Innovation Within the Patient Financing Landscape
In this podcast episode Jay Letwat, Executive Director of Business Development at Sunbit, and Amy Eveland, COO of The Smile Group, sit down with Brian Zimmerman, Senior Director of Content and Strategy at Becker’s Healthcare, to discuss the current patient financing landscape, why innovation in regards to patient financing has been stagnant, what can be done about this and more.
Brian Zimmerman: Hi everyone. And thank you for tuning into the Becker’s Healthcare podcast series. I’m Brian Zimmerman, Senior Director of Client Content Strategy with Becker’s Hospital Review.
Today I’m pleased to be joined by Jay Letwat Executive Director of Business Development at Sunbit and Amy Eveland COO at The Smile Group. Jay has over 23 years of leadership experience with his career spanning several industries, including finance and healthcare. He specializes in maximizing growth for new products and services, in particular companies whose product or technology is disruptive to the current market landscape.
At Sunbit since the very early days, Jay has focused on building strategic national accounts and introducing some innovative buy now pay later financing technology solutions to service providers across the U S. He has built Sunbit’s presence in the dental market from zero to over 2,000 locations and manages its current hypergrowth across single practices, multiunit practice groups and DSOs.
Amy Eveland has been in dentistry for a total of 30 years and has worked with Dr. James Burden for 28 of those years. She started as a dental assistant and worked her way through each position until becoming the Chief Operating Officer in 2018. In 2018, Dr. Burden and Amy created The Smile Group, which now consists of five dental offices and a call center with more growth expected this year. Between all of the offices, The Smile Group collected over $11.5 million in 2021.
Jay and Amy, thanks for being here today.
Amy Eveland: Hi, I thank you for the invite.
Jay Letwat: Thank you, Brian. Appreciate it.
Brian: So let’s dive right in here. And Amy, perhaps we can start with you on this first question, which is just sort of to give our listeners the lay of the land here. So can you give our audience an overview of the current patient financing landscape?
Amy: What we have offered in the past is just your typical third-party financing on top of, you know, if the patient can’t pay in full with their credit card, your typical Care Credits, Lending Points, different types of financing. And of course, Sunbit, which has been new to us for the past four and a half months, but it’s kind of hard to compare the finance companies because Sunbit is totally different and innovative and something that we’ve never been able to have before in the dental field.
Brian: Well, thank you, Amy. And Jay, from your perspective, you know, what are you seeing out there? What what’s the current patient financing landscape like?
Jay: Well, basically what we see are, are really a couple of things. There are really two types of current patient financing solutions out there. And it’s been pretty consistent for the past 30 years. There’s solutions that accept only patients which are prime, so folks with very high credit scores. And that’s typically what you see with some of the dominant leaders that are out there today. The issue there is that they only approve about 25 to 40% of patients that apply, which, which is generally pretty subpar, then you have other solutions that cater to subprime folks, good people who may have had some trouble with credit in the past, and these sorts of solutions, Brian are more, really long, drawn-out terrible processes that are typically very harmful to patients with respect to, you know, skyhigh APRs. Lots of paperwork and clearly in some cases, they can be deceptive. So what we see are these two very different solutions and what Sunbit is, it is a solution, which is one stop for folks that are high credit, low credit, everything in between. That is a super quick process that enables 85% of people that apply to actually get approved for financing.
So Sunbit, as Amy mentioned is very, very different from what’s out there and we think it’s quite innovative in the space and that’s really what’s driving our hyper-growth.
Brian: Yeah, Amy describes benefited as innovative. And Jay, I guess the question I have then is I’m curious about this: why is innovation with regards to patient financing been so stagnant for so long?
Jay: It’s a great question. And I would kind of think about it in like three buckets why it’s like that, and I think the first thing is there has been a single dominant player for the past 25 or 30 years. I think that’s the key reason.
And when you’re so large, when you’re 10,000, 20,000, 30,000 people, it’s really, really hard to innovate and also why would you innovate when you dominate a market for so long? So that’s why it usually takes, I would say a small upstart company to really innovate and take over a market. You think of like folks, like, you know, Airbnb, Tesla companies like this, which came out of nowhere and are now dominating a very specific vertical market who didn’t have really any experience in that market before. And, and I think the third reason is. The technology market has really, really changed in the past three to five years, specifically financial technology, or, you know, a lot of folks call FinTech.
So here’s a quick stat I’ll throw this to you. There are more bank accounts being open annually at neobanks, these online banks like Chime and others, than are opened at Bank of America, Chase and Wells Fargo combined. So the whole banking and financial technology industry has changed and when you’re a big company, it’s really hard to innovate and that’s really why I believe that it’s been so stagnant for so long—the innovation in patient financing.
Brian: Thanks for laying that out, Jay. Amy, would you add anything to that and any other thoughts on perhaps why innovation has been so stagnant around patient financing?
Amy: Just from my perspective and dealing in the offices with patients directly, I believe it’s a little bit more of they catered to the higher credit scores. There was nothing out there for those who really want to be healthy and maintain their health, but then, you know, just couldn’t afford it. Or like Jay said before, they had been through some things in life and their credit score was lower than normal. Sunbit has, you know, is thinking outside the box and being able to offer these patients an opportunity to get their treatment done and get their mouth healthy. As well as, you know, I guess other areas in, you know, financing, but for me, that’s, what’s been why it’s been so stagnant because they’re focusing on the higher credit score folks that and those people are little more able to take care of their health, if that makes sense.
Brian: Yeah. Yeah, no, totally. And then Amy, I mean, I think we’ve already sort of been alluding to this, but can you talk more about what could really be done to sort of accelerate past this, this stagnation, and really create more innovation when it comes to patient financing and specifically, I guess, starting with you, how can dental leaders, healthcare leaders prioritize innovation and the patient financing space could prioritize bringing those offerings?
Amy: For me, again, being in the dental offices, I think it starts from the ground up. And our profession, a lot of doctors and offices, groups, they focus on what the insurance covers and that they really allow the insurance to dictate the treatment that the patient gets. We, however, do not do that. We treat the patient on what they need regardless of the cost and this is where the financing aspect would come in. If the doctors would do that a little bit more it would make it more normalcy for the community to finance their medical care or dental care—just not letting insurance dictate what their coverage is and they’re staying within the maximum for the year, putting things off that should be done…We’re just not like that. If doctors changed their train of thought for patient care and not insurance, I believe there would be plenty more patients financing their treatment.
Brian: Thank you, Amy. Jay, anything to add there?
Jay: Yeah, I think Amy makes some really great points and I think what, what I see in what we see is as a company, 40% of folks cannot afford a $400 emergency expense. That’s outside of outside of healthcare and within healthcare, but the average dental bill is about $1,200. So you start to ask yourself, nearly everyone that’s coming through the door may have some financial issues, but because the solutions that are out there have a 40% approval rate, or they’re very difficult to, to apply for, the good folks at the front office, they simply don’t offer it. But I would say this: just because they’re not offering financing, doesn’t mean there’s the need goes away. The need is great. It’s greater now than it was a year ago. And it was greater a year ago versus five years ago alluding to a lot what Amy said regarding insurance.
So I think groups who want to care for the patients clearly have to ask themselves: Is 40% approval of patient financing, is that good? Are the patient financing processes currently, are they are those efficient for my front office team? And I think when you start to step back and say, do we have an issue with affordability at our dental practice? A lot of the front office team members, most of them would tell you yes, but there hasn’t been a solution that really caters to both prime patients and folks that have maybe less than stellar credit as Amy was alluding to earlier. So I think that’s really the point, bringing the conversation, the affordability conversation to the forefront, is really a way to really bring more innovation. It comes to, it has to come from need, Brian.
