Implementing a profitable Medicaid practice into your local school district: a convo with Dr. Ryan Hansen
20/20 MONEY: The Business of Optometry
Release Date: 06/15/2026
Implementing a profitable Medicaid practice into your local school district: a convo with Dr. Ryan Hansen
20/20 MONEY: The Business of Optometry
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...
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A blueprint for scaling your practice (while having a life in the process): unpacking Eyecare B.O.S.S. with Eugene Shatsman
20/20 MONEY: The Business of Optometry
Why do so many optometric practices hit a ceiling in their practice? We know it's not because the owner isn’t working hard enough, so what is it? It's because the business was never designed to scale in the first place. Eugene Shatsman joins me back on the show to talk about the ceiling practice owners inevitably hit in their practice—and a system he's created to help owners break through it. In our conversation, we discuss the systems and frameworks behind building a more intentional, scalable practice, including the five operational pillars Eugene believes every successful practice must...
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Are you building wealth...or just feeding the machine?? A conversation with Nathan Hayes on investing capital in your practice
20/20 MONEY: The Business of Optometry
What if one of the biggest financial mistakes practice owners make is confusing “spending money in the practice” with actually investing in it? In this episode, I’m joined once again by Nathan Hayes for a thoughtful and nuanced conversation around reinvesting in your practice, opportunity cost, and the hidden tradeoffs owners often overlook when deciding what to do with excess cash flow. We explore the mindset many owners have that every dollar spent on equipment, technology, or expansion automatically creates enterprise value — and why that assumption can quietly create...
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Making These Merchandising Mistakes is Costing You Tens of Thousands of Dollars: An Optical Conversation with Kayla Ashlee
20/20 MONEY: The Business of Optometry
Most optometric practice owners have no idea how much money they’re quietly losing in their optical simply because of merchandising, layout, and the conversations happening—or not happening—between staff and patients. Welcome to this episode of 20/20 Money: The Business of Optometry. My guest on today’s show is Kayla Ashlee. Kayla joins me on the show to talk about the subtle but incredibly powerful levers that influence buying behavior inside the dispensary and why the difference between a thriving optical and an average one often has less to do with pricing and more to do with...
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Practice financing decoded: what owners need to know now about how banks think about deals
20/20 MONEY: The Business of Optometry
Thinking about buying or expanding a practice, but nervous about debt, banks, or making an expensive mistake? In today’s episode, I’m joined by Mike Smith of Bank of America to demystify the lending process for optometrists. We break down what banks actually look for in a borrower, how student loans and cash reserves really factor in, why tax returns matter more than stories, and the common traps buyers and sellers fall into when financing a deal. If utilizing OPM, other peoples' money like a bank's, is on your radar (now or in the future), this conversation can save you time,...
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How great practice owners build teams that stay and perform
20/20 MONEY: The Business of Optometry
What if the biggest threat to your practice isn’t reimbursement, competition, or overhead—but the way you hire, lead, and retain people? In today’s episode, I’m joined by Mike Dixon, president of Hoops, for a conversation every practice owner needs to hear. We unpack why staffing issues feel so hard, why most owners were never trained to lead, and how the right systems can turn your team from your biggest headache into your greatest competitive advantage. If you’ve ever said, “I just can’t find good people,” this episode may challenge the way you think about the real...
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Don't make these financial and business mistakes! (the talk I give at every optometry school's private practice club)
20/20 MONEY: The Business of Optometry
The financial decisions you make early in your career can shape the next several decades—and most people don’t realize it until much later. On this episode, I’m sharing a presentation I recently gave to students at the Indiana University School of Optometry on the timeless financial and business lessons every optometrist should understand. I discuss the power of compounding, how to think about saving priorities, student loans, disability and life insurance, and why your income is your greatest wealth-building tool. I also cover important concepts on the business side of optometry,...
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Using EOS to Create Clarity and Traction in Your Practice with Tom Restivo
20/20 MONEY: The Business of Optometry
Ever wonder if, when, or how to build stronger operations within your practice? In this episode, I sit down with Tom Restivo to unpack EOS and what it looks like to build a stronger operational foundation inside an optometric practice. Tom shares his experience leading a rapidly growing eye care organization through expansion, complexity, and the pressures that eventually exposed where systems were missing. We talk about why growth without structure creates avoidable friction, how core values shape hiring and leadership decisions, and why vision has to be more than a vague idea if you want...
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How a Limiting Mindset Can Cost Practice Owners More Than They Realize with Dr. Steve Vargo
20/20 MONEY: The Business of Optometry
In this episode I sit down with Dr. Steve Vargo to unpack a mindset that many practice owners quietly wrestle with: the belief that there is no longer money to be made in the basics of optometry. We start with a real question from a practice owner who feels discouraged by stagnant reimbursements and declining capture rates, and use it as a springboard to discuss the deeper issue underneath it all: communication. Steve explains why successful practices are not necessarily dependent on adding new cash pay services, but instead on improving how doctors listen, communicate, and guide...
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Independence vs Isolation in Private Practice with John Marvin
20/20 MONEY: The Business of Optometry
In this episode I sit down with John Marvin to explore a challenging but important idea for private practice owners: the difference between independence and isolation. We unpack John’s perspective on why fierce independence can sometimes limit growth when it prevents doctors from learning from others or leveraging the resources already available to them. Our conversation touches on mindset, the importance of personal growth as a business owner, and why building something bigger than yourself often requires becoming comfortable with discomfort. If you are thinking about the long term...
info_outlineWhat 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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How Ryan sees up to 16 pediatric Medicaid patients in just a few hours each morning
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Why low overhead dramatically changes the Medicaid profitability equation
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The logistics of scheduling, transportation, and dispensing glasses through the school system
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The role school nurses and principals play in making this model successful
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Why many children who “pass” school screenings still desperately need glasses
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The hidden challenges of working with Medicaid reimbursement and bureaucracy
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How this model creates remarkable work-life balance and flexibility
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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:
Download the Practice Owner's Financial Toolkit
20/20 Money Ultimate Financial Success Masterclass
Check out Adam's new book: How to Buy an Optometry Practice
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The Optometry Success Podcast
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