PPO Patient vs Cash Patients vs Membership Patients

what's up everybody and welcome to another exciting episode of the automatic patient podcast I'm your co-host Jordan comto with me Dr Dan Nelson what is up Dan how you doing good I'm just I'm working on my second zip fiz so I'll be ready for the show I'll be all hyped up caffeinated like I us here we go yeah that's now we're talking I'm trying to make it a theme for every time that you ask me what's up I'm like just caffeinating you know just kid just

getting some energy for the morning yeah no that's that's me every morning too so uh the older I get the more caffeine I need it seems especially with my my three young daughters wearing me out every day oh yeah you know so anyways dude what's new with you guys ah wow so we just got back from Africa um did our our Dental Legacy Foundation trip um part two for this year part two of three um so part three leaves in a week and a half um

but yeah it was it was epic um hey saw we saw a leopard uh which has been on the big five they have this thing called the big five um animals that are out there and the leopard's Elusive and we saw a leopard so check that off the old The Bucket List there we go that's cool was R like we were on the Rafiki River and saw it up on a rock I don't even know how our guide saw it the gu's like oh there's a

leopard over there we're like casual leopard oh my gosh it was leopard hanging out yeah I I felt very safe it wasn't going to jump off and kill me it was great gez have you ever seen those videos at least like in the mountains of here in Utah and probably Idaho where the Cougars pop out in people when they're driving that would freak me out or when they're hiking that would freak me out well on our safaris um it's super common to get within 10 feet

of lions like geez yeah I'm not doing that yeah like no thanks we we have I have epic video of us like parked next to this cheetah eating a zebra and like I'm we're so close to it I'm like oh my gosh if this cheetah decides that it doesn't like us and it feels like the guides always park with me closest to the animal I'm like is there what I must bug the driver or something when we go on these things because they're like let's put

him closest so that if the leopard or lion leaps up this gets that dude so I'm always that guy but it oh it was epic we saw um I have the numbers back yet for the patient count that we had but yeah we we uh we had some really cool awesome experiences there that that uh my favorite is probably um um I won't use her full name I'll just call her Dr brenn um Dr Brin came with this and U one of the things that she

um specializes in in her office is cosmetic veneers and so composite veneers excuse me compos okay and one of the uh the texts at the uh hospital that that we our Clinic is in she had some really bad fosis and was super self-conscious of her smile and um and so Dr Bren gave her a some uh some composite veneers and the girl was just over the moon she was she would cover up her face anytime she would smile or laugh before that and she was like

smile yeah total like tears of joy like she was ecstatic and so you know doing little things like that have been a that's a that we're able to even do that now because our first trips were all just like infection treating infection treating you know massive problems and now we've built it up to a point which was our goal is to get it to be self-sufficient we've got a Tanzanian doctor in the in the clinic now which was for us and so and that's something unique

you guys are doing with your foundation you're actually building like the infrastructure there with with like the doctor that's there exactly yeah our goal is for us to not have to be there anymore so we can go on to the next location and do the same thing again that's rad I love it so you're starting week three here when is it next week you were saying uh visit Three yeah a trip three is going in a week and a half yep and they'll be there for

two weeks and is Ryan still uh lost down there in Le I checked in on him this morning he seems to be okay yeah he's doing good he's like I saw another leopard these are great yeah he's learning more Swahili which is good yeah he's good that's awesome dude no I love I love I love hearing those stories uh it makes me uh really want to figure out how to get down there with you guys um I think that'd be really a really cool experience lifechanging

I tell you it's life it's that's what everybody describes it as as life-changing yeah and I know I say this every episode but it's it's it is my wife's dream and I I I need to I need to be a better husband and just make it happen right dude yeah what hey let's let's change the topic of the show to being a better husband let's do that yeah I don't know if I can I can't speak for that sorry dude CLE I'm joking I'm joking no

I I think it would be really cool so um just need to get that Nanny um hey let's get started with our episode today today I got some questions um my questions are we're going to talk about couple buckets of patients we're going to talk about po patience fee for service or cash patience and membership patients uh the other day we um me and my team were talking to several uh like multilocation practice owners and they were grilling us with these questions that now I'm GNA

Grill you with um I find it fascinating whenever whenever anybody in the industry asks me questions um I I there's a saying that we we we say here uh whatever what's the I'm going to Butch the saying whatever fascinates your boss should Intrigue you my boss are are clients and practice owners right is how I look at it uh here at boomcloud we don't have any investors my investors are our customers so whenever somebody a prospect in the dental industry or a practice that we're working

with has questions I'm very intrigued by them and uh so this is a list of questions that my boss ask me um all right so the first question I got for you Dan is what is your conversion rate for treatment plans with po patients compared to patients on a membership plan okay so so the elevation Association we do a lot of this type of um data interpretation data analytics and so this one was actually pretty easy for us to pull so this question we were able

to compare against um po patient or or membership you know uh plan patients and cash patients and um what was interesting about this was and let me just tell you the numbers really quick and keep in mind um this is reflective of of not every practice is going to have this EXA there's other factors that g go into it that I'll get into in just a second but these numbers are decently close between Po and patient Benefit Plan members which they should you think about it

because similar there's yeah there's similar mechanisms yep so it for patient Benefit Plan members it's 40% for po it's 38% and what's interesting is that cash patients are 24% oh so yeah an outlier so and let me get into some of the interpretation the data interpretation behind some of this and this data interpretation is not exact um we're we're jumping to some we're making some assumptions with with this so don't hang me by that this news but um what we can infer from some of that

is that the the conversion rate um you know the patient acceptance probably has more to do with uh how it's presented um sure you know uh or not more to do with but certainly that's a that's a component you know and what you would want to do in your office is take a look if you have multiple provider multiple providers in your office that's kind of nice because you can compare and see you know what the U treatment acceptance rate is across providers so and if

