The Best Practices Show with Kirk Behrendt 937: Metric Mondays: Is Getting Out of Network Dead? The Data Will Shock You! – Dave Monahan
Sep 1, 2025
Dave Monahan, CEO of Kleer, shares insights on the rising trend of dental practices moving out of insurance networks. He reveals shocking data that suggests going out of network can enhance profitability and patient care. Monahan discusses the financial implications and the growing appeal of membership plans, likening them to successful subscription models like Costco and Netflix. He offers practical advice for dentists making this transition, encouraging them to embrace new strategies to build loyalty and improve accessibility in dental care.
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Major Shift Away From Insurance Networks
- Many practices are moving out of insurance networks, with ADA data showing ~40% already out and ~40% planning to leave.
- Dave Monahan estimates 60–70% of offices may be moving out of network in some form based on overlap and trends.
Pair Memberships With Network Exit
- Implement a membership plan when you go partially or fully out of network to provide alternative coverage for patients.
- Membership plans improve cash flow for the office and offer cost-effective care for patients.
Measure Write-Offs, Then Reduce Dependence
- Analyze your actual write-offs and true reimbursement losses before assuming network participation is harmless.
- Gradually reduce insurance dependence to get paid fairly for your time and maintain practice viability.