Patterson Cleveland Membership Deck

1. Dental Membership
Plans
The Path to Practice Prosperity

2. The Dental Economy
Source: ADA – State of the U.S. Dental Market Outlook 2018
Since 1990 the
dental market has
grown from $40b
to $117b or a
292% increase
(nominal)

3. Doctor Earnings
Source: ADA – HPI Data for 2017
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$160,000
$180,000
$200,000
Doctor Earnings
Doctor
earnings have
gone from
$80k/yr to
$172k/yr, or an
increase of
215%.
(nominal)

4. Which tells us…
• And it seems to be declining
• So where is all the money going?
• INSURANCE COMPANIES
That the doctor’s earnings (up 215%) are not trending
with the market growth (up 292%)!

5. What Your Practice Sees
How We Pay For The Dentist
Commercial Dental Insurance Publicly Funded Dental Inusrance
No Dental Insurance

6. The data from insured patients
• 33% of adults with dental benefits do not have a single claim within a year
• For 69% of adults, the amount they spend on dental insurance exceeds the value of their
payouts to providers
• Fees paid to dentists through dental benefit plans are significantly lower than market fees
• Patients with dental benefits get a prophy a little over 1.5x every 3 years on average
• Allowed once or twice per year
• Patients with dental benefits get bitewings once every 3 years on average
• Allowed once every two years (sometimes once a year)

7. The insurance money trail
• In medical insurance 80% or more go to the physicians for care
• 40-45% of all payments made to dental insurance stay with the insurer
At MAX 55-60% of the dental benefits are going to
the actual provider

8. Uninsured Patients
• 75 million patients with no form of insurance
• 30 million uninsured patients visit the dentist
• Leaving 45 million who go with no dental treatment
• Uninsured patients are 50-70% less compliant than insured patients
• Primary reason is cost and not having coverage

9. Treatment Plans
Typical Dental Practice
Insured Uninsured
# of prophys per
patient 1.3 0.5
# of procedures per
patient 5.5 2.5

10. I can’t raise my fees because I
have cash patients

12. Attack the uninsured first
• 89% of uninsured patients are interested in membership plans
• Membership plans are dental care plans that the office offers directly to their patients.
Patients pay a subscription directly to the practice for preventative care and discounts off
other treatment
• It’s a win-win because the practice receives almost all of the revenue and the patient get a
simple, affordable dental care plan that enables them to maintain their oral health

13. Membership Participation
• The average office with 1,500 patients
• Has 600 uninsured patients
• 25-85% of those patients would participate in a membership plan
• Low end 150 members
• High end 450 members

14. So what does it look like?
• The membership can be tiered or just a one size fits all
• As you go through these remember that we pay $20 out of pocket just to have our own
dental
Tiered
• $19 a month ($228 a year)
• One exam ($49)
• One cleaning($89)
• One set of bitewings ($62)
• Doctor nets $28 more than the 50th percentile / Managed plan it’s about even

15. So what does it look like?
• The membership can be tiered or just a one size fits all
Tiered
• $30 a month ($360 a year)
• Two exams ($49)
• Two cleanings ($89)
• One set of bitewings or pan ($106)
• Doctor nets $22 less than the 50th percentile / Managed plan it’s about $50 less

16. So what does it look like?
• The membership can be tiered or just a one size fits all
Tiered
• $55 a month ($660 a year)
• Two exams ($49)
• Two cleanings ($89)
• One set of bitewings or pan ($106)
• Fluoride treatment ($30)
• Free fillings on two teeth
• 20% discount on all other dental services
• Doctor nets up to $248 more than the 50th percentile

17. So what does it look like?
• The membership can be tiered or just a one size fits all
One Size Fits All
• $40 a month ($480 a year)
• Two exams ($49)
• Two cleanings ($89)
• One set of bitewings or pan ($106)
• Fluoride treatment ($30)
• 15% discount on all other dental services
• Carry over treatment credit
• Doctor nets up to $248 more than the 50th percentile

18. Membership Plan Design
• Much like everything else, if they do it themselves they have to have lower expectations
• Working with a larger company would suggest better results
• Run it like a traditional insurance sign up
• There is an open enrollment for new patients and patients without insurance
• If partnering with a large company have an iPad available with a video explaining
• GPs can lean on specialists to give discounts as well
• The specialist can use this as a marketing tool to bring in more referrals

19. Legal End
• CAN’T BE CALLED INSURANCE
• Can be called a membership
• There is no law endorsing or outlawing these membership plans
• Closest law in Ohio is ORC 3961.01 – Discount Medical Plans
• Customers can cancel within 30 days – Any registration fees above $30 must be refunded in
that time period
• Doesn’t limit membership fees