you have an outlier like a um you know let's say that it's you know around 40% uh for for most of them uh I'm just rereading the question here I've got it written down um I if if you compare those different providers and one is low then you probably have a verbiage problem or a personality issue in your office and so Point yeah yeah so taking a jump back to a bigger scope of things of like why this number is important um if you're a practice

owner and you have an associate multiple Associates or a partner you're going to want to look at that and say and then to look at your treatment teams so what I mean by that is the hygienist with the provider or the provider with the assistant or the treatment coordinator whoever it is right what combo increases conversions exactly or where where do you have a low one right and so and we've been able in our office to identify that and say Hey you know we've had a

provider or a provider team that doesn't work well or for whatever that they put off a weird vibe or something and so we've had to pull those teams in and say hey how are you guys presenting treatment how does that discussion go what does it look like because you're conversion is 24% or 22% or what I'm making up the numbers yeah sure and you know that discussion and sometimes you know as an owner you can go be a fly in the wall and listen to how

it's going and go oh no wonder that is awkward I'm uncomfortable and I'm not even in the conversation you know so we have uh in in in my business I have Associates they're just not clinicians right we have salese that that are my associates right and I have customer success people that are my associates what we look at we put them in pods too very similar to what you just mention mentioned look business is universal whether you're a software company or dental practice there are some

Universal things that we both do to optimize whatever right optimize numbers for conversions in this case um but I know we we look at the same thing here too at boom floud with our with our team members um does sales rep a and appointment setter uh B and adoption customer success rep uh C right those three people do they work well together and do they one get uh appointments to uh our boomcloud 8 salese and do those salese close those and do our adoption people actually

help that practice get adopted and how can we move those around so yeah that we look at it the same way I every time I talk about anything within operations in the practice I'm like oh my gosh we're doing the same things here at boomcloud just in a different just different slightly different function anyways yeah me the principle the principles are Universal that's what's nice is that you don't have to go very far to find good practi principles you know yeah okay that's interesting so oh

go ahead oh I do want to talk to the outlier the 24% cash um yeah you know that that one's pretty interesting because everyone says oh the ideal patient is a cash patient you know which which is true to which is true but you have to remember when you we've had our patient benefit plan in place for multiple years now so you have to when one of the things that you infer is that you've now transferred a decent amount of that those would be cash patients

into your patient benefit plan right so so now your what's left over is going to be a certain percentage of those cash patients now that uh that would that haven't joined your patient benefit plan are probably you know transient emergency these people that are are coming in with you know big issues you look at them and you let's say you treatment plan five different things because they haven't been to see a dentist in 10 years you know and you're like oh boy you got a lot

and so their acceptance rate is low because they're just like oh we'll just fix the problem that I have this thing that bothering me today fix the thing that hurts and then I'll figure out per later geez exactly and then you don't see him again for three years until the next tooth breaks or whatever you know and so you have to factor in that's why that percent that's one of the reasons why that percentage is probably lower you know and then again yeah and then you

factor in your transients you know it's a lot of times um if they don't have insurance or they not part of your if they haven't invested in to themselves into the patient benefit plan then they just kind of go wherever right and so you know you have you have to look at that as well there's probably some other factors into that number as well but certainly you know those are the two big things that you'd want to look at that's interesting here's how I think about

when I see this data that you just shared um I I talk to fif for Service practice owners all the time right and often they pound their chest and say why would I give a discount to my fee for service uh for my cash patients when I'm collecting 100% of the fee right with this data it's like well you're actually only getting them to 24% of those patients are going to say yes to treatment the reason why you're seeing membership and even po patients say yes

more to treatment is because it's it's a mechanism designed for case acceptance right both both are very similar right a membership and a PO uh the only difference is you keep the recurring revenue on a membership plan and the insurance company keeps the recurring revenue on a PO plan that's the difference and you and I you and I have discussed the psychological component to that too right the whole the add to add to cart component which is if I'm on Amazon and I'm looking at something

and I know I'm getting it Prime I'm more likely to add to cart you know what I mean and so yes because I want to I want to capitalize on this thing that I've paid for and I want to maximize my my benefit from that that membership so um yeah there's certainly a psychological component to it as well yeah no that's great data okay question number two unless you you've got another comment on this one the first question you good sweet that was awesome uh second

one is what is the retention rate for each patient type PO feif for service and membership plan patients loyalty rate however you look at that right yeah so this one this one is hard to answer um it takes a lot there's no data sets for this um sure but I do want to talk to a couple points regarding this and and the first one and I've I've mentioned this in multiple podcasts I've mentioned this in webinars that we've done and I've mentioned this in CE events

that we do um because I think it's really important is that one of the things that drives me crazy and and marketing companies are guilty of this uh crappy office managers are guilty of this is is they will tell you really fast what the new patient rate is or average is right and so they oh we have we we get 50 new patients a month okay great how many do you lose right and so yeah and that's not tracked people don't know like how many no

they and even if they I track that like clockwork here they they office a lot of office managers don't even know how to do it they'll just go and look all they'll do is they'll go and pull the previous month's active patients or patient base and then compare it to that month's active patient base and say oh we have a net gain or net loss of X interesting so then they go and they go okay well then I'm going to go in and look at the

new patients that we brought in and then I can determine by factoring that into the equation how many patients we lost which that's fine you can do it that way yeah you know but it doesn't tell you which patients they are that you lost you don't know where they went like to get them re remarketed to or re uh back into activation you don't even know like did they then you have to pull in if you do it that way then you have to pull in

