Episode #398

Implementing a profitable Medicaid practice into your local school district: a convo with Dr. Ryan Hansen

June 15, 2026

What if serving Medicaid patients wasn’t a drain on your practice… but one of the most efficient and fulfilling business models in optometry? In this episode of 20/20 Money, I’m joined by Dr. Ryan Hansen to discuss a truly unique model he’s built inside a public school district that provides eye care exclusively to children on Medicaid — while still creating a financially viable and highly efficient practice structure.

Ryan shares how he operates a school-based satellite clinic inside the Rockford public school system, why the traditional “either/or” mindset around Medicaid and profitability may be flawed, and how he’s leveraged simplicity, delegation, and strategic partnerships to create a practice that serves an incredible need in his community. We also unpack the emotional realities of caring for underserved populations, the operational logistics of working within a school district, and the surprising economics behind a model many ODs assume can’t work.

We also discuss:

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  1. How Ryan sees up to 16 pediatric Medicaid patients in just a few hours each morning
  2. Why low overhead dramatically changes the Medicaid profitability equation
  3. The logistics of scheduling, transportation, and dispensing glasses through the school system
  4. The role school nurses and principals play in making this model successful
  5. Why many children who “pass” school screenings still desperately need glasses
  6. The hidden challenges of working with Medicaid reimbursement and bureaucracy
  7. How this model creates remarkable work-life balance and flexibility
  8. What optometrists should consider if they want to explore a similar partnership in their own communities

As always, we close the conversation with practical NBSs (Next Best Steps) for listeners who may want to explore opportunities like this in their own school districts and communities.  

Resources:

Book a Triage call with Adam

Download the Practice Owner’s Financial Toolkit

20/20 Money Ultimate Financial Success Masterclass

OD Mastermind Interest Form

Check out Adam’s new book: How to Buy an Optometry Practice

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The Optometry Success Podcast 

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