Transitioning From Dying Business Models | Ep 829

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Previously titled “Transitioning From Dying Business Models | Ep 853” — renamed by the publisher on Aug 2, 2026

The Game with Alex Hormozi 1h 5m 8 speakers 3 chapters transcribed
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What common challenges do businesses face?

Alex Hormozi 0:00
A number of businesses just lined up over two days to ask me questions. They range from $200,000 a year to $140 million a year. And the crazy thing is, is the questions between businesses are so similar that they apply to all of them. And we pulled out the best moments that we think will give you the highest ROI. Enjoy.
Zach Levine 0:17
Hey, Alex, thanks.
Alex Hormozi 0:18
Yeah, you bet.
Zach Levine 0:18
So my name's Zach Levine. We sell pain management services to New Yorkers. Okay. Integrated pain, so chiropractic PT.
Alex Hormozi 0:27
Like old people, young people, women, men?
Zach Levine 0:29
We have a bunch of avatars right now, which is potentially a problem.
Alex Hormozi 0:32
Okay, brick and mortar?
Zach Levine 0:33
Brick and mortar. We're out of network insurance, which is a dying, which we'll get to. Sure. We do 4.2 in revenue. Okay.
Alex Hormozi 0:40
So you're mostly insurance or you're mostly cash?
Zach Levine 0:42
Mostly insurance.
Alex Hormozi 0:43
Oh, mostly insurance out of network. Got it.
Zach Levine 0:45
Yeah. Yeah. 4.2 want to get to 20. Okay. Got it. We have three offices and don't know exactly how to transition out of the dying business model. Obviously our industry is growing.
Alex Hormozi 0:55
Yeah. So what business model are you thinking about switching to? Cash.
Zach Levine 0:59
Cash.
Alex Hormozi 1:01
I have a bunch of friends who are in-network and murdering it.
Zach Levine 1:03
In-network, yeah.
Alex Hormozi 1:04
Why don't you get in-network?
Zach Levine 1:05
We've just heard it's a grind, you know, it's commoditized down to the bottom, race to the bottom, yeah.
Alex Hormozi 1:11
Why do you feel like the way that you have right now is dying from out-of-network?
Zach Levine 1:14
Because reimbursements from payers are declining each year, whereas inflation is up. Costs are going up. And because the amount of people who have out-of-network benefits is dwindling as well. It's mostly just corporate, and that's even declining. Yeah. Yeah, they're just getting smarter and they want to push everyone in network, so we're getting squeezed. Administrative burdens through the roof with prior auths, all this crazy shit.
Alex Hormozi 1:38
So this is a therapy provider who bills insurance. He's dealing with an issue that a lot of out-of-network are dealing with, which is that reimbursements, aka what insurance companies pay providers, is going down, but inflation and costs are going up, and so that's squeezing their margins. And for this individual, he was making zero profit. And so he felt like he needed to change his model quickly. And so basically he had two options. You could go in-network, which is you have guaranteed customers, but you're getting, in a lot of ways, lower quality customers that the government and things like that are paying for, mass market insurance is paying for. Or you can go cash, cash pay. People can just pay privately for whatever you want.
Alex Hormozi 2:16
And so he felt more aligned with the cash payment. And so either way though, I think understanding what strategy is required to win within each of those paths was kind of the real decision, which is like, what problem do you want to solve? Do you want to solve the problem of learning how to market and sell customers? Because that's what it's like when you are in kind of the cash business. And if they've never done that before, then that's a real beast to get over. On the other hand, if you want to be in network, then it's going to be a business all about operational efficiency. It's about returns on capital and basically how efficiently you can staff up and how low you can keep costs across the business because you have no pricing power. So it has to all be off of efficiency.
Alex Hormozi 2:53
And so those are basically the two paths that he had. And so I wanted to walk him through the kind of the questions to figure out which of those he felt more aligned with. And it sounded like he definitely wanted to go more the premium cash pay version. And so that was kind of the direction that I let him in. So you basically see it as like, I could either go in network and then make your entire business model around operational efficiency. Which is, I mean, I've got some buddies who murder it doing that, so I don't think there's anything wrong with that. Or alternatively, you just go premium, be the best, and be private, right, be cashback. So the question is, how do you transition it?

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