your office team and say where did this patient go did they do we know what happened to this patient like what happened so you know companies like Dental Intel they build that into their system and so you can actually go into a loss feature and look and see okay yeah this is we lost them um you know they moved maybe they passed away maybe they TR office whatever now you can start to get granular on like what's happening and usually once you have like we have

a weekly review of this with our front office team that we go through and we say why did they transfer why did they move you know oh well they just moved oh this kid went to college oh this oh okay but it's like you know they hate Dr Nelson yeah yeah then now we have you know oh you made that patient mad you know it's like okay you know but at least you can do something with that you know but yeah you can call them up

and and fix it yeah if they moved yeah it's like cool that's you're always going to have attrition or churn no matter what Like There's No Business that's uh free of that I wish that wasn't the case building businesses would be and practices would be a lot easier without that exactly you know what I mean yeah so I mean I I just don't want anybody to get you know practice owners you guys don't get too hung up on the you know new patient per month because

you could be bleeding patients out the back door too and not know so you know you you want to track both these so to to get back to this original question on retention rate um it's difficult to get into you you you have to pull a data there's no like nobody makes a none of the none of these data companies make a interesting um anything that would drop my pen Jordan that's awful um nobody makes uh anyine yeah yeah cheers so what what we're working on

this right now at EA we're trying to we think this is an interesting question I think it's worth further discussion so we're trying to pull a um create a database for this to find out what uh exactly uh the numbers are um there is something to be said about uh when someone feels like they are connected to you or your office whether it's a personal connection between the patient and the hygienist personal connection between you and the patient connection whoever it is whatever the connection is

that will create more loyalty and keep someone there so now if they associate I'm part of a membership plan um and there's a certain factor of ease to that knowing that I can just go and get my cleaning go get my you know all these things whatever you want to include in your membership plan there is again we're going to get into that psychological component of of loyalty to an office so and yeah you know so I I we are going to get that number dialed

in and figured out but as of now um that's a that's a tough one to get but we will figure it out uh what I can do at least on the membership side um since I have all access to a lot of the data on our platform I can look at membership plan patients because I have start dates and turn dates uh within our data data set um one I bet you we can create a a at least for membership cohort of patients we can create

a like a a metric on our dashboard uh within the boom Cloud platform that will show the average retention rate for membership I think that's a really interesting question too um so I'll after this podcast I'm going to go pull the data at least on the the cohort of membership patients and we can see how like we can at least see the like the average uh days or months or years on a membership plan per patient within our database because we track that um and then

we can also see turn rates like based off of yearly membership patients or monthly uh payment patients whenever I've looked at this in the in his history we've see that monthly patients actually stay longer U because it's an evergreen payment under the radar type payment but I that's an interesting thing for me to do some homework on as well um very interesting uh okay question number three well before we move on to three I think the other thing that's important to understand about this particular question

and and why it's hard to answer cleanly I guess I think even when we run the data the data is going to be dirty and what I mean by that is that you are you you can't make that c causal you can't say oh people are staying or leaving because of their patient Benefit Plan member or they're not because because people move and there's just a lot of nuance there well there is and and you have to factor in too you know I would say that

a bigger thing would again going back to the answering this question in the beginning is to track and see what your attrition rate is that's going to speak more to do you have an office-wide problem versus you know what's your what's your attrition rate on po versus patient what is I know you guys work with a lot of practice what is like a common monthly or yearly let's look at yearly that's probably a better cohort to look at an attrition rate for like an average practice

you have that data on top of your head I know that's a I didn't I don't I don't have it on top of my head we' have to look at it but when you were asking the question it got me thinking right away about the variance you have in you know take our practice for example we we live in a transient place because we're in a sure this is a uh vacation Community it's kind of like Jackson Hall or Park City right yeah yep so we

get a lot more uh variants with that um where you know anytime you live in a transient place you're going to see more action with that sure versus you know a place like you know I'm going to pick Salt Lake City off the top of my head just because I lived that there before where people tend to stay there you know I lived in sugar house um where it's estblished people don't leave you know and so um looking at practices like that we work with a

practice in Salt Lake there in Sugarhouse that um they still have you know a decent amount of attrition and and you know um but again there's a lot of variance that goes into that so I I I don't know the number off the top of my head I would have to look into it to get to pull that information but again there's going to be a lot of variance as to why and I think it's going to change based on you know where you live location

by location yeah so knowing your data is just even more important because whatever you hear on like a podcast like this or any other other ones it's a certain data set for a specific type of practice that may be different for a practice in Texas versus Salt Lake you know what I mean yeah exactly and you know and I think Jordan the point that I think that would be profound to to this talking point would be that going back to what is your what's your office

net growth rate and if you you also need to go back and say what is my how many patients are we losing how are we losing them why are we losing them yes because if it's and how do we fix it exactly because it can be so many things that contribute to that and if you are trying to grow maybe you don't care maybe it's the model there's a there's a practice there's a group practice down in in Arizona um that I won't say their name

but their whole model is over transients they off transients and that's what they do they don't care that's their Niche yeah that's their Niche so so it's not it's for some offices they're gonna be like yeah you know I run a discount office and we thrive on on the turnover we we had a when I was at the dental lab with my Dad we had a client they're called o I think over the road Dental in Salt Lake and they were very transient like truck drivers

they were they were literally a dental office on top of a big like on the second story of a big gas station for truck drivers and they crushed it yeah and it's all transient type uh truck drivers right that was their Niche and I remember talking to the doctor years ago and they they were doing a really like an amazing amazing job growing and because we were doing all all their cases right at the dental lab so I I was seeing their restorative work every week

and they were kill killing it so yeah as long as you know your Niche and often I I think though uh that location the the market for that and our locations often Drive the marketing the organic marketing at least right our locations are really important that location uh drove that type of C patient base right uh but the practice figured out how to adapt and and serve that Niche which is really interesting to me um and the same goes for any other practice right what is

