Take a look at your payment patterns (any billing software can do this), and see which payor pays you the least. Then drop that payor (don’t inform the insurance plan just yet- just tell patients you no longer accept their insurance). Unless you have an extremely light schedule, I bet that you won’t miss it, and then, in a few months’ time, drop the next payor. Keep doing that until your schedule gets too light. We have to stop seeing patients for peanuts. Some of these patients will stay and pay out-of-pocket (give them a discount, but a fee higher than what you were getting), and you’ll be seeing more patients with plans that pay higher fees. That’s why even if your volume goes down, you’ll probably still make more money. Hell- even if your income stays the same, at least you are not working as hard.