Despite controversy, fee-for-service (FFS) remains the predominant insurance model in the United States. Under FFS, physicians are incentivized to perform services based on negotiated rates by insurance companies. These agreed upon rates for reimbursements may indirectly drive overutilization, specifically of procedures. Dermatology is a unique field with procedures performed quickly in outpatient visits. As a result, FFS and current policies can add a conflict of interest that incentivizes dermatologists both to perform more procedures and to optimize payer mixes and populations.