your organically what is your your location what type of patience is it tracting and how can you really Niche down and and and figure out that cohort of that market right that's really what we should all do uh as as practice owners and no matter what city you live in there's little niches that you got to figure out right that not every practice deals with well yeah and I'll take us on a little TR uh I'm good at at taking us off the tracks but one

of the things that we're working on right now that pumped about is patient profile um yes me I'm obsessed with this on on my side we call it the we call it I ideal customer profile it's it's Universal what you and I are talking about yeah yeah so yeah what what we're looking at is two things um we're looking at what the ideal patient profile is so uh and we can build that we currently have the ability to build that at elevation Association we actually have

you fill out a questionnaire you have tools and stuff great Y and then we build your ideal patient profile so you know who you want to Market towards and then what we're working on now is building a existing patient profile so that will help you to know okay who currently is attracted to my office you know and so you fascinating yeah so and that's really important information because if you look and say oh I'm you know people that are in this demographic tend to come here

you know that that helps you to know well maybe I shouldn't the organic that's what organically happening based off of your location and maybe some of your marketing yeah um usually oh go ahead oh I think that would be huge if you're if you're looking to buy maybe you're an associate that's wants to buy out somebody in a practice and you've just come on or you're looking to purchase a practice you know you maybe you want to see that what's that patient profile look like geez

that's really interesting there's got to be some type of module you can create in software that automatically collects that criteria and displays it sweet yes that's pretty cool dude yeah I'd love I'd love to peek in that uh when we're bored on a Friday sometime that's really interesting to me um Okay cool so we know that we have a saying at least in the software uh world that uh our Marketing in sales causes attrition which is silly not silly which is in interesting because when you

think of like well sales people don't cause attrition they're they're bringing new new Revenue in the truth is they may be bringing the wrong ideal patient profile the wrong customer profile in my case in and it's causing attrition we've seen that over the years when I've when our salese don't understand uh the type of practice we're we're trying to attract here at boomcloud we see attrition go up like we for example startups we don't want to work with startups that's just not our cup of tea

right we we like practices um that have uh they're they're maturing practices with with like two doctors are running it typically they've got enough patient flow coming in through marketing or or some type of marketing function whether they're using an agency or or they've got a referral marketing program that they're running in house whatever it may be right uh or or their location's in such a great spot it's just getting organic traffic uh marketing to their their their practice regardless like startups whenever a startup calls

up we like hey get get on with a marketing agent first and then and then come and do this because you need patient flow and then a membership plan could be amazing for the practice right once they're a little bit more mature so that's kind of like one of our ICP and I have a whole documented like criteria on who we're attracting and then emerging dsos right do really well on on our platform so knowing your ideal customer or patient profile is so critical because then

you can go to market and uh use the right language to attract more of those patients right starts with the front of of marketing anyways I geek out on that on this stuff all the time it's oh yeah I mean you and I have talked about it on this show before we're such it's so well yeah but it's so important you know I think that I think that generally we kind of don't know you know what I mean and it's if you do the ma like

I was talking who was I talking to I I can't remember who I was talking to another practice owner and we were talking about um driving new patients that yes new patient marketing is really important right but the truth is there's patient acquisition costs that you've got to pay back after a period of time I don't know the average cost to acquire patient again that probably varies based off of your Market it's there's markting webinar that we actually talked specifically about the cost acquisition cost yeah

oh that's great the um but the truth is with new patients like well we spend all this money to acquire them and it takes time to pay back that that initial investment um and that's yes you need to have that that motion turned on your practice but it's really expensive and there's still risks with it because of the payback periods based off of the customer acquisition cost or patient acquisition costs so that's obviously you need to keep that on the smartest way to like grow a

practice is by increasing the average revenue per patient um which is just optimizing case acceptance right y it's anyways we can probably do a whole episode on just that topic that would actually be yeah I mean hey Jordan you took us on this tangent but I'm Gonna Keep I know I know that we go down there that's the purpose of the podcast let's go down this travel so the the the the thing about that and this is one of the when we bring a new member

on at EA one of the first things that we talk about in addition to getting you know the actual organization organized is we start to focus on um patient retention and we great what we want to look at with that is you know are the getting rescheduled and so recare is a huge deal and all I I it's probably every office we've worked with when we ask them what is your recare rate you know what's your reappointment rate is it like recall as well is is

that recall reappoint so um and we say okay well what what is your reappointment rate and they go oh well it's probably you know it it's probably 90% probably you know probably like it's like I they prob you know so measur and we say actually it's 60 your 60% reappointment rate which is abysmal you know and so um and so in that marketing webinar I talk about um and it's on YouTube if anyone wants to go listen to it um send me I'll put it in

the show notes yeah okay so one of the big things about that is the acquisition costs if you let that patient go away and now you've got to go and get the new patient to replace that patient that you've just not rescheduled doubled up your acquisition cost how is it any different if you don't reschedule a patient you might as well have lost them because they don't come in either way so however you want to look at it if they're in on your schedule it's not

an active patient so you have to look at it and go okay well what is the cost to go and reacquire that that patient never mind like getting a new patient in just going to go get that patient back on your books if you don't it at the time that they are in the office there's a extra cost to that there's additional cost so we beat that drum nonstop and we beat it to death because you are wasting money anytime you now have a front desk

person having to call that patient up send them text adding to the customer acquisition cost is how I would look at it it's exactly what's happening is you're burning overhead anytime you do that so that's a really important I mean you know we'll probably hit on this again just because it's that important it's so important well we we look at the same thing here at boom Cloud being a software company you you think we're so different but it's the same thing like we look at that

if if people sign up and they don't adopt and they're not paying like we have costs and if my team is have to get back involved like your team would if if they're having to recall a patient back into the office for appointments if we have to recall recall as well and get them to actually try to onboard and adopt and use our software it's adding to the the acquisition cost because it's like oh these guys really aren't adopted and and into our system because we

we have adoption metrics just like a practice would or activation metrics or however you want to say it it's the same thing so no that's really interesting and yeah very important um for practices to really understand and dial that that uh process in for the practice so you're not losing um and and adding more to your acquisition costs uh that was great thanks that was great going down that that RIT yeah that was great it was valuable okay here's my third question for you what is

the average revenue per patient uh for each type for a PO patient a feif for service patient and a or a cash patient and a membership plan patient yeah okay so I love this question um I'm gonna frame it in what we call the annual patient value yes that that's that works too yeah this is the this is the easiest way to the easiest metric for us to describe yeah to measure all of that so um and this was shocking and we've actually talked about this

before Jordan on and off the camera um for uh for our in network you know for po patients our annual P at our office and it's Gonna Change It's Gonna Change yeah yeah so I just pull we Ryan pulled it for just for our office we all the way from Africa H he's pulling that yeah yeah and so we we we can pull it for other offices but we just wanted to give everyone a taste for a very personal level right so we pulled it for

our office so for our office the patient uh the annual patient value for a PPO patient is about 900 we'll call it 9 50960 um I think the exact number was 961 um and if you look at our patient benefit members the annual patient benefit or excuse me annual patient value for those benefit members was more than double it was about 18 it was right around $181,900 per patient so that's crazy that that's just that's just treatment Revenue that's not that's not including the subscription right

for the that is just treatment Revenue that is annual patient value of of what that patient brings to the table yeah so what can we infer from that right like so what does that tell us other than obviously our our patient Benefit Plan members are twice as valuable as our po patients are well that sounds awful doesn't it but yeah it's just data well that well that gets worded um but yeah what what we can infer from that is a couple things is if we know

that their acceptance rate is about the same right y if it's 38% to 40% we know that if they're worth double the value that's because you're getting more return on per patient you're not having to do these massive write-offs so now we're back into the write-off discussion y you know and you know discussing the crappy things that are going on with insurance right now the fact that insurance companies are decreasing reimbursement rates the fact that we are dud off more I just did another episode on

my other podcast it's a it's all dental insurance podcast and more and more uh insurance companies are using AI To Deni deny more claims it's insane what they're doing it's like wow what a great partner practice owners you get you get a partner that's not really care caring about patient Health they're just bottom line like look I'm a capitalist and an entrepreneur I I like bottom line but you got to balance it out between taking care of your customers and and profit right it's a it's

always a balance anyways it's huge like that that is think about that for a second if basically what you're saying is that you could lose if you build up for every your your patient Benefit Plan members one of those is worth every two of your PO patients so you can actually do less work if you wanted to by optimizing your your patient typee to like a membership patient for example you could do less work and make more money exactly as a practice so you're not hurting

your back and neck and shoulders every day yeah we yeah we should probably I mean uh so my partner Dr Hill was sick this week and so we had a full two doc patient load and I I talking off screen that I Saw 52 patients yesterday and like I was feeling that believe me when that number came across you know um my email this morning I was like oh I could yeah half sounds nice oh man yeah that's that's a big day big day that was

a big day that was a big day but yeah nice job nice job by the way yeah uh I we're we're seeing that more and more though where paatti excuse me U practice owners are wanting to get out of network yeah but are scar they're like they're freaked out that like am I going to be able with my patient load you know if I let go of of this insurance how many patients am I going to lose right and how's that impact practice I have a

story years ago I talked to a practice in Texas I was in Texas speaking at an event and we were talking about going out a network and reducing dependence on ppos and you know most the audiences vibe in with it like yeah let's do it like we don't want ppos right but then there was this one doctor in Texas and I totally get like how he was feeling he's like Jordan I was talking after I presented he's like Jordan I'm super scared to do this I'm

like walk me through that doc like I I'm genuinely curious about why you're scared he's like man if if I cut out ppos like I feel like I'm going to lose all my Revenue I'm like that is a valid concern yeah and it can it can happen right and then I sat down and chat with him for a little bit longer I'm like look you don't we're not I'm not telling you to rip off the Band-Aid like that's the last thing I would recommend to have

practice like this is is a strategy right that you should go I mean you guys have been working on this that that type of strategy of reducing dependence on ppos for probably a few years now I would imagine um I'm assuming here so you correct me if I'm wrong yeah I mean in the different phases that we've gone yeah it's a it's a phase out strategy and your your office needs to learn certain ways to ways to treat patients uh ways to speak to patients you

know it's it is the it is a whole culture shift within the practice right and the patient base but sat him down and I'm like look doc identify the least like your smallest cohort po that's driving patients to your practice look at the add a network benefits for going out a add a network and see if those increase just automatically right and start with a small cohort and just practice right phase one is I'm gonna practice this this PO has 50 patients that come to my

office right for example start with that one versus versus like Delta don't start with that one that's probably the biggest one in most practices right but then I said but before you do that like you need a you need a layer of protection and that's your membership program because you can add those patients and say you know what we actually developed our own plan for for practic or patients that are not on this on a specific po plan to get quality care and and benefits for

staying loyal with our practice right and you start with that and you start to build up a recurring Revenue uh pipeline right that's constantly driving recurring revenue and Doc as you start to reduce one by one and build this this recurring Revenue machine for your practice it will relieve you of that burden of loss because you're building recurring Revenue while you're taking away uh like a a PO plan but the reality is when you do most out of network benefits are higher than in network right

when it comes to pay so anyways he's like oh my gosh I didn't even think of it that way and he started doing that and exactly that he's now starting to reduce more and more over time and he's not as scared anymore but yeah it can be really scary to go out a network like I especially if you build your practice in the PO environment so well and I think you've hit on a huge huge component and that's you've got to have a plan you you

absolutely have to have a solid strategy and a plan on how going to to do this and it's you know most offices uh especially new offices newer offices they usually have we talking we were talking to an office uh in Idaho and we said well what no Montana I said what what plans are you taking all of them every PP owner of the sun I say like no for real which ones he's like I think it's all of them I think he's probably probably like 5,000

yeah yeah he's like yes he's like all the umbrell networks too yeah so it was like well have you talk about phasing off any of he's like I don't even know where to start you know so that's a common problem it's like I don't know what to do next and so there's a lot of good advice out there and a lot of good um plans and programs and podcasts and webinars on on how to come off of uh the PO train and but it is it

takes time and it it's it's not a low energy low effort kind of thing there's a lot of discussion with patients and it's a high investment uh as far as uh emotion and time you know because there is a fear of like oh my gosh but with that data set in the back of your mind if you go you know that my PE my patient Benefit Plan members are twice as valuable you know monetarily as someone that's a you know in network Insurance patient that's I

mean that takes a little stress off and you know I think that in speaking to the data of that depending on who you look at or what you read you can probably plan on a minimum of 30% attrition minimum of 30% attrition um if you go going out of network of losing those those in network patients okay so I would I would say worst case scenario depending on where you're at you can lose up to 90% so you do need to look at that and go

you know if you live in a highly insurance if you live in Utah for example yeah Utah's bad that's so Insurance driven in so you have to look at that and go I could potentially lose 90% of my patients I'm going to lose a minimum of 30 of these of these you know Delta Blue Cross whatever patients um and plan for that and you have to look at it go how many patient Benefit Plan patients compensate I would I was just going to say that so

if if if it's 30 30% for example Le calculate the revenue what that equates to based off your practice size uh and then you can say okay before I start this I need to create a marketing program to attract more uninsured patients for example or small business owners that don't have insurance and if it's 30% potential loss then you need to then then building up a membership program prior to that is even more critical because you want to replace that Revenue before it it's lost in

in in recurring Revenue so if you're a million dollar practice and it's 30% what is that three uh what is that number 300,000 in in potential loss do the math right I think so now people are like so relyant on they're gonna check it they're gonna be they're gonna have the calculators out and they're gonna yeah yeah it's 300,000 emails so that's 25k a month in recurring Revenue so you got to find the average po or the average membership program across the United States is about

$45 a month for a preventative care uh plan so figure out how to get uh 3 to 500 active patients on your your membership program and that will cover that will that will replace that with in terms of recurring Revenue will generate about 25 30k in recurring Revenue that then you can start taking that off and then we know the math now you those patients are going to spend an average of two times more on Delta I think it was like 4X more but on the

average I would imagine it's it's you said two times more so by attract just by attracting that type of that cohort of of patient and getting them on you're replacing the the potential the potential loss of a of going out of network with ppos or a patient turn but then you know that cohort of patients are going to spend two times more so it's like a huge win to focus on that first before you reduce right and just get your your financial house in order in

terms terms of patient Revenue so no that that's really interesting data and and one of the things that you that has to be looked at is if you look at any of your cash patients and I understand like what we were talking about earlier like people saying oh I don't want to mess with that cash base because they pay 100% of my fee and it's like well it's a myth that's you would think right but 24% pays 100% yeah exactly yes it's a it's a percentage

within a percentage so yeah and and for us always a starting point for anybody that wants to move towards their patient benefit plan and building that up is okay take a look at your cash patients yeah and we I get it we still have patients here that have been longtime patients here that are cash patients in have that they're like I like paying more and we're like oh all right sounds good um sweet dog yeah start with that yeah Swip great great we love you like

um you'll get an extra Christmas card because we love that but the the the that base of patient should be your target right off the bat to build your patient Benefit Plan yeah I agree you should have some verbiage in your head of like how to present that and what that looks like and you know again there's formulas uh I love that boomcloud on your guys website there's actually a calculator that you can go in and factor in and say okay well what let me figure

some of these numbers out you know uh to to help to figure out what what do we need to set costs on on membership plans and all that so but that's that's where I would start for anyone that's like yeah I'm thinking about doing this is okay look at your cash base and start moving those patients into your patient benefit plan because they pay more when they're in their plan what about so if a if a cash patient is not on a membership plan back back

to this number three question what is the average spend uh annually per patient on the in the cash cohort um that one I totally forgot Jordan I didn't look and you good we we'll have to put the numbers in the notes because I do have them we'll put the numbers in the notes yeah yeah cool so we know we know in network is like 961 per patient and then we know um membership plans were like 1900 it wasy I don't remember the exact number but I

can tell you it was pretty close to the PO number okay so comparable to a PO number okay yep yeah which again that's interesting right like because you look at interesting but you correlate that with if it's only 24% % of that cohort is actually like spending exactly because and you have to look at it at least for our office you have to look at it and look at what that patient base looks like and again that's your transients that's your emergency patients these are people

you know that probably need something you know um very acute addressed and then once it's done they go away so interesting go look at that okay no I love that data all right last question then we'll we'll end the show here today this been great thanks man yeah okay so question number four what percentage of benefit usage do you see with po patients compared to those on a membership plan uh so this was a fun question um and this was one again that is super hard

to answer you know uh the the biggest reason that it's hard to answer is that benefit usage if you're a patient Benefit Plan member your benefit is infinite there is no cap like there's no limitation yeah there's none it's almost like the insurance companies don't want patients to get care right no Li they don't well why would they then they have to pay for it right so um the the there is no cap on your membership plans in your office um a matter of fact when

