How to transition out of a managed care plan smoothly in 5 easy steps

Oct. 16, 2012
If you have decided to reduce your dependency on managed care plans, Kathleen O’Donnell explains how to carefully and seamlessly make the transition. Following these steps will help you involve your patients in the process and thereby strengthen your relationships with them over the long run.

Managed care plans can make or break your practice. They play a large role in your finances and affect your bottom line every day. Discovering ways to efficiently reduce your dependency on managed care plans will allow your practice to truly thrive and prosper.

Let’s first define managed care as reduced-fee insurance plans. Two of the most important aspects regarding managed care are what to do if your practice is thinking about joining a particular plan and how to drop some or even all of your plans.

When thinking about adding a new managed care plan to your practice, it is essential to determine the benefits of joining. Lucky for you, Jameson has put together a list of 17 questions for you to ask the possible insurer to help you make this decision. Some questions include:

  • What employers offer your insurance plan in my town?
  • What other dental practices in my area participate in your plan now?
  • How often are the fee increases accepted for this plan?
  • How much time is required if we decide to drop plan participation?
  • If I disagree with a claim payment, what is the appeal process?

For a full list of questions, please talk with your Jameson advisor or visit our website.

Now that we’ve gone over questions to ask before joining a plan, let’s discuss how to drop a plan or several plans. Don’t ever just quit a managed care plan. This could be detrimental to your practice. You first want to come up with a strategy.

We highly recommend following these steps so that your transition out of a managed care plan will be a seamless as possible:

Step 1: Data collection

Step 2: Training

Step 3: Marketing

Step 4: Implementation

Step 5: Evaluation and adjustment to plan

Let’s look at these steps a little closer.

Step 1: Data collection

The first step is figuring out what kind of impact dropping a managed care plan would have on your bottom line. To figure this, gather data for the past two years and determine the answers to these two questions:

  • How much money did your practice collect from managed care companies?
  • How many patients and families are involved with specific managed care companies?

With this information you will be able to determine which plans are ideal to drop, if any at all. You can then create a detailed plan of action, including steps necessary to flawlessly drop one or multiple managed care plans. But before execution comes training.

Step 2: Training

Dropping managed care means bringing your team on board and engaging them in this process. This requires months of training and conducting sessions with your team that cover the following:

  • Verbal skills exercises — Discussing with your team how to communicate with patients regarding the change in managed care.
  • Written communication — Best writing tactics and determining what pieces need to be written, including brochures, flyers, statement attachments, etc. Important note: Never send written communication about dropping managed care to all patients. Send only to patients who will be affected by the change.
  • Financial options — Determine how patients’ finances will be affected and discuss how your practice can provide flexible financing options.

Step 3: Marketing phase

When dropping a managed care plan, your practice will want to increase marketing activities to boost fee-for-service dental patients and possibly bring in better-insured patients. Here is a step-by-step guide to enhancing your marketing during this process:

  1. Brainstorm marketing and advertising ideas among team members.
  2. Devise a plan of action.
  3. Create an annual marketing calendar.
  4. Implement.
  5. Assess and evaluate.

Be sure to initiate your marketing strategies prior to dropping a managed care plan. This will help in successfully informing your patients, while possibly increasing your referral rate and bringing in new patients.

Step 4: Implementation

This step is all about getting your patients involved and properly informing them that your practice plans to drop a managed care plan or plans. Your entire team will need to use active listening to address your patients’ concerns and objections. This means asking for their feelings and input, and really listening to their thoughts and opinions. Make sure to let your patients know their input is important and that you appreciate their feedback. Your understanding will lead to stronger relationships and long-term patients.

Step 5: Evaluation

Evaluation is a necessary step no matter the project, task, or objective. The first step in evaluating is celebrating success — everyone needs a pat on the back for hard work. The second is making sure you are on the right track. If you are, great! If not, take a step back, adjust your plan, and cycle back through the training and implementation phases. Nothing is cast in concrete. Your plan is flexible and can be changed as needed.


It can be good to join or stay in some managed care plans — it all depends on the needs of your practice. If you decide to reduce your practice’s dependency on managed care, slowly and very carefully access the needs of your practice and your patients and move forward. Then, follow the action plan steps, making sure to assess collected data, train your team, market your practice, implement your plan, and evaluate.

Author bio
Kathleen O’Donnell is vice president of coaching at Jameson Management, Inc., the international dental practice management, marketing, and clinical advising team helping dental professionals improve productivity and profitability while reducing stress. Visit for more information and to reach Kathleen.