Brian: It makes a lot of sense that you may know, perhaps a below the average credit score shouldn’t be necessarily indicative of how healthy your mouth is. Right? Maybe I’m implying too much there, but I think like some of the obvious benefits that you’ve kind of of laid out here is access to care.
But I’m curious if we could talk more about those benefits, you know, so Jay, can you speak to how the integration of these solutions and, or new new patient financing practices will yield benefits for the patient and provider?
Jay: Sure, absolutely. So from the, from the provider perspective, case acceptance is, is the number one thing. We want to make sure that patients get the dental care they need today. Ultimately, that’s why we’re in dentistry. That’s why someone becomes a dentist. They want to help folks. But if you can only help a very small sliver of folks that walk through your door, you’re not really doing that. So we see today between 20 to 40% full case acceptance. You get the treatment plan, it’s $4,000 and there’s a gasp, how am I going to pay for it as a patient? Because most people don’t have that kind of money lying around. They don’t have a yearly budget of what they’re going to spend for dental, so having a solution that approves 85% of folks in less than 30 seconds with no hard credit check is a big, big thing for the provider and for the patient. From the office team staff, again, it’s a very rapidly changing environment. There’s a lot of responsibility that the office team has and what Sunbit does is we allow a super quick, super efficient process that gets the patients in, gets them qualified and gets the loans funded so they can get the work done quickly.
And I think overall, it’s just a better experience for patients. They’ll have better outcomes. I mean, what good is someone walking in the door that has needs, and they walk out that same door without their oral health being taken care of? So those are kind of some of the things for the provider as well as it’s for the patient.
And if I can just add one thing, Brian, and I think it’s an important point. What I see, and I’ve been to a lot of offices through the work that we do at Sunbit, I increasingly see is dentistry as a-la-cart for the patient.
They get the treatment plan. There’s a list of five things. Those five things may add up to three, four or $5,000. And then you kind of see this uncomfortable moment where the patient has to decide what they would like to take care of today and what they would like to put off because they don’t have the money. It’s like going to, you know, a fancy French restaurant, you order the appetizer, but you don’t order the main meal because of the cost. And that’s really not what dentistry should be. This is really what we want to change at Sunbit.
Brian: Thank you, Jay. I really, really appreciate that. Amy, anything you’d add there about, about these benefits?
Amy: I 100% agree with everything Jay just said. From our perspective in patients focus and patient health, from a staff member standpoint, it feels so good to be able to finally help someone when they walk in the door, they feel like there’s no way I can get this done, it’s expensive, and then we’re able to show them, it’s not hit your credit. We’ll be able to work out these payment arrangements with you. They just walk out the door more confident and they feel better about themselves and they’re happy and healthy. And that’s our main focus with our group is just making sure our patients are happy and healthy and Sunbit makes that so much easier. Less stress on the staff, because it is stressful when you get that decline from another financial institution and it’s hard to figure out how to dictate what treatment they get. And our goal is to make sure all of our patients keep their teeth because studies show that you live 10 years longer, if you keep your teeth. So that is what we like to focus on, but just keeping our patients happy and healthy. Of course the case acceptance is great as far as business and the office goes, but if we focus on the patient care we’re going to get that acceptance regardless.
Brian: Yeah, it’s great to hear it. It’s gotta be gratifying for your staff and everyone involved. I’m wondering if we can hear more about it, Amy. So can, can you talk more about sort of the effect of adopting Sunbit and what effect that has had on your group? Thinking here from a production efficiency and patient and dental team perspective, all of the above, anything you can share there.
Amy: I mean well, we’ve been with Sunbit for I believe about four months now. I think we started back in September and from that time we’ve generated $367,000 and that’s people that are actually getting their work done, starting their financing. I mean, if you average that out, that’s an additional $91,000 or almost $92,000 a month throughout our whole group. The one thing I would like to kind of focus on with this is in those four months, 150 patients were subprime. So we were able to do $237,000 worth of dental treatment for those that would not be approved otherwise through another company. They would have been stuck either figuring something out, do something else out or doing something that they really wouldn’t want to do, like an extraction if they wanted to do a root canal. So they’re actually able to get the treatment that they need for long-term care, not just the here and now, get me out of pain, type thing.