you pull up and we use eaglesoft and if you pull up eaglesoft and you click on our page it populates the patient information and it says insurance and it says patient benefit plan it says remaining benefits it's the biggest number we can put in there so because because there is no cap to to to what that benefit is when you're offering a percentage right so yeah 20% off of infinity is 20% off of infinity you know so it's like where Insurance um you know what percentage

do they use up uh you know that probably is an easier data set to pull from but again there's no there's no precedence for that we're H we're having to create that these are really good questions because it's made us dig in and we're actually going to pull yes I love it yeah we're going to create some new data sets um to answer these questions but um in the time that we had to to from the time that I got your message to to today you're

still digging well it's really hard like because you have to look at it and go holy crap how that is a super hard one to answer because you you basically have to go through and pull first of all everybody's benefits uh the number is different depending on what plan they're on um depending on what insurance company they're with what plan they're on all of that stuff and then to go in and you almost have to go in individually and go how much did they spend out

of that benefit and then the other thing is is like they offer so if it's Ortho the percentage off is different than say like crown and Bridge which is different than say restorative like sure you know fillings so there's factors that go into that I have some data on the on the on the PO side right so dat data from the National Association of dental plans which is interesting because they spent like a half a million dollars on lobbying um just that organization spent a half

a million in lobbying to pay less uh for help the insurance companies pay less last year actually here's an interesting stat that I just remembered from a podcast two two days ago um 100 uh insurance companies spent last year like $80 million dollar more or less on lobbying to pay less to out to practices Jud that piss you off um this article here is saying uh the association of dental plans indicates that very few Dental enroles so patients reach their uh annual maximum for in Network

Services they're saying in this article 5% utilization for ppos right which makes sense if you look and I'm digging into this more to make sure that uh this is accurate but I would imagine yeah right here here's a quote very few Dental enroles 5% reach their annual maximum for in Network Services most people don't hit the maximum meaning insurance companies been around for a long time it's a game for them they've figured out psychologically how to how how to uh get the patient thinking less right

not not saying yes to as much treatment because it's psychological we know that too that I think the average um maximum is like what 1,500 bucks still hasn't changed it's like what is it what is like an implant Crown cost all all in like what is it I know it's it's going to vary uh ZIP Cod an implant CR yeah I mean an implant Crown in our office is is um we'll just call it 1,500 bucks it's a little bit more than that but yeah we'll

just say 1500 which 100% on yeah sure okay that's interesting and then I'm sure there's other work that you got to do that goes into that cost right they pay 50% of that 15 we'll just call it 1500 for ease of P % of it so and that's silly to me well I I don't I don't like that data set think that that that data point is bad um first of all because if someone if they say only 5% but if if if their benefit is

1500 let's say because again that number hasn't changed in how many years you know since the 70s I think is awful yeah but let's say they have 1500 and let's say they use $1,499 and so they still have one1 left on their benefit so it dirties the number you know and so I don't really like that but it does tell an interesting but 30,000 foot view data yeah yeah you know but I do think that if you look at it and you say okay well uh

only 5% are maxing out um you know and I think that that's something where we have to take that seriously and and apply it to what you were just saying is that insurance companies have been at this for a long time and they absolutely they figured this game out way before you open up your doors into practice theyve on a scarcity mindset and they thrive on this idea of uh you know getting the patients to believe that they cannot do any additional treatment Beyond or or

doing the minimal amount of treatment well yeah the PO patient says I will only do what my insurance covers it's like well you're not gonna get much you g get 1500 bucks yeah and you know we talked about this before and this is infuriating to me and I want to get this back out because I want to hear you I want to see push back from our providers they need to know this is happening in multiple States uh um Insurance you know through our members that

I've been talking to um members have gotten letters from insurance companies threatening them threatening them that they will drop them very common that they are doing unnecessary work which these are docs that are extremely moral individuals and oh yeah and and like these are helping the old ladies across the street kind of quality you know these are amazing guys the red tape put on practices by these corporations is insane this scare game pisses me off so bad like to to send a letter to a provider

and say if you don't stop doing crowns we're gonna drop you yeah you've done X andx and so now what it's forcing I was on a forum the other day a Dental Forum with this topic on there and it was just you know comment after comment after comment about you know we're we're having to use AI photographs multiple images you know as far as radiographs and send all of that into the insurance otherwise they'll deny them and now they've gone to not yeah the AI denials

dude you listen to that podcast that I just did two like two days ago on AI Den it's ins it is insane that how tight they're getting on on denials because of AI right it's like how do we use AI to fight back right and that's what that episode was about but it's insane what's going on it's like oh my gosh if you're not adopting and and changing with the Innovation you're going to get left behind in in regards to denials oh totally and you know

for we we use Pearl there's an you know an unvetted uh push for Pearl yeah we're friends with pearl yeah what's up Pearl we love you guys hey there's a lot of Utah Pearl guys so we we see them they they come visit us at the boom Cloud office all the time so so yeah we use we use Pearl and um you know and I love Pearl for multiple reason I won't get into why I love Pearl but I really love Pearl we can bring them

on and talk about them but I think it would be good to have you know an actual provider of an AI software come and chat but you know one of the things that that AI it's not perfect yet and anybody that uses it knows that it tends to pick up burnout sometimes that it'll pick out like a tongue line or something you know and and and it just happens because it's not perfect yet but you have to keep that in mind when you look at your

