PPO vs FFS: The Math Still Favors FFS

PPO vs FFS: The Math Still Favors FFS

Your PPO contracts keep shrinking. Reimbursement is down 3-5% per contract over the past 18 months. Fee-for-service collections are actually growing faster. The gap is widening.

Why it matters: Your production doesn't increase when you sign a PPO contract. Your overhead does. If you're doing 40% PPO cases at 30% below your FFS rate, you're working harder for less money. That's not a business model.

What to do: Calculate your actual break-even point on PPO cases. If it's higher than your current PPO average, drop the network or renegotiate. The insurance companies bank on your inertia.