Hello everyone. I'm Brian Zerman with Becker's Healthcare.
Thank you for tuning in to the Becker's Healthcare podcast series.
Today I'm pleased to be joined by Oliver Gillis,
c m o of Ori Oliver, thank you so much for talking with us today. Uh, to,
to begin here, can you just take a moment to tell us more about yourself, uh,
and your role at OrthoFi? And also I believe you have a, a book coming out soon,
um, level the Curve, if I'm not mistaken. Can you, can you talk, um, to,
to our listeners just a bit about that as well?
Yeah, thanks for having me, Brian. Um, yeah,
I am the Chief Marketing Officer for OrthoFi,
a company that 10 years ago started with the mission of making orthodontic
treatment more accessible and affordable to patients. Um,
and you know, that has been a, a fabulous journey. Uh,
it's been 10 out of the 25 years that I've been in the dental industry. My,
um,
specialty and passion is helping practices to again,
connect patients with high quality care,
whether it's aligners or orthodontic treatment or as we're getting into now
in the general dental space, um, high quality restorative care. And, uh,
I've been focused on that. I've, uh, you know, my career has been, you know,
built on analyzing data and this book that you referenced that was just
published, um, last month, um,
through Forbes Books is all about how a,
an orthodontic specialty practice can build, um, a,
a growing and sustainable patient base using some of the universal principles
that I think we're gonna be talking about today.
Excellent. Appreciate you, you sharing that background with,
with our listeners there. Let, let's dive in.
I wanna pull out some of that expertise, Oliver.
So case acceptance rates are obviously a,
a major challenge for dental practices. Can,
can you talk a little bit about the, the factors, the, the,
the trends here that are preventing patients from accepting recommended
treatments and, and,
and then what sort of effect does this have on outcomes as well as the effect it
has on, on, on the dental practice itself?
Yeah, great question. Um, obviously, you know,
macroeconomics always has a guiding force on,
you know, case acceptance. Um,
right now we're a little bit of a lull through some of the uncertainty.
That said,
a lot of people are too quick to latch onto economy as the sole reason
affordability and the economy are linked.
But affordability is also how fees are presented. And fees, let's be honest,
are one of the main reasons why people accept or don't accept treatment,
especially in the dental practice environment where they are not coming in with
the express intent to get some form of electric treatment.
They're often finding out at their dental visit, um,
often a hygiene visit that they need additional care.
So there's a little bit of that extra surprise vehicle.
What we've learned over the last year and a half of putting together this, uh,
wonderful, um, project and,
and this great solution that we're building is that there's a lot more to it
than just the, um, economy or even the fee presentation dynamics.
What we've seen is that there are, uh, a handful of factors,
really four factors that are, are moving the needle here.
Number one is the whole fee presentation experience is often
highly disjointed,
and that is because practices are cobbling together a number of
vehicles to try to get this case accepted and these finances approved and
accepted, um, from a number of different sources.
They're often going into their management system to present the fee as a whole
fee. Then they're waiting to hear a yes or a no from the patient before deciding
whether or not to, um, get them to apply to a third party lender. Um,
we'll talk about approval rates on that as sort of the second thing,
but if that doesn't work, then they're gonna go and do a different thing.
And it's a very disjointed experience that when you're thinking about influence
mechanics is not really ideal.
You're waiting for people to say no several times before you may get to the
final result. Um,
so that's really the first thing is that disjointed experience.
The second part of of this is the fact that the actual, you know,
offers themselves are very limited.
There are historically relatively low approval rates,
and even if the patient is approved,
what is very common out there in the dental market is that you've got lenders
that are constantly promoting and pumping these high approval rates, 80%,
85% approval.
But what they're not telling you in the fine print is that those approvals often
are partial approvals where the patient may be approved for 10 15 or maximum
20% of their total cost, um,
which is great for the lender to be able to advertise the approval,
but that doesn't get the case accepted.
And so there's a lot of that misnomer and clever use of, of, of success metrics,
which doesn't end up turning into case acceptance,
which to be honest with you at most is around 30 to 35% out in the dental
market. Um, the offers themselves are often not very compelling.
So that's the third reason, is that there's often, you know,
predatory interest levels or very high MDRs for the practice to pay.
And so that is not really designed well for the practice.
And then the last part is the actual metrics. Um, you know, the,
the Drucker saying that you can't manage,
what you can't measure is operating here where very few practices have a clean
view to their actual case acceptance.
It's a lot of garbage in garbage out in their management system.
And we've seen even in our beta test that, um,
practices often are way lower in their actual case acceptance than what they
even thought anecdotally, um, because the measurement, um, is not really there.
So all,
you put all those four together and all of that is touching case acceptance.
The other side effect of our current environment where there's imperfect
solutions and a disjointed experience is that a lot of practices
expect that they are going to have a problem.
And so they get into a bad habit of a wallet sizing, right?
Where they are looking at the brand of the patient's shoes or purse or bag
and deciding whether or not they're going to present treatment.
And then what often happens, and we've even seen this in the beta,
is that they will often present a very small fraction of what the patient
truly needs because they are expecting that the patient will not be approved.
I mean, a, that's not good for the patient, right?
If you're only telling them about a fifth of the care that they need, and B,
you're not even giving the patient a chance to accept and say yes to a higher
fee. One anecdote, by the way,
we were in one of our beta practices and the practice shared with us that this
patient probably could use up to I think $7,000 worth of treatment,
which I mean, that's a, that's a definitely a big number. Um,
but instead of allowing our system to show them the financial options,
they opted to only present 700.
The way that the workflow works in a,
in a dental practice today has been largely informed and, and informed
by the lenders, right? Like the, the,
the fact that practices have been educated to only want third party
financing for cash flow. And the fact that, um,
the workflow works the way it does, again,
has been essentially formed by the lender. So the, the,
the most important stakeholder that is the patient is a
last consideration derivative,
and the practice is the second most important stakeholder,
and they are behind the lender in terms of the priority of this process.
So that's kind of backwards and, and it's understandable. The, the lenders,
you know, have the control of the money, and so it makes sense,
but the workflow is not designed to make it better and easier for the patient
and better and more effective for the practice first. So this is the,
this is, as an industry, whether it's our product or whether it's another,
we really gotta take a, a, a look at
who is this flow being designed around?
And it should be designed around the patient first and the practice second.
Yeah. I really appreciate you walking us through sort of the,
this disjointed experience that, that patients have and,
and staff have as well trying to, to execute on this. Uh,
and I wanna dig in even, even deeper here. Can, can you talk about,
and maybe it's expanding upon what you've already shared,
maybe it's something new, but, but different parts of the patient journey or,
or clinical processes that,
that could really be improved here to increase acceptance. And,
and I also would love it if you could talk a little bit about the,
the element of patient choice here and why that is so important and why having
choice matters to to patients.
Yeah. Open choice is our, um, you know, really proven concept.
And we've tested this and proven this out on over a million patient starts on
the orthodontic side,
and we're really trying to bring the fruits of all of this intelligence over the
dental side. Um, the, the truth is, open choice is very, um,
you know, is already proven in other retail environments. If you look at,
you know, big high-end retailers like Amazon, uh, Wayfair,
apple,
they are all learning and understanding that presenting a total cost along
with, uh, a pay as you go option increases the total, um,
acceptance of that particular cost. So we didn't invent it.
What we have done is we've really put it into the dental environment and proven
it over a million times. The concept of open choice really is just this,
that you wanna put the power in the patient's hands and let them
decide between options. It's the old concept of, rather than ask a question,
do you want to do something? Yes or no?
It is which of these wonderful options is best for you? And automatically,
psychologically it already sets you off on a better, uh, on a better path. Now,
in order to do that, you need a workflow that, that, that, that works that way.
And, um,
unfortunately we've been trapped in this mode where you wait to hear no,
then you apply and, and see if that works. And then there might be a no there,
and then there might be a break in case of emergency third option. So again,
it's set up, um, the, the, the wrong, uh, way.
What's super interesting about that is we've also seen that there's a bit of
Stockholm syndrome, right? Practices all experience this.
When we ask them, they all agree and experience that, you know,
they often have to deal with what to do when there has been, you know,
when there's not an approval. Um,
but what they think they need is just a better lender that's gonna approve more.
And what they really need is an actual completely new experience and
flow where all of this happens within a certain flow.
So you're not gonna have one lender application that goes to one lender and then
a, a a, you know, acceptor or reject.
We're gonna have all the lenders in a network app, you know,
where one application is gonna make, um,
the practice understand what the options are for every patient.
And when that's not an option,
there's gonna be a seamless compliment where the patient is gonna have a
financial option regardless of their credit, uh, rating,
and they're always gonna be able to say yes.
So the key is they need a whole new workflow and experience,
not just a better lender, if that makes sense.
No, no, it absolutely does. But it, it sounds like here to,
to create such an experience, uh, to create such a workflow, uh,
what immediately comes to mind for me is technology's gonna be critical here.
Correct. Um,
can can you talk a little bit about how technology can be leveraged in this
space to, to sort of improve case acceptance rates?
And are there any best practices here tools, specific tools that,
that you wanna discuss or recommend for our listeners?
Yeah, so obviously the technology, I mean,
there's a convergence between the technology that we have available. Um,
the fact is that we can,
today one application can simultaneously go out to a network of different
lending opportunities to get,
see who approves and by how much user interfaces are able to display multiple
choices, um, so that patients, you know, have that open choice. Um,
we have the control to display it in the most patient, uh, friendly way.
We have the ability to take payments virtually.
We have the ability to take payments in real time, um,
and get all these approvals. So all of that technology convergence.
And then on the back end, the other technology that's available is automated,
um, multi-channel messaging. So we've talked a lot about, you know,
getting that case acceptance when they come in at that point of sale,
but what we haven't talked about is that automated pending management
functionality that is also required to maximize case acceptance.
Not every patient is ready to make a decision today.
We're gonna make that far more possible than it's ever been,
but when they don't say yes today, modern technology and, and,
and other companies are leveraging multi-channel automated messaging
that follows the patient for, in this case up to 90 days.