AI and know the insurance is using that same freaking stuff on their end and saying oh we're using this to deny this and it's like yeah you're using an imperfect system and now you have to go fight that you know and it's it's getting so comp it's like it's like yeah it is because like often I think of Dan I'm like man we got to do as business owners we've got to uh justify like our expenses with like the IRS for example and now it's like

yeah yeah let's barf uh and then it's as a practice own you have the you have the insurance companies which is like an auditory uh like a like a like an IRS like secondary clinical IRS you know where they're like auditing and and making it really difficult to run the company and there all this unnecessary admin cost right because if you look at like everything we have to do today to like manage our businesses from just an IRS perspective it's like man this task that I'm

doing today is doesn't really serve like bookkeeping for example doesn't really serve the business it serves the IRS and what what you're saying today in dentistry is like you have that and then you also have the clinical side of it to fight for your your patients to get the care they need because insurance companies are doing the same type of audits to pay less well and you know anybody sorry it's ridiculous so true and and anybody that's had to deal with insurance in the last you

know two years you've definitely seen that push you know policy's been changed uh you know insurance coming because all of a sudden you're seeing you know weird things happening across that you've never experienced before you know what is all this red tape that the insurance companies are putting us through you know and so um I think that it's important that people be aware that that's what's happening you know that that and again you know we need to talk to our our state um you know Dental

boards and appeal to the Ada this is stuff that is really really important that that these groups that represent us that they represent us irly and that there's push back because I agre how much how much money did they spend on lobbying what' you say toward uh they spent more or Le yeah more or less I I did an episode on this three days ago like all I do is podcast um three days ago I think it was around like 100 between 160 180 million last

year in lobbying right um just to so they don't have to pay claims out right it's all that's all the money spent on which is silly me because it's like I love capitalism and privatize capitalism a lot because we can solve a lot of problems uh in the private Market but whenever a private business or a nonprofit goes and whines to the government says protect us because we have a shitty product that's not really serving people uh that's that's why lobbying exists right it's because they're

they're it's they're scared that people will turn out and they'll lose their their revenue Source it's like but the truth is we should allow people to choose best service for them versus forcing them to do it through lobbying that's that's all that's how I look at it no I agree you know what I mean but no uh yeah it's it's a large amount of funds every year that go to lobbying it's insane it's like maybe we can create a coalition of practices that we can then

like do a Lobby like a lobbying for practices against it if we get a coalition together I've talked to attorneys on this this is how geeked out I get on this type of topic like how do we create a coalition of lobbying of of like a whole network of dentists to to then fund a lobbying effort uh on behalf of the the practice owner side against insurance companies and all that stuff I'm sure there's some that exists but that's what I think about on the weekend

sometimes this is what I do when I'm in the bathroom this yeah this is my morning routine yeah shower thought shower thought shower thoughts the thing about this question Jordan the question number four here that that we've been talking about and and I don't mean to like dismiss the question but on top of everything else that question is a little bit um it's kind of unnecessary it the question really because I mean so what if they use 100% of their benefit what does that tell you

that it doesn't really tell you a lot yeah that's a that's actually a good point because at least with a membership plan it's like well 100% is infinity because there's no cap or limitation no that's great so even if even if a patient comes in and uses 100% of their benefit right let's just say that they're train wreck and they have they need full mouth rehab sure so they use up 100% of their benefit well what does that tell you that doesn't tell you we want

to go back to that annual patient value that gives us a lot that's more important yeah yeah so which number three is more important much much more important so don't get you know anyone listening to this don't get hang up on that question that's not really you know whether or not someone utilizes their benefit or not you know there's some peripheral information that can be you know drawn from that you know like would they be better off on a patient benefit plan if they're not utilizing

all of their you know benefit and they're you know if they're private if they own a company and they can make that change you know is that a pitch you want to say to them is like hey you know you can actually save a lot of money by dumping you know your insurance company coming on board bringing your company on board to our patient Benefit Plan you're going to save you know X of thousands of dollars depending on how many you know uh employees you have

to that point it's probably worth discussing you know if they have a healthy employee base but um but beyond that's we do with all of our place yeah Dr Anderson Dr Anderson loves us down the street what's up Dr Anderson him and Dr Anderson yeah and we we actually just started getting ready to sign up to an optometry practice that we're helping do the same thing just here in Lehi um so Dr Gray excited to get on board on on your uh Vision membership plan have

with vision like you know what I mean like a vision plan like there's so much like fun marketing you could have with like having a vision plan just think about that for a sec like you go nuts you can go nuts yeah they do really well that in that industry and it's they actually have worse po problems than Dental it's that's alarming to me it's they treat them worse than than the dental industry I feel bad for the Optometry industry with the insurance companies in there

they're sharks you're saying there people worse off than with than Dental it's it is going on Dental wow yeah it is it is hard medical raising their hand they're like uh hello hello yeah yeah yeah no dude this has been an awesome episode and a lot of data a lot of fun uh and it sounds like as you as we both do some more homework we'll have some more data to come future shows so yeah and and to you know if anyone has any questions on

this I think that they you know reach out to us reach out to Jordan you know let's you know our our our emails um really easy it's always on our web page at elevation association.com it's just yeah just elevation Association gmail.com so if you have specific questions about your office or like hey we I'd love to get some answers like we love doing that stuff um and and digging in and helping people make sense of uh or or collect in data or making sense of their

current data so yeah that's great you guys have got a lot of resources on your end too so I think that that should that should be something that people know is available to them yeah if you're interested in uh increasing the average re annual revenue per patient uh membership plans are the way we've got a lot of calculators ebooks uh webinars uh on our site that you can download and and consume and as well as scheduling the demo looking our at our software program and how

it can help you uh launch and scale your patient membership program so Dan Awesome episode as usual uh I look forward to every Friday because we have really awesome high quality in- depth conversations in dentistry so appreciate it man that was rad it was way rad so with that said all of our listeners we hope you guys have a rocking day [Music]