{"id":337280,"date":"2025-12-10T05:58:23","date_gmt":"2025-12-10T05:58:23","guid":{"rendered":"https:\/\/peraltafinancing.com\/uncategorized\/the-journey-toward-comprehensive-dental-and-medical-integration\/"},"modified":"2025-12-10T05:58:23","modified_gmt":"2025-12-10T05:58:23","slug":"the-journey-toward-comprehensive-dental-and-medical-integration","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=337280","title":{"rendered":"The Journey Toward Comprehensive Dental and Medical Integration"},"content":{"rendered":"


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Download the \u201cThink Oral!_Stephen Thorne audio file directly. <\/a><\/p>\n

Think Oral!_Stephen Thorne: this mp3 audio file <\/a>was automatically transcribed by Sonix <\/a>with the best speech-to-text algorithms. <\/a>This transcript may contain errors.<\/p>\n

Jonathan Levine: <\/strong>
Welcome to Think Oral.<\/p>\n

Mariya Filipova: <\/strong>
Where we connect the unconnected between oral and physical health.<\/p>\n

Jonathan Levine: <\/strong>
I\u2019m your host, Dr. Jonathan Levine.<\/p>\n

Mariya Filipova: <\/strong>
And I\u2019m your host, Mariya Filipova.<\/p>\n

Jonathan Levine: <\/strong>
Let\u2019s get at it.<\/p>\n

Mariya Filipova: <\/strong>
Hi everyone, and welcome to another exciting episode of the Think Oral Health podcast. I am Mariya Filipova, and I\u2019m joined by my co-host, Dr. Jonathan Levine. We are both on the East Coast today, hopefully after a couple of weeks of travel, and we are joined by a thought leader, change agent, and a business guru who has been able to do the unthinkable, which is build a successful business and scale a successful business in oral health. And we\u2019re very excited about the topic and the guests that we have lined up for you today. With that in mind, I will hand it over to Jonathan to give us, to reveal who is our conversation partner today.<\/p>\n

Jonathan Levine: <\/strong>
Yeah, we are so excited. Steve Thorne is right at the heartbeat of the connection of oral systemic health. Did you get that? At the heartbeat. He is the founder and chief executive officer of Pacific Dental Services, PDS, and he has built it since, what would we say, 1994 maybe, established that early, but PDS is a global leader in this integration of dental and medical care with a dedicated focus on their practicing clinician? As a company, they\u2019re committed to the achievement of very efficient practices, providing just excellent patient care management services for the dental practices. They have a core value, which is really interesting, it\u2019s called We Believe. We\u2019re going to be asking Stephen of how he takes concepts and good ideas, but how does he really make it all happen? Because that\u2019s what they do there. They have also PDS foundation. It\u2019s a 500 and 1C3 charitable organization, we\u2019ll talk about that, but through Steve Thorne\u2019s leadership, PDS has become really a preeminent authority on what they call the body, mind-body connection, what we\u2019ll call oral-systemic health. And what we\u2019re doing at Think Oral is to talk to people like Stephen Thorne of how they are creating this integration and the delivery of care and delivery of this type of mindset and thinking, but how does it really turn into outcomes to improve the health of people, not only their oral health, but that connection into the overall health? So with all of that, let\u2019s begin. Stephen, thank you so much for joining us.<\/p>\n

Mariya Filipova: <\/strong>
Great to have you.<\/p>\n

Stephen Thorne: <\/strong>
Yeah, yeah. Thank you for that warm, warm welcome.<\/p>\n

Mariya Filipova: <\/strong>
You\u2019re an expert on Jonathan. What a great intro.<\/p>\n

Jonathan Levine: <\/strong>
Well, that\u2019s right, I know Stephen for quite a bit, and I\u2019m so impressed because we met together at.<\/p>\n

Stephen Thorne: <\/strong>
Yeah, where was the first time we met?<\/p>\n

Jonathan Levine: <\/strong>
Yeah, we met at one of their early preceptor programs, and we shared the passion. But Stephen, let\u2019s start there. Tell me what got you passionate about the oral-systemic connection and expand not only what we do in dentistry, but how does it have that impact on the overall health for people? What got you there?<\/p>\n

Stephen Thorne: <\/strong>
Well, give you some context for what got me so passionate. The first part was pretty much purely business-minded. I\u2019m a capitalist. I\u2019m a business guy, not a dentist, not a clinician. I think I\u2019ve failed out of high school chemistry and biology and all that stuff, but excelled in the business stuff. It was about 2011, 2012, I started seeing all these articles coming out in the dental rags and journals. I was on a couple of boards talking about the oral-systemic link. I hadn\u2019t really heard of it before, and I\u2019d been in dentistry since I got in dentistry in 1989, and I started by putting in a computer system in my dad\u2019s dental office. That\u2019s how I got started. My grandfather\u2019s a dentist, he graduated Harvard in 1939 or something. \u2026, my brother\u2019s a dentist, one\u2019s a periodontist, and they still weren\u2019t all talking about this link, right? Most of my friends were dentists, but I started seeing all this, and I go, wow, there\u2019s something happening here. And I was watching it over a couple of years, I\u2019d known about the Surgeon General report in 2000 that said, look, basically you can\u2019t, we can\u2019t have good overall health in America if we don\u2019t have good oral health. That was the first, that was the kick-off for this. And then, the 2010 Surgeon General report went much deeper and talked about the importance of dentists in overall health related to cancer, the jaw, the neck, the able to eat what, much broader. So I put together a task force in 2015 to look at this for me, and I wasn\u2019t on the task force because I didn\u2019t want to steer it. And it was a bunch of leaders names you would know from across the country that were on it, Judy Haber, Mike Alfano, a couple of other leaders in this space, and a couple of my team members to collect the data. I wanted to, I wanted this to be real. I wanted to know if this was real. So they came back and reported me. They met for about nine months, collected a bunch of data science, all the things you guys have probably seen out there. I said, Steve, this thing is real. We got to think about. So I say that because one of the main as CEO, I have two main jobs. One is capital allocation, making sure we\u2019re investing in the right places to keep the company going. Second one is pattern recognition and staying, looking at what\u2019s happening in the world and trying to figure out where things are going so we\u2019re there, and we\u2019re not left behind. In the famous example, whoever was leading Blockbuster at the time didn\u2019t really see the streaming thing coming, and they missed that, or Kodak who said, oh, we like film, nobody\u2019s going to switch to digital, things like that, right? Those are the examples of companies that didn\u2019t see the patterns. There\u2019s a lot that.<\/p>\n

Mariya Filipova: <\/strong>
Reed Hastings\u2019s example, you always do, you always have to come back, disrupt yourself before you get Kodaked.<\/p>\n

Stephen Thorne: <\/strong>
Totally.<\/p>\n

Mariya Filipova: <\/strong>
As Peter Diamond is a good friend. Like\u2026<\/p>\n

Stephen Thorne: <\/strong>
Oh, really?<\/p>\n

Mariya Filipova: <\/strong>
\u2026 About this, that\u2019s right. Yeah. It\u2019s always you have to disrupt yourself. Otherwise, you\u2019re leaving the opportunity to somebody else to do it.<\/p>\n

Stephen Thorne: <\/strong>
And what got me passionate is, during that time, my mom died of heart attack. So she was 65 years old. No reason in the world she should have died that young. She had just been to the cardