How to Build a Contract Health Score for Your Dental Practice A Contract Health Score tells you, at a glance, how much of your insurance revenue comes from contracts that actually pay well — versus contracts quietly dragging on your bottom line. Instead of celebrating total collections, it judges the quality of those collections, so you can see which carrier relationships are carrying their weight and which deserve a second look. You don't need to know a secret formula to use it. What matters is the read it gives you: a clear signal of whether your revenue is concentrated in healthy, sustainable contracts or spread across low-performing ones. A Contract Health Score measures the share of your insurance revenue coming from strong contracts, not just how much you collect overall. It separates profitable revenue from busy-but-thin revenue, which gross collections alone can hide. A low score points to a contract-mix problem you can act on — renegotiate from strength, or reconsider plans on the economics. Why does contract health matter more than total collections? In a market of declining reimbursement and rising paperwork, total collections can flatter you. A practice can look like it's thriving on gross numbers while a big slice of its effort yields very little profit. That pressure is why so many practices are re-examining their networks. The ADA reported that 23% of dentists dropped insurance networks in 2024, with another 33% considering it for 2025. The point of a Contract Health Score is to get ahead of that decision with data rather than frustration. A Contract Health Score reframes the question. Instead of "how much did we collect?" it asks "how much of what we collected came from contracts worth keeping?" That single shift changes which problems you can see. The danger isn't a bad contract you know about — it's the average that lets a bad contract hide inside a healthy-looking number. What does the score actually tell you? The score gives you a concentration read: the portion of your insurance revenue tied to high-performing carriers versus everything else. A higher score means your revenue leans on contracts that pay sustainably; a lower one means too much of your effort is going toward thin or burdensome agreements. What makes a carrier "high-performing" comes down to a few practical traits: Favorable reimbursement — contracted fees that stay close to your full fees, with smaller write-offs. Efficient claims processing — quick, clean payment that doesn't tie up staff. Low administrative drag — fewer pre-authorizations, appeals, and chase-downs. You don't have to hand-build the math to benefit from the read. The value is in knowing where you stand and which contracts move the number — not in the arithmetic behind it. How do you read your score and act on it? The industry generally treats a healthy score as somewhere in the 70%–90% range — most of your revenue coming from contracts that pay sustainably. Where you land tells you what to do next. If your score runs low, it means too much revenue is tied up in thin or high-friction contracts. Sensible moves: Identify the drag. Pinpoint which plans are pulling the number down on reimbursement, admin load, or both. Renegotiate from strength. With benchmark data and your production in hand, approach those carriers for better terms. Here's how to renegotiate a PPO contract from strength. Communicate clearly if you do leave a network — continuity of care and personal service keep patients with you. Lean toward fee-for-service over time where it fits, lifting per-patient profitability. If your score runs high, that's a strong position — but contracts and carrier policies drift. Keep watching your top performers so a quiet downgrade doesn't slip past you. One sequencing note that keeps the strategy honest: raise your fees first, then renegotiate. Strong, benchmarked fees give every later conversation more leverage. What's the broader trend behind all this? The landscape keeps moving. The decision to leave a network has grown more common — 29% of dentists dropped insurers in 2025 (Becker's Dental). Low reimbursement and administrative burden are the two reasons cited over and over. It's shifting on the patient side too: DPPO enrollment declined 1.9% in 2024 (NADP), hinting that both patients and providers are testing alternatives to traditional managed care. 30–40% of gross production lost to PPO write-offs (ADA 2023 Dental Fees Survey) Practices that track contract health proactively are simply better positioned to adapt — and to keep their revenue concentrated where it actually pays. Frequently asked questions What is a Contract Health Score? It's a measure of how much of your practice's insurance revenue comes from high-performing carriers. It tells you whether your contracts are aligned with strong, sustainable reimbursement — or whether too much revenue is tied to plans that pay poorly. Why does it matter for my practice? Because it judges the quality of your revenue, not just the total. It surfaces which agreements truly help and which cost you through low reimbursement or heavy admin, so you can make strategic, data-driven calls instead of guessing. What's considered a good score? A healthy score generally sits in the 70%–90% range, meaning most of your revenue comes from profitable contracts. Where exactly you land matters less than knowing the number and watching its trend. What should I do if my score is low? Identify the low-performing contracts, renegotiate better terms where you can, plan clear patient communication if you leave a network, and shift gradually toward fee-for-service where it fits. The aim is concentrating revenue in contracts worth keeping. How often should I check it? Quarterly or semi-annually is a good rhythm. Regular review lets you catch policy or reimbursement changes early and adjust before a slow drift becomes a real problem. See which contracts are worth keeping You don't have to reverse-engineer your own score. Igion's Carrier Profitability Scorecard™ ($149) ranks your carriers on real economics using federal-grade, public-domain, carrier-bias-free benchmark data modeled to your ZIP — so you can see, plan by plan, what to keep, monitor, or reconsider. The Practice Intelligence Bundle / "The Practice Playbook" ($199) pairs that with fee benchmarking so you can raise fees first, then renegotiate from strength. See my numbers, or read What Is a Good Net Reimbursement Rate for a Dental Practice? and Which Dental Insurance Carriers Are Worth Keeping? next.