And we're seeing some really compelling, um,
results from that that is really surprising, the patient. So for example,
in our beta, um,
right now we're seeing that 32% of our accepted cases
were accepted between day seven and 30 following their,
their visit and their feed presentation. In a typical practice,
the follow up is lacking. It's, it's not consistent, it's hard to do.
There's just a lot of patients going through and the team often is unable to
sustainably kind of keep behind them, um, in that way,
but technology makes it to where it's automated and simple.
Yeah, I, I really wanna hone in here on the,
on the payment element of this just because anecdotally and as,
as a consumer broadly in the economy, right, it's,
it's never been easier to pay for stuff.
It feels very convenient and easy to pay for things that is not necessarily true
when it comes to, to healthcare and, and, and dental care, right? Uh,
it's not always easy, uh, or convenient to, to pay for things. But, uh, that,
that said,
can you talk about why these payment technologies that you just laid out are,
are just so important and, and,
and having this streamlined sort of different payment options for,
for dental patients is so important?
Yeah, I mean, when people want something, you need to capture that moment.
The attention span of the average consumer is getting shorter and shorter and
shorter and shorter. And so, you know, when,
when you have an environment where it's disjointed and difficult,
you may have a patient that is at the peak of their desire for a particular
treatment. And if that,
if they can't consummate that desire right then and there,
there's a chance that you're gonna lose that moment,
you're gonna lose that window.
And so offering technologies that are mobile friendly that meet the patient
where they are,
where they're able to open a link to review their payment options from a visit
they might have had a week or two weeks ago,
and they're able to see their financial options and say yes to them and actually
make that payment right then and there you are basically compressing the entire
awareness, interest, desire, action cycle into the,
into the two minutes that you have their attention.
And that is mission critical.
The likelihood that they're gonna remember all that and maybe revisit that on
their next dental visit six months later is close to zero.
And it's also very unlikely that the practice is gonna remember that they need
to follow up with that patient, um, on their next visit.
Yeah, and I'm sure that rings true for a lot of folks, a as consumers, right?
I know I, I've shared this on the, the podcast I believe before, but, um,
anecdotally for me, if,
if it doesn't have Apple pay and I'm online looking at it and I've gotta like go
get my card and fill out a whole bunch of stuff,
if it's not very convenient or doesn't capture me in that moment,
I'm less likely to do it. I think that's that's true for a lot of folks, right,
Oliver?
That's right. In, in every, in every corner of your consumer experience,
this is just one of the corners,
but in every aspect of your consumer experience,
if you search your own behavior, um, you'll,
you'll see that that's universally true.
Excellent. So, so you've given we, we've covered a lot of ground in a,
in a relatively short period of time,
but as we come to the close of the conversation,
I'm wondering if you can share any other specific success stories you've seen
here or notable outcomes you,
you can share from your experience with OrthoFi partners that have adopted this
technology and input it to use any specifics you can share with our fo our,
our audience.
Absolutely. So if you talk about the proven concept of open choice, you know,
what you'll find in the OrthoFi solution,
which up to this point has been largely, um, you know,
specialty related, right? So specialty practices,
we are in over 1100 locations and you know,
for the last 10 years we've been tracking results.
And what we can report is that the average practice on, you know,
the OrthoFi solution is seeing same day conversion rates over 40%,
which is over two times the industry average.
So this concept works in terms of like the, the,
the dental version of this that can be used not just for aligner cases,
but for any elective dental treatment is currently in beta.
And we're seeing some really exciting results.
So practices that are utilizing this fully for every case are
seeing their short-term case acceptance, um, at, you know, around 40%.
And that's just in the first, you know, seven to 10 days.
We still are collecting data on all the case acceptances that are gonna be
coming in over the next 30 to 60 days.
So we're still collecting what will be an improving data set. Um,
and the other thing I mentioned is, you know,
we are seeing that evidence that that automated pending management is having a
really big impact. Um,
so that's why we expect that these numbers are only gonna improve. Um,
so some very,
very exciting early results and more and better to come.
And looking forward to hearing about those more and better to come, uh,
a as time goes on here. Oliver, thank you so much for,
for being with me today and, and, and thanks a and, and congratulations on,
on having the book published. I think that's, that's fantastic. Is there any,
any quick closing thoughts? Any,
anything left you'd like to share with listeners before we sign off?
Yeah, just in general, you know,
what I would ask everyone out there to think about is, you know,
really consider this issue of analyzing what it is that is going wrong with
their case acceptance and really questioning is it really just that I need to
shop a new lender or is it that I need a new patient acquisition and
conversion workflow? And if you come to the ladder, um, we do have a solution.
It's called accept care. Um, we are, um, excited about launching it,
um, later this summer. Um, if you are interested in, you know,
being a beta user, um, you know, we, I, I would, uh,
encourage you to contact us and or to visit accept care.com. Um,
we are gonna be, you know, taking, uh, interested practices into the last,
um, phase of our beta and then obviously, you know,
into launch later this summer. So.
Excellent. Oliver, thank you once again for being here. I also, of course,
wanna thank our podcast sponsor OrthoFi.
You can tune to more podcast from Becker's Healthcare by visiting becker
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