Preventistry and Building a Culture of Oral Health Care with Fred Menko

Alec Goldman (00:52.477)
Welcome to How I Grew My Practice, a podcast presented by NexHealth. I'm your host, Al Goldman. In this episode, we have Fred Menko, VP of Growth Strategy and Experience at Advantage Dental Plus. He's here to talk about “Preventistry”, an interesting concept. It's about building a culture of oral healthcare that empowers the overall health of patients. Fred, welcome to the show. How you doing this morning?
Fred Menko (01:19.65)
Doing great, Alex. Thanks. Happy to be here.
Alec Goldman (01:22.301)
So excited to have you. Fred, for our folks in the audience who do not know who you are, if you can share a little bit about your background, what you're up to over at Advantage Dental, and kind of how you got into the industry, and maybe a little bit about this preventive street concept that you guys have going on.
Fred Menko (01:38.946)
Yeah, so my background is I've been doing marketing in healthcare for about 15 years now. Before that, I was involved in digital and large media organizations. Advantage Dental is a chain of about 80 practices across the country. We're really focused on Medicaid. My role there is kind of overseeing marketing, and some of our business intelligence. And then...
patient and to a large extent employee experience at the practices as well. So that also covers some of the recruiting and things like that.
Fred Menko (02:29.448)
Yeah, so preventive dentistry is kind of our big idea. Like you said, it's around really empowering the patient to take control of their oral health and impacting their overall health. We really look at it as being three major components, making access to care easy. So that means everything from making it easy to get to one of our practices.
To making the experience within the practice as seamless and as painless for them as possible. It's about having a really, we think, unique and differentiating experience of partnership between the care team and the patient where they work together to find a solution that's gonna improve their overall health and their oral health in particular. That can be anything from the traditional brushing every day and flossing to really, look, you have two cokes a day today, what if you just cut that back to one?
And that will even help. And then really looking at what we're doing with that patient and measuring the overall quality of care through our data and the information we have there to really drive a improved overall health experience.
Alec Goldman (03:40.181)
That's awesome. I mean, I think lots of, you hear this weird stigma with dentists in the industry of people pushing product and this sounds almost the exact opposite. And it's like, how do we make sure that people are living healthier lives and getting ahead of issues that would actually cause much greater expense? So I think that's an incredible thing that you guys are taking on, or taking head on.
Alec Goldman (04:09.297)
I guess when you think about setting goals for DSO and trying to obviously grow, see more patients, and increase revenues, I can feel that part of this preventive tree concept would increase effectively lots of cleanings. How do you mitigate driving successful outcomes and preventing bigger procedures from happening and growing something where the...
certain procedures might be more expensive and are more reactive than they are preventative.
Fred Menko (04:46.754)
Yeah, I mean, so it really kind of comes back to the idea that preventive street is more than just our day-to-day care. It's, it's a culture. But it's also, and it really, we've built structures with a preventive street that have to do with our customer service kind of bountries and the things we focus on there. And also on our care, our clinicians are actually measured on a clinical preventive history kind of scorecard that we've created that our clinical side of the business has really organized around. And then at the highest levels in our organization, we have a preventive history scorecard. And it's really eight metrics and it impacts everything from how easy it is for...
for us to deliver the care to the overall experience that our patients are having, and then also kind of the measurable clinical stuff. So we're really trying to create that culture by looking at those data points at least once a month, by talking about how people should be treated and what that access should look like in the practice consistently.
And then our business model is really built around a preventative structure. We have mostly a capitated population, so we're value-based, care-based, and so we're not necessarily getting extra revenues for the more complex care. So we really can focus on that preventative stuff.
Alec Goldman (06:12.51)
That's great.
Fred Menko (06:16.25)
production is tracked based on an elevated credit for preventative care over reconstructive. You know, you're always going to get new patients with great needs and our goal is really to get them, I'm not a dentist so I can't get too detailed in it, but to really get them to a very healthy state and then maintain that healthy state and improve on that.
Alec Goldman (06:37.769)
That's excellent. So I know that prior to our conversation, I think this idea of the prevention industry is so fascinating. I think it's so great that you guys are again, tackling that. Um, but you said you have this whole dashboard. Um, kind of what are the things that you're tracking around the concept of prevent history, I wanted to see if you were able to share that today with our audience.
Fred Menko (06:56.49)
Yeah, let me pull that up. I've got a kind of obfuscated view of it here. So let me share it and then go to a place where I can share it with you. Hold on.
Fred Menko (07:44.458)
Yeah, there you go. Are you seeing that? All right, so yeah, we look at this dashboard every month and keep it up to date. This one's a couple of months old and I've kind of obviously had the data, but you can kind of see here, we're tracking that promoter score. We do a not-promoter score survey to every patient. We feel like we do really well with that and have seen some really big increases this year.
Alec Goldman (07:46.952)
Yep.
Fred Menko (08:10.89)
We look at how many of our patients we're seeing with virtual visits or teledentistry and kind of see that as an opportunity and something that we're kind of innovating around to see if we can improve.
kind of the number of visits a patient actually is getting with the dentist by using teledentistry and really on emergent care, it's a huge lift for us. How many of our patients are getting sealants or carries arrest medicated, so things that will stop the kind of growth of cavities?
And so, and then Workplace is our intranet platform. So we wanna see how many, this is really the way we look at our employee engagement and how many of our employees are active on that platform. Advanced dental services that are not referred out. So how many of the referrals that we could be sending out to external are we kind of keeping inside of our network and making that care easier to get to show rate, how many of our patients are showing up for their appointments, and what percentage of them you know are not getting care for, employment rates, how many of our roles are filled, and then oral assessment compliance. We have three oral assessment tests that are used and we...
We look at those, we want every patient to see, to get those three assessments on their visits, especially during a comprehensive exam. So really these are the eight metrics that we kind of look at and say, you know, this kind of covers experience, it covers quality of care, it covers employee engagement, it really tells us how we're doing with our preventive street culture overall in a quick look.
Alec Goldman (09:55.221)
That's so awesome. So when you're reviewing this, I mean, what are some indicators, like taking data knowledge, or, you know, the information, taking information and turning it into action, right? So when you're taking a look at this dashboard, how are you going about on an individual location basis, going to the team and saying, these are the following changes that we need to make in order to better serve our customers?
Fred Menko (10:20.842)
Yeah, I mean, we spend a lot of time on external referrals and like figuring out, you know, who are we, so external referrals are one where we constantly are talking because we're below our targets on that one. And you know, we're really looking at what kind of procedures are referring out, where are those happening? Are we lacking a specialist in that region?
Do we have some of the things that end up getting referred out are things that a general dentist can do? And so do we have a general dentist who's comfortable in those skills and we're just not aware that they're in the market that we could be referring to or taking some of those cases? Same with the show rate. If we see dips there, what are we doing to improve the show rate? We've actually seen a large improvement this year due to some of the things that we've done to try to improve that. And those were things that took some time
but that we knew we were going to have an impact on the show rate. And so we've been looking at these data points and really looking for ways to improve on that on a regular basis on every one of them. Some of them are new and we didn't know what to expect this year. So, we're pleased with kind of where we're at with them. And we're also always looking, you know, it's an annual review process of what data points end up on the scorecard. So the ongoing discussion is, okay, you know, we feel like we picked good things for this year, but what's next you're going to need to be, where do we want our focus to be looking at?
the business overall. Most of them stay. Some, you know, a few of them are for us, just they have to be there so that we're looking at them and tracking them as a business. But every one of them we look at and have a discussion, especially if we see them drop off and talk about, you know, what's going on and why did this happen. And what can we do to fix it, which is the action that always, that's really if you're looking at data, that's the reason you should be looking at it.
Alec Goldman (12:07.669)
That's right. So can you talk a little bit about all the different tools? I know that we work together between Advantage Gentle and NexHealth, but what does the tech stack look like that enables and is really building this type of dashboard that you can view from a high level and kind of look down at all the different practices that you're helping in overseeing?
Fred Menko (12:28.01)
Yeah, so I mean, the tech stack is really every tool that we use in the practice, all the tools we use in the practice. So we're looking at our front end, our practice system, and the practice management system that we have in place and grabbing data from that. We use NexHealth, we're grabbing data from that. And then all the other tools that we have at our disposal and we're pulling those into really a Power BI system.
creating a data lake basically within and accessing it through Power BI to kind of create dashboards like this and several others that we use to day-to-day manage the practices.
Alec Goldman (13:05.557)
Can you talk a little bit about the relationship of guess how you guys are leveraging specifically NexHealth in the greater idea of the preventive street again, kind of like thinking back to no-shows and getting the door?
Fred Menko (13:18.582)
Yeah, yeah. I mean, show rate, if you think back to the dashboard, we saw some large jumps in May, and we've really been, our valleys this year were January, February, and March. From May on, we've been really seeing huge increases, and that was aligned 100% with the launch of NexHealth and our practices and the confirmations process. And I think if we don't look at this, but it's actually on our list of things to consider for next year, but actually, you know,
how we're doing against the capacity of the practice, what percentage of total capacity are we hitting on all the practices. We've actually made that work really great with NexHealth along with the kind of wait list features. So if we have an opening at the last minute, we've had openings at practices, 10 minutes before the appointment, we get the cancellation and we've been able to fill those with waitlist.
that way, this functionality. So while that won't show up on our show rate as being a cancellation, a negative cancellation on our show rate, we know that we're filling those gaps with technology that allows us to communicate much faster with patients. You know, texting and email are.
in many ways the preferred way that our patients want to interact with us. And it really helps us actually in the practice because it takes so much load off the phones. You know, we don't have to, we're not calling out for confirmations as much as we used to have to. We also not have to have inbound scheduling happening as much because patients are comfortable scheduling online. They do their paperwork online. We're really, we're even looking to completely digitize that experience because we think if it goes back to the dentistry, it makes the access to our practices that much easier.
Alec Goldman (14:59.229)
So you mentioned that ultimately even technology certainly helps the patients and how they want to communicate. But it certainly makes the lives of your staff much easier. Can you talk about how this idea of preventive strategy also is helping the staff experience?
Fred Menko (15:18.59)
Yeah, so I mean, our staff consistently is talking to us about how, you know, other places they're, they're feeling a lot of stress around, around production, around having to do a certain number of the more, of more complex care. And here they really get time to spend.
with a patient teaching them how to have better oral health habits. And so many, many of our patients, because we're Medicaid focused, our kids, there's so much that we can just teach them early on today that will impact the rest of their life and the docs and all the staff really benefit from.
The fact that technology is reducing the amount of time that they have to spend on phones and things like that, they can spend that time having those educational conversations and really making a difference in the habit instead of just treating issues.
Alec Goldman (16:12.569)
You've been with Advantage Dental for a few years. I guess one, how does this differentiate from past organizations that you've worked with, would be my first question. And then where do you see Advantage Dental going in the next five years? Especially like kind of growing out this idea of preventive history and as you guys scale the organization even more so.
Fred Menko (16:38.186)
Um, so how is it different? I mean, compared to places I've been at in the past, we are, um, well.
So most of my background has been in the medical side of healthcare. So it's very different because it's oral health as opposed to medicine, but it is different even in those regards in that the way we focus on production is very different. We're not really focused on production. We're really focused on seeing and impacting as many of the patients that are assigned to us as possible. We really are mission-focused. Our mission is to improve the oral health of all. And
It is the mantra that we have every day. And like the, and preventive history really is how we do that. It's really focused on having the biggest impact we can on the population that we're focused on, which is, you know, the Medicaid population who oftentimes has a hard time getting access to care, being treated and cared for in a.
you know, in a way that's gonna really change the way that they approach healthcare and in particular, their oral health. And, you know, the idea that we live our mission every day, I think is, you know, you hear a lot of people talk about it. I'm sure people will think I'm just saying this, but we really do live the mission every day. We focus on really making a difference in each person who comes into our practice and in all the people that we're focused on caring for, all of our patients and assigned patients.
Alec Goldman (18:10.717)
That's awesome. And what's next for Fred?
Fred Menko (18:14.95)
What's next for Fred? That's a good question. I mean, I'm really focused right now on, you know, making the practices and patient experience as great as we can in the practice, making sure we're getting great employees who are really focused on our mission and who put the mission first and who can get behind that mission. I mean, that's what I do every day and it's a lot of fun doing it. Great people to work with.
You know, being great at what we do is what makes me happy.
Alec Goldman (18:50.642)
That's awesome. Um, Fred, we're coming to the 20-minute mark. What is kind of like a last concept on, or a last thought on the preventive street that you haven't shared with the audience that you'd want to share? Um, what would you leave us with?
Fred Menko (19:04.65)
Man, I feel like I've covered a lot of ground on it. Really again, it's the way we achieve our mission. It is really behind everything that we do. The only other thing I guess about it is, you hear the word preventistry and everybody thinks it's just about preventative care and about cleanings and those kinds of things. And it's really about more than that, I think. It's really about.
It's really about this culture and the idea of a culture of preventive industry of everything you do is focused on improving the oral health of the population that you're taking care of and especially populations that in our case anyway have a really hard time getting oral health care, whether it's for time constraints and personal issues or whether it's geography really.
It's that access piece is a huge piece of what we do and making it easy to get to us and convenient is a big focus, I think. That's a big part of it, prevent history, and it's not just a clinical thing. It is something that people from our support teams, and our shared services teams are focused on all the way to our front desk, all the way through care.
Alec Goldman (20:17.469)
That's awesome, Fred. Fred, it was so great having you on the show. I know that we're extremely appreciative of your time and having you as a CAB member at NexHealth and all that you guys do with our organization. So I just want to say thank you and thank you for joining the show today.
Fred Menko (20:31.031)
Thank you, that was a lot of fun.