Great Patient Conversations

The link between cost concerns and value creation

Sameer Bhasin, MBA, MHA

Patients often cite cost as the reason that they are reluctant or unwilling to move forward with needed, recommended dentistry, but sometimes, perceived value plays a more significant role in their decision-making process. Let me give you an analogy. I have friends who refuse to pay $5 for a cup of coffee at a popular coffee shop because they can get what they perceive to be coffee of comparable quality for a cheaper price at a convenience store on the corner. Can they afford the $5? Yes, of course, but they have placed a certain value and price on coffee, and that is what they are willing to pay. In dentistry, many patients place a value or price on treatment that aligns with their dental benefits. Because of this insurance mindset, some believe that any dentistry that isn't covered by their benefits is "just too expensive." What they need to understand is that all too often, not having the dentistry performed can actually be more costly to both their oral and overall health.

The key is how the team responds when a patient says that treatment is too expensive. If they respond in the affirmative, then they are reinforcing the patient's mindset and may have undermined treatment acceptance. Instead, they should be educating the patient about the value of the treatment. People will buy what they value. To raise patients' perceptions regarding the value of dentistry, it is not something that should only be discussed when talking about cost. The perception of value is something that is slowly and steadily built throughout the patient's entire experience, which starts with the first phone call.

The VIP: Very Important Phone Call

The new patient call is the first opportunity to communicate to patients how important they are to the practice and the value of their oral healthcare. One policy that can help you to accomplish this is to never put a new patient on hold. Instead, create a system that signals to the rest of the team that a new patient is on the phone and that they need to step in and answer any other incoming calls or handle patient care needs for the duration of the call. This allows this first critical conversation to be in-depth and uninterrupted. The team member on the phone should be smiling, enthusiastic, and purposeful in capturing and sharing key information. He or she should also be respectful of the patient's needs and objectives for the call. This means asking appropriate questions and listening to, not just hearing, the patient's story.

For example, staff can inquire about what prompted new patients to call and make a dental appointment and then ask them to share their previous dental experiences and explain how the practice can meet their needs. Let patients know that you heard what they said, that you understand their concerns, and that their concerns and questions are valid. Be empathetic and ask permission to share information about the practice, such as what makes it so unique and why its patients are so happy.

Try to uncover patients' needs, set appropriate expectations, and never overpromise. People are happy when you exceed their expectations but become upset when they are not met. Tell patients that you want to make sure that the practice is meeting thier needs and ask them what they expect to happen at their first appointment. Make sure to take detailed notes about these conversations and document them in the patients' files.

Don't Tell, Codiscover

Regarding the conversation about examination results, diagnoses, and treatment recommendations, because doctors are so knowledgeable, they may inadvertently talk to patients rather than with them. Ideally, this conversation should take place in a clinical setting so that patients remain focused on the condition of their mouths and the solutions that will enable them to improve their oral health. It should also include an explanation of how their oral health benefits their overall health and why they should value the recommended treatment. During the examination, encourage patients to be a part of the journey and discovery. Communicate in a way that patients understand and verify their understanding of any information that will help guide their treatment decisions. It can be effective to both show and tell patients what is going on in their mouths. People learn in different ways, so sharing information both visually and audibly can help improve patients' understanding.

To build value around dentistry in the minds of patients, when discussing their diagnoses, specifically reference the potentially catastrophic results of avoiding treatment for certain issues, such as the potential fracture of a cracked tooth, and ask their permission to share your treatment recommendations. Give patients the opportunity to ask questions. Generally, when patients are engaged and interested, they seek more information because they are already in the process of making a treatment decision. Value creation should be a goal in every patient conversation, but it is especially important when discussing treatment options.

Talk Solutions, Not Money

As the patient is escorted from the clinical examination to the financial coordinator or practice administrator, the patient handoff provides another opportunity to build value. As one teammate introduces the patient to another teammate, the need for and value of care can be reinforced during the communication. Explain that the recommended treatment is going to help the patient get healthy and avoid additional cost and inconvenience in the future and that the financial coordinator or practice administrator will be working with the patient to optimize his or her dental benefits and provide payment solutions that will help him or her receive the recommended care.

At the beginning of the ensuing financial conversation, which is possibly the most critical patient conversation, it is important that the financial coordinator or practice administrator is able to restate the clinical need for the treatment being recommended and reinforce its value by explaining the consequences of delaying or declining care. After reviewing the treatment recommendations, verify that the patient values the dentistry before embarking on the discussion of financial options.

Great financial conversations happen when patients understand how their insurance benefits contribute to paying for the cost of their dental needs, the payment options, and the alternative solutions available. When a patient says, "That is expensive," they are not saying, "No." Acknowledge and validate their concerns and then work together to make financial arrangements that meet their needs.

Emphasize that treatment is an investment in patients' long-term health and identify their specific underlying concerns, such as the total cost of care or how it will fit into their budgets. Once their underlying concerns are identified, it is easier to focus on discussing the most appropriate payment solutions that you have available. After communicating that you understand that they didn't expect to have this expense and that they do not want to tap into their savings, explain that the practice can offer them several payment options, including financing solutions, such as the CareCredit healthcare credit card.

The themes running through all of these critical patient conversations are value creation, participation, and permission. Connect treatment to a benefit that patients' value, give patients the opportunity to participate in their healthcare journey, and always ask permission to take the next step. The dentist and team are there to provide information and guide the patient through the process via great conversations that build value.

About the Author

Sameer Bhasin, MBA, MHA, is the vice president of strategic alliances at CareCredit.