front desk in the interim
- A clear path for patients to ask questions
Tracking the actual impact
After a drop, the practice should track:
- Patient retention rate among the affected PPO group
- New patient acquisition during and after the transition
- Per-patient revenue compared to pre-drop figures
- Overall practice revenue impact
In most cases, the loss is smaller than predicted and the per-patient revenue is higher. The practice ends up in a stronger position.
Dropping a PPO is not a one-size-fits-all decision. It depends on the carrier, the patient base, the practice’s other PPO mix, and the local market. But it should never be off the table just because of the fear of patient loss.
If you’ve been in a PPO that no longer serves your practice — and you’re not sure what dropping it would actually cost — a complimentary assessment will give you the data to decide.
👉 Schedule your complimentary assessment: https://pponegotiationsolutions.com