Abundant Practice Podcast Summary
Episode #599: 3 Reasons To Stay On Insurance, feat. Tiffany McLain
Release Date: December 4, 2024
Hosts: Allison Perrier & Tiffany McLain

Introduction

In Episode #599 of the Abundant Practice Podcast, host Allison Perrier engages in a thought-provoking conversation with her business best friend, Tiffany McLain of Lean and Make Bank. The episode delves into the nuanced decision therapists face regarding whether to stay on insurance panels or transition to a cash-based private practice. Contrary to Tiffany's usual stance advocating for premium fee, cash-based practices, this episode explores compelling reasons to remain within insurance networks.

Reason 1: Considering Your Season of Life

[03:54 - 07:51]

Tiffany McLain emphasizes the importance of aligning professional decisions with one's current life circumstances:

• Life Phases Matter:
  "We need to think about what season of life we're in... What phase of life am I in? What's my bandwidth?"
  ([03:54])

  • Practical Considerations:
    • Bandwidth: Emotional, financial, and personal capacity to handle significant changes in practice.
    • Family Responsibilities: Therapists with young children or other personal obligations might find stability in staying on insurance panels.
    • Unexpected Life Events: Allison shares her experience of moving cross-country due to her mother-in-law's illness, highlighting how insurance panels provided necessary financial cushioning during turbulent times.
      "I knew I just needed to get on panels to make my life easier with a one-year-old moving cross-country with a sick mother-in-law to make it make sense."
      ([05:09])

• Strategic Planning:
  Allison recounts the necessity of having a clear strategy when staying on insurance panels, ensuring there's an exit plan when circumstances stabilize.
  "I got on insurance panels to make my life easier... and then when things had settled down some, I got off the panels because that's what I wanted to do."
  ([06:11])

• Reflection:
  Recognizing that different life seasons may prompt different choices, Tiffany advises therapists to be honest about their current capacity and future aspirations.
  "Be honest with ourselves about these things... whether you want to stick with insurance or leave at some point."
  ([07:51])

Reason 2: Preference to Avoid Marketing Efforts

[12:09 - 17:09]

The second reason centers on therapists' desire to minimize or eliminate marketing responsibilities:

• Choosing Ease Over Marketing:
  If therapists prefer not to engage in marketing activities—whether due to lack of interest or fear—it may make practical sense to stay on insurance panels.
  "You simply want clients to come to you, even if it means you see more people... That is a price you're happy to pay to not have to get into this whole marketing world."
  ([12:35])

• Distinguishing Motivations:
  Allison clarifies that the decision to avoid marketing should stem from personal preference rather than fear:
  "I don't want that to be a fear-driven decision... I want everyone's decisions to come from what they want instead of what they're afraid of."
  ([13:19])

• Clinical Implications:
  Tiffany connects marketing avoidance to clinical effectiveness, suggesting that avoiding personal challenges in business may hinder therapists' abilities to fully support their clients.
  "If you're not marketing because you're afraid... that is, sorry to say, you're a less effective clinician because you're avoiding those parts of yourself in your journey."
  ([15:08])

• Market Realities:
  Allison notes that staying on insurance can be more financially advantageous than agency work for many therapists:
  "Many insurance panels in most of this country are paying you more for a lot less work than you made in agencies."
  ([13:19])

• Encouragement and Support:
  The hosts encourage therapists to evaluate their motivations and ensure that decisions around marketing and insurance are aligned with their true desires, not external pressures or fears.
  "If you're saving with the insurance, that could be a slower journey... but it's something to consider."
  ([18:09])

Reason 3: Scaling and Potential for Practice Sale

[18:39 - 22:09]

The third reason discusses the strategic advantage of staying on insurance panels for therapists aiming to scale their practices:

• Group Practice Scaling:
  For those looking to expand into group practices with the intent to sell, maintaining insurance panel participation is often essential.
  "If you're trying to grow a private practice, a group practice, and scale it so that you can sell it... you have to take insurance to sell that practice to one of these big conglomerates."
  ([18:39])

• Operational Benefits:
  Large group practices benefit from bulk reimbursements and can afford to hire administrators, making insurance participation more feasible and profitable at scale.
  "Insurance panels at scale make sense in a way that insurance panels as an individual practitioner doesn't always make sense."
  ([19:23])

• Challenges of Selling:
  Many therapists opt not to sell their practices even when offered lucrative deals from venture capitalists, primarily to preserve the integrity and culture of their practice.
  "Most of my friends have decided not to sell... they really love what they've created because once things are bought by VC, it's all about the investors."
  ([20:07])

• Maintaining Values:
  Tiffany highlights the importance of preserving the practice's heart and values, which can be compromised when sold to profit-driven entities.
  "A VC backed group practice is not going to have the same heart or intention or presence as a therapist owned group practice."
  ([21:20])

• Financial Sustainability:
  Group practices on insurance panels can offer competitive salaries to therapists, providing financial stability that might not be achievable in single-provider practices.
  "They can make 80, 100,000, 60 to 80 hundred thousand a year... You as a business owner can be able to sell your business ultimately."
  ([19:24])

Reflections and Conclusions

[22:10 - 27:09]

• Personal Responsibility:
  Both hosts stress the importance of therapists taking full responsibility for their practice decisions, ensuring choices are intentional and aligned with personal and professional goals.
  "Be fully responsible for the choices you're making and the results that come from those choices."
  ([23:07])

• Tools and Resources:
  Allison recommends utilizing resources like Tiffany's "Fun with Fees Calculator" to help therapists determine appropriate session fees based on individual needs and circumstances.
  "Doing that calculator helps people understand... it's actually easier to stand behind too."
  ([25:24])

• Empowerment Through Choice:
  The episode emphasizes that there is no one-size-fits-all answer. Therapists are encouraged to assess their unique situations, desires, and capacities to make informed decisions about insurance participation.
  "Nothing is right or wrong... It is your practice. And I want each therapist to be fully responsible for the choices that they make."
  ([23:52])

• Community Support:
  Allison and Tiffany invite listeners to engage with their communities and resources for further support, emphasizing the collaborative nature of building a successful private practice.
  "Join the Abundance Party and I'll see you in there. We'll have Q and A and actual live... how do we actually do this thing."
  ([26:46])

• Final Encouragement:
  Therapists are empowered to make decisions that best fit their current life circumstances and long-term goals, whether that means staying on insurance panels for stability or transitioning to a cash-based model for greater autonomy.
  "Be the captain of your ship... Always be willing and ready to reflect."
  ([26:21])

Key Takeaways

1. Align Professional Decisions with Life Phases:
   Assess your current life circumstances and capacity before making significant changes to your practice structure.

2. Understand Your Motivation for Marketing:
   Decide whether avoiding marketing is a strategic choice or driven by fear, and recognize how it impacts your clinical effectiveness.

3. Strategic Growth and Scalability:
   Staying on insurance panels can be advantageous for those aiming to scale their practice, particularly if considering future sale or expansion into group practices.

4. Empowerment Through Choice:
   Therapists have the autonomy to choose the path that best aligns with their personal and professional goals, supported by tools and community resources.

5. Continuous Reflection and Adaptation:
   Regularly evaluate whether your current practice model aligns with your evolving needs and aspirations, making adjustments as necessary.

Notable Quotes:

• Tiffany McLain:
  "What phase of life am I in? What's my bandwidth?"
  ([03:54])

• Allison Perrier:
  "I don't want that to be a fear-driven decision... I want everyone's decisions to come from what they want instead of what they're afraid of."
  ([13:19])

• Tiffany McLain:
  "A VC backed group practice is not going to have the same heart or intention or presence as a therapist owned group practice."
  ([21:20])

• Allison Perrier:
  "Nothing is right or wrong... It is your practice. And I want each therapist to be fully responsible for the choices that they make."
  ([23:52])

For therapists contemplating their position on insurance panels, this episode offers a balanced perspective, highlighting that staying on insurance can be a strategic and beneficial choice depending on individual circumstances and professional goals.