88: The Economics Between In-Network vs. FFS Fee Models

In this insightful episode of The Dental Boardroom Podcast, Wes Reed, CPA, CFP and founder of Practice CFO, breaks down the real financial impact of staying in-network with PPOs versus transitioning to a fee-for-service (FFS) model. Using a crown-focused case study, Wes illustrates how fewer procedures can yield significantly higher profits under FFS — even with some patient attrition. If you're a dental practice owner evaluating your profitability strategy, this episode will give you a clear-eyed view of the numbers that matter.

Key Points Covered:

• The purpose of PPOs: high patient volume but lower profit margins.
• FFS model: fewer crowns, less overhead, but more profit.
• Why many dentists feel trapped in PPOs despite shrinking reimbursement rates.
• A detailed crown-based financial comparison: 30 PPO crowns vs. 20 FFS crowns.
• Key overhead costs: fixed vs. variable and their implications in each model.
• Why switching to FFS can potentially double your net profit.
• The long-term sustainability challenges of staying in-network.
• How patient relationships and brand strength affect attrition rates when transitioning out-of-network.
• Practical considerations for associate-driven vs. solo practices.

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