- Hello everyone, and thank you for tuning in
to the Becker's Healthcare podcast.
My name is Mariah Moham,
and I'm absolutely thrilled to be joined today
by Paul Bernard, CEO of inside Desks.
Paul, thank you so much for joining us today.
Let's jump right into today's conversation.
Um, so when it comes to RCM, what is scale
and why does it matter to A DSO?
- So, great question. First off, good morning, uh,
Mariah, thanks for having me.
Scale is sort of this catchall word that a lot
of people throw around.
So I like to take a simple approach
and basically what scale means is as you grow,
the bigger you get, your cost per unit decreases, right?
So the worst thing is that as you grow,
as you get more volume, more offices, more claims, whatever
that your costs follow a linear curve,
which you ideally want, is you want to start bending
that cost curve downward.
So that's what scale is.
And why it matters to A DSO, quite frankly, is
because DSOs, at least in, in a large part, exist
because of the desire for scale benefits.
So in a process like RCM that really is driven off of,
uh, the number of claims, the number of appointments,
the number of patients, those types of things, uh,
for every patient that you add
or for every claim that you, that you bill for, uh,
you really want to be thinking over the long term about
how the, the cost to serve, um,
and to, to get paid on
that claim goes down, uh, incrementally.
So that's what scale is.
- Wonderful. Thank you so much
for giving us that information.
So, when thinking about scale,
when do you think a DS DSO should, uh,
begin thinking about it?
- Well, yeah, it's interesting
'cause most of the, the clients that we see today, not most,
I'd say some of them at least, um, sort
of wait till till it's sort of right in their face.
And so I would tell you it's never, it's never too early
to think about scale and to think about the processes and,
and how you might scale them if you go from, you know,
one office to five offices to 10 offices, et cetera.
So I guess the, the simple answer is it's never really too
early, uh, to scale.
But you know, what's really important for I think, DSOs
to understand is that the work changes the bigger you get.
And what I mean by that is a lot
of DSOs start at the single office
level, then grow from there.
RCM work in a single office typically is
done by a generalist.
So your office manager or,
or some other administrative person in the business
does RCM in addition to doing, um, scheduling and,
and perhaps even treatment planning, et cetera.
Um, as you grow, as you gather more offices, the work, uh,
to achieve scale starts to change
and the work becomes specialized.
So for instance, if you have 10 or 20
or 30 offices, you might have one person or two people,
or three people who exclusively work on RCM, you know,
from the, from the moment they get there till the moment
they leave, that becomes their specialty.
So what we usually see is we usually see people starting
to get questions about scale around the, the 10
to 30 unit, uh, 10 to 10 to 30 store, uh, level.
That's usually when they start thinking about it.
- Got it, got it. Yeah, thank you so much
for giving us that insight.
Uh, it's definitely interesting
how scale can change depending on
the level of the organization.
What role does technology play in facilitating the scale?
- So I think technology, especially, you know,
when we think about dental, I came from medical and,
and the use of technology to help facilitate scale
and medical is, is further downfield,
but dental is catching up very quickly.
The, I think the first thing when you think about technology
is, is can you get your hands on your data, right?
And so practice management systems,
different software vendors, et cetera, really need
to concentrate on interoperability, right?
Can the practice, uh, uh,
can A DSO get its hands on its data
to understand its processes?
So I think the first role
that technology plays is facilitating interoperability.
And then I think, you know, there's different levels
of technology, different kinds of technology
that you can apply to help drive scale, refocus,
particularly on automation technology.
So doing, doing a job or doing a parts of a job
and automating it to so that whatever, uh, person
that works in RCM has automated steps in their process,
that makes them much more efficient.
So that's where we tend to focus.
Um, but I guess I would say that there, there are a lot
of technological, um, tools that can be used,
but in my view, and this is coming from somebody
that runs a software company, I would tell you
that the most important thing for DSOs to start
with are their business processes.
And so technology can
absolutely make an existing process faster, more efficient,
more consistent, but if you apply technology
to a broken process, you're just gonna
get bad results faster.
And so, uh, I really, you know, counsel people
that think about their processes
and think about how the processes flow,
and then there's a whole myriad of tools that can help sort
of take it forward from there.
But it all does start with process.
- Yeah, definitely. So thinking, uh,
of what's happening right now in the industry,
where do you see the industry today in terms
of understanding RCM scale?
- Well, I, I think, um,
I think it's really just getting started.
And, you know, when I compare
and contrast, let's say, you know, medical versus dental,
for instance, on the medical side,
there are very large health systems.
Um, we've all got them in our,
in wherever we are in the country, right?
Very large health systems.
And these large entities have actually, uh, helped push
software companies and helped push innovation
and push sort of automation
and a lot of other technology adoption, uh, in dental.
Um, I think DSOs are starting to play that role,
meaning they're bringing the whole industry forward
from a technology perspective and from a scaling process
and scaling technology perspective.
So I think we're at the very,
the really the front end of this.
And if you think, you know, we would say there's
probably about 25% of the, of the dental industry is,
is consolidated into DSOs.
Um, and that's only gonna gonna continue to grow.
I think more and more as companies start operating as 10,
30, a hundred, 200, 500 sort of practice
entities, uh, scale becomes more and more important.
I think the other, the other thing
that's helped accelerate it more recently has really, um,
been the fact that most of us, you know,
were in dental went through covid.
I, um, and Covid D was extremely clarifying in terms
of the importance of RCM, uh, for, for just about every DSO
that I'm aware of in that, hey,
you don't have patients coming in,
or they're only coming for emergency visits,
or you, you've got shutdown,
you better get the most you can out
of whatever you're billing, including whatever you've
already billed and is in your accounts receivable.
So COVID really, I think opened a lot of people's eyes
to the need for scale, uh, in RCM,
and I think that's just, uh, that's just continuing
and if not accelerating.
- Yeah, definitely. That makes complete sense.
Uh, and Paul, before I let you go, as of last year,
inside Desk has acquired 11% of the DSO market with 10
or more locations.
What are your plans for continued growth in 2024?
- Yeah, um, interesting question. Great question.
We had a great 2023 wasn't just great in terms of, you know,
our growth and partnering with a number, uh,
greatly increasing the number
of DSOs that, that we partner with.
We'll certainly will certainly take those results,
but it was also great in terms of advancing
our understanding of all of the underlying processes.
I think we operate our business extremely close
to our customers, uh, in that, in
that there's almost no distance, right?
We consider ourselves in many cases, an extension
of their RCM teams.
And so we benefit greatly from that in terms
of really in-depth understanding of the problems,
the challenges, the blocks that, that many of our, uh,
our DSO partners, uh, face.
And so that helps us tremendously in terms of prioritizing
where we want to innovate.
And so we're gonna continue to
keep pushing, uh, on our mission.
And our mission's quite simple.
We really, uh, uh, want to continue to take the,
the cost per unit down, uh, for all
of our customers while increasing the cash flow and,
and collections of realized revenue.
And so the best way to do that, we feel is, is,
is really working in close proximity to them
and letting them help prioritize our innovation.
So we've got some cool stuff coming up.
Uh, we're gonna continue obviously to, to try and,
and get to beyond the 10%, right?
It'd be nice to have, uh,
many more DSOs and so we'll continue that.
But we see some really practical artificial uses
of artificial intelligence in very practical ways
that we'll be introducing the first half of this year,
partnering with some, some great partners to bring really
what I would think are game changing uses of, uh, voice,
uh, ai, uh,
and some other things to, to, again,
to help improve the productivity of our clients and,
and reduce their cost to serve.
And so we're gonna stay focused on that mission,
keep getting better, keep going deeper,
and introducing practical, uh,
artificial intelligence technologies where we see it
as having a real impact, uh, on our clients' results.
- Perfect. Perfect.
Well, I wanna thank you so much, Paul, for sharing your time
and insights with us today, as well as Inside desk
for sponsoring today's content.
To our listeners, thank you so much for joining us,
and please be sure to check out other Becker's podcast.
Have a wonderful rest of your day.
- Thank you.