The Most Important Talking Point When Dropping PPO Plans

When you drop PPO plans, the question isn't whether you'll retain your patients—it's whether you know how to communicate with them effectively. The most successful practices keep 85-90% of their insurance-dependent patients when they transition to reduced insurance dependence. But this doesn't happen by accident. It happens because they understand and articulate one critical message.

Why Measurement Matters

Before we dive into the talking point itself, let's address something fundamental: if you can't measure your success, you can't manage it. This principle applies directly to dropping PPO plans. Many dentists approach this transition with vague expectations, then get surprised by the results. Instead, establish clear metrics from the outset.

There are two primary benchmarks to track:

Benchmark 1: Income Growth

Look at your collected revenue before and after dropping plans. Many practices we work with collect significant increases—some jumping from $1 million to $1.4-1.5 million annually after successfully transitioning away from PPO dependence. This isn't just additional revenue; it's additional profit. You're not generating new expenses; you're simply keeping money that would have previously gone to insurance companies.

To put this in perspective: when you drop a PPO plan, the revenue you lose gets replaced by fee-for-service patients you attract through proper marketing and patient communication. The net result is often significantly higher revenue with zero additional overhead.

Benchmark 2: Patient Retention Rate

Track what percentage of your in-network patients you retain when you go out of network. This is a critical metric that directly reflects how well you're communicating your transition. The goal is simple: keep as many as possible. Most practices achieve 85-90% retention when they implement proper communication strategies. That means only 10-15% of patients choose to leave—and often, those are patients you weren't as invested in keeping anyway.

The Most Important Talking Point

After years of coaching practices through PPO transitions and analyzing patient retention data, one talking point consistently emerges as most effective. This is the message you should embed with every team member and repeat to every patient multiple times:

This is deceptively simple, but its power lies in what it addresses. Most patients' primary concern about dropping plans is a single fear: they won't be able to use their benefits anymore. They've been conditioned by insurance companies to believe that if a practice goes out of network, they can no longer access their coverage. This talking point directly counters that misconception.

Why This Works: Understanding Patient Psychology

There's a deeper psychological reason this talking point is so effective. When insurance companies send out-of-network notification letters, patients receive confusing information designed to discourage them from seeing out-of-network dentists. These letters work partly because of a principle of communication: people tend to remember the last thing they hear.

If a patient receives a confusing letter from Delta and then nothing from you, that letter becomes the "last thing" they heard. But when you proactively communicate—multiple times and in multiple ways—that they can use their benefits with you, your message becomes the new "last thing." This simple reversal dramatically impacts patient behavior.

The DISC Personality Factor

Research on personality styles reveals something important: approximately 65% of the population are "rule followers." These are people high in the DISC S (Steady) and C (Conscientious) styles. Rule followers naturally interpret instructions literally—and they interpret the insurance company letter as a "rule" that they must go elsewhere.

This isn't a character flaw; it's how their brains are wired. When you explicitly tell these patients, "You can continue to come here and use your benefits," you're overriding that rulefollowing instinct with a new, more authoritative rule: the rule from their trusted dentist.

A Real-World Example of This Talking Point in Action

One of our coaching clients, a gregarious and outgoing dentist, dropped her PPO plans and discovered something telling when she reviewed the patient losses: nearly all the patients she lost were ones she didn't particularly enjoy treating. They were, as she put it, "difficult patients." Only three patients she actually valued had left—and she knew them personally.

We suggested she call those three patients directly and tell them they couldn't leave. Her exact words: "George, you can't leave my practice. I like you too much. You add too much texture to my practice. My life wouldn't be as good without you as a patient. I'll work out whatever accommodation I need to make this work for you."

What happened next is crucial: each patient, surprised, said some version of the same thing: "I thought I had to go somewhere. I thought I wasn't able to still come see you. Now that I know I can, I'm never going anywhere else. And you don't need to do any special accommodations. I just need to know I can come here."

This is the power of the talking point in action. These patients' primary concern wasn't cost or service quality—it was the belief that they had no choice. Once that belief was corrected, they enthusiastically stayed.

Implementation: How to Use This Talking Point

Simply knowing the talking point isn't enough. You need to embed it throughout your practice. Here are the key implementation strategies:

1. Train Your Entire Team

Every team member who touches patients needs to know, understand, and believe this talking point. It should come up naturally in conversations with patients about their benefits. Your front desk, your hygienists, your dentists—everyone should be able to deliver this message with confidence and sincerity.

2. Repeat It More Than You Think Necessary

You cannot tell your patients enough that they can use their benefits with you. Most dentists significantly underestimate the frequency of repetition needed. Once you think you've said it enough, dial it up more. Put it on your website, in your welcome materials, in your office, in conversations, and in follow-up communications.

3. Use Positive Mindset Language

Pair your benefit statement with positive future-focused language: "I look forward to taking care of you and your family for many, many years into the future." This combines the practical assurance (you can stay) with emotional reassurance (we want you to stay).

4. Customize Your Delivery

Brainstorm different ways to express this core message. The talking point can be delivered in different formats depending on the context: in conversations, in written materials, in welcome packets, and in policy discussions. The core message stays the same, but varying the delivery keeps it fresh and increases retention.

Addressing Patient Concerns Beyond Benefits

While the benefits question is primary, patients may have secondary concerns. Be prepared to address these:

• Payment Process: "Yes, there will be a change in how we handle billing, but we'll guide you through it completely and make it as easy as possible."
• Out-of-Pocket Costs: "Your costs may be different, but we'll work with you to maximize your benefits and discuss payment options."
• Insurance Company Hassles: "If Delta doesn't process things correctly, we'll help you resolve it with them."

Each of these concerns is secondary to the core fear—the belief that they can't come to you anymore. Once you've addressed that primary concern, the secondary concerns become much more manageable.

Measuring Success After Implementation

Once you've implemented this talking point strategy, track your retention rate carefully. Most practices that execute this properly see 85-90% retention. If your retention rate is lower, it usually indicates one of two things:

1. Insufficient Repetition: You may need to communicate this message more frequently and through more channels.
2. Team Misalignment: Some team members may not be delivering the message with appropriate emphasis and sincerity.

Both issues are correctable with focused effort.

Marketing as a Complementary Strategy

One crucial insight: practices that proactively market to attract new patients tend to execute PPO dropoffs more successfully. Why? Because they have less fear of losing existing patients. When you know a steady stream of new fee-for-service patients is coming to you through marketing, you approach existing patients from a position of confidence rather than desperation.

This confidence is contagious. Patients feel it, and it makes them more likely to stay. The combination of clear communication about benefits plus proactive patient attraction through marketing creates the optimal environment for a successful PPO transition.

Reviewed by

Naren Arulrajah

CEO & Founder, Ekwa Marketing

Naren Arulrajah is the CEO and Founder of Ekwa Marketing, a 300-person dental marketing agency that has helped hundreds of practices grow through SEO, reputation management, and digital strategy. A published author of three books on dental marketing, contributor to Dentistry IQ, co-host of the Thriving Dentist Show and the Less Insurance Dependence Podcast, and a member of the Academy of Dental Management Consultants. He has spent 19 years focused exclusively on helping dental practices succeed online.