Imagine if Hamlet was a dentist rather than Prince of Denmark. Would his soliloquy have gone like this?
“To be in network, or not to be in network: that is the question: Whether 'tis nobler in the mind to suffer The slings and arrows of outrageous fortune, created by a fee schedule below the 50th percentile Or to take arms against a sea of troubles, (Delta, Blue Cross Blue Shield, MetLife and my patients' insurance mindset) ...”
Many dentists are suffering through this existential crisis as we speak, although they don’t quite have the Shakespearian talent to communicate their concerns so eloquently! While linking this to Hamlet may be over-dramatic, the painful decisions that must be made are very real.
With Spear Practice Solutions, we are working diligently to create new models and methods to support and guide dentists through their insurance conundrums. Every decision that dentists make about their practices can and should come from their vision, values and philosophy of care, rather than from fear, scarcity and a “keeping up with the Joneses” mindset!
There are times when a dentist can and should “sign onto” plans and there are times when a dentist should “sign out.” Either way, education and preparation are key to ensure that the decision does not lead to a comedy or tragedy!
Here are some of the basic questions we recommend answering, before you ponder, “To be or not to be:”
- What is my vision and goals for one, five and 10 years?
- What is my current active patient base and what do I need it to be?
- Can I afford to be on this plan? What percentage of new and existing patients will be part of this plan? How does this plan’s adjusted fee schedule compare to my usual, customary and reasonable (UCR) fees?
- Can I afford to leave this plan? If I lost half my patients on this plan, would I still be busy? Productive? Profitable?
- Can I build an education and marketing strategy to inspire patients to stay and make up the difference for those who don’t?
Answering these questions is just the first step in deciding your future. Make sure you are asking these questions as a dialogue (not a Shakespearean monologue) with family, team members and trusted advisors who can guide you through these difficult times.
Amy Morgan is Vice President of Consulting Strategy, a member of Spear Resident Faculty and former CEO of Pride Institute.