For our staff, it’s quick, easy, literally takes 30 seconds to get the approval, help the patient figure out which arrangement or what monthly payment they would like. It’s just very simple, efficient, and quick. They get the answers right away. As far as the dental team’s perspective, it is rewarding. Number one, because we get to help this patient. That’s sitting in front of us that thinks that they can’t get anything or they have to get their tooth pulled or something like that. But on the flip side of that, Sunbit creates games and make it fun for our staff. They incentivize the staff for their cases that they’re closing. So we have several, several of our treatment coordinators that, you know, play that game and get gift cards and other, such things. So it kind of keeps the staff more engaged with Sunbit as well. So it’s just great all the way around.
Brian: Thank you, Amy and Jay, I want to invite you to build on any of those comments from Amy, but I’d also love it if you could explain to our listeners you know, just how Sunbit’s technology.
Jay: Sure, absolutely. How the process works is it, As mentioned, it’s a quick 30 second process in order for the patient to apply. We scan their ID just to make it very easy so that there’s no paper, it’s a purely digital process, no pen and paper, no invasive questions. Your listeners may be familiar with, you know, what is your income? Are you married versus single? Do you rent versus own? These are kind of all relics from like 1975, that credit card companies still use. We don’t ask any of those questions.
You simply scan your ID and then automatically we have an offer that comes up. We approve, our technology approves, 85% of all applicants, which is about double of what the average is, sometimes triple in certain demographics, certain areas. So we’re approving a lot more. It’s a faster process and it’s healthier also for the patient.
We have automatic repayments from the patient’s checking accounts so there’s no licking stamps needed. And then from the practice perspective there’s no risk of loss. So Sunbit takes care of the reimbursement in full to the practice and then we wait for the patient to pay us.
We have about a hundred employee customer care staff based in Las Vegas and what we call it is “Collections with Kindness.” And that’s really how the process works. So it’s really full circle where we’re trying to do good by the patients and the provider and really change and shake up things quite honestly in a dental space, which really needs some shaking up with respect to patient financing.
Brian: And Amy, any, anything to add there with regards to your experience with Sunbit technology?
Amy: I think he pretty much covered the majority of it. It does, the time, doing it in 30 seconds, as opposed to filling out a long form and getting their family history to see if they can get dental treatment, is so much easier. And it’s interactive with the patient as well. Just scanning the license and their debit card. And then they get options for payment arrangements and they can actually sit there and see each one of them and choose which one works best for them. So it’s very easy.
Brian: Appreciate that, Amy. And I like to move now to closing thoughts. So Amy, we can start with you any, any parting words of wisdom for our listeners out there. Anything you want to share before we sign off?
Amy: Just basically sign up. We’ve had nothing but wins with Sunbit. Just from a patient’s perspective, office perspective, business, everything has increased. I highly recommend any practice to join Sunbit.
It’s really rewarding to be able to help patients and if that’s your focus, this just gives another opportunity for them to become healthy and get their treatment done so, highly recommend it.
Brian: Thank you, Amy. Jay, to you now for closing thoughts.
Jay: Sure. Absolutely. And Amy said, well, so I’ll just add onto her for anyone listening out there that would like to see a demo you can go to sunbit.com/dental, and we’ll have someone walk you through a demo and hopefully get your practice started. I just want to emphasize, we work with a single practices, multiunit and DSOs. Everyone is welcome. We really want to help all dental offices and groups out there.
Brian: Well, thank you, Jay and Amy, it’s been a pleasure speaking with both of you today.Really appreciate you taking the time.
Amy: Thank you.
Jay: Thank you Brian.
Brian: I’d also like to thank Sunbit for sponsoring this episode, you can tune into more podcasts from Becker’s healthcare by visiting our podcast page.