Will My Income Go Down When I Drop PPO Plans?

This is the question that stops dentists in their tracks. You've heard about the benefits of reducing insurance dependence, but the fear is real: What if dropping PPO plans tanks your income? After analyzing hundreds of practices that made this transition, the answer might surprise you.

The Fear Is Valid—But It's Based on a False Assumption

When you're already operating on tight margins—which most PPO-dependent practices are—the thought of losing income feels catastrophic. The average dentist on PPO plans hands over 45-50% of treatment fees to insurance companies as adjustments. You're already underfunded, and the idea of going backwards feels untenable.

But here's what we need to examine: Is your fear based on what actually happens, or what you imagine might happen?

What the Data Actually Shows

In over 2,200 coaching engagements, Gary Takacs has never seen a dentist's income decline after dropping PPO plans—when done strategically. Not once. Could it theoretically happen? Sure. But it's comparable to asking if it's possible to lose money in the stock market. Technically yes, but not if you follow a sound strategy.

The key insight here is that most dentists who worry about income loss are looking at only half the equation. They're focused on the patient volume they might lose, but ignoring the dramatic increase in revenue per patient when you collect full fees.

The Math That Changes Everything: A Real Case Study

Let's walk through an actual practice transformation. One of our coaching clients made the decision to drop PPO plans. Here's what happened:

After dropping plans and implementing strategic patient replacement, here's what changed:

The math is straightforward:

• Before: Collecting 64% of full fees across all patients
• After: Collecting 100% of fees on 88% of former PPO patients (88% overall collection rate)

That's a 24-point increase in your collection percentage. For practices with $700,000+ in annual adjustments being written off, this translates to six figures hitting your bottom line.

Why Income Doesn't Just Stay the Same—It Multiplies

Here's the principle that most dentists miss: You've already paid for all your overhead. Your team is already on the payroll. Your lab costs, technology, supplies, and building rent are already factored into your expense structure.

When you drop PPO plans and eliminate those adjustments, you're not increasing your expenses to generate that additional revenue. The money that previously went to insurance companies flows directly to your bottom line.

We often see income increases of $100,000 to $300,000+ per year when a practice strategically transitions away from PPO dependence. These aren't incremental increases—they're transformational shifts that move dentists into different tax brackets.

The Flip Side: When You're Not Ready

There are rare cases where we advise dentists NOT to drop PPO plans—and they're not the ones you'd expect. The limiting factor isn't patient volume. It's differentiation.

If your practice hasn't established clear, tangible reasons for patients to choose you over the clinic down the street, dropping PPO plans is premature. You'd be removing the primary reason many patients choose you: insurance acceptance. Without a compelling alternative reason to stay, some patient loss becomes inevitable.

However, this applies to only a handful of practices—maybe 1-2% of those we evaluate. Most dentists reading this already have the foundation they need.

Your Readiness Checklist: Two Critical Factors

Before dropping PPO plans, assess these two areas:

The Bottom Line: Income Loss Is Not the Real Problem

The question "Will my income go down?" reveals a deeper concern: Am I safe making this decision? The answer is yes—but only if you approach it strategically.

The practices that see income increases after dropping PPO plans share these characteristics:

• They've built relationships with their patients beyond insurance coverage
• They have a marketing strategy to replace any lost patients
• They understand the math of how adjustments impact their bottom line
• They recognize that 88% retention at 100% fees beats 100% retention at 64% fees

These aren't exceptional practices with unique advantages. They're practices that took deliberate steps to transition thoughtfully. If you're reading this, you likely have what it takes to do the same.

Moving From Fear to Strategy

Staying in PPO networks isn't safe—it's just familiar. The real safety comes from building a practice that isn't dependent on insurance companies deciding your fees. The real opportunity comes from understanding that the money currently written off as adjustments should be going into your bank account.

Your fear about income loss is valid in a PPO system. But the data shows that when you transition strategically, that fear transforms into one of the most rewarding financial decisions of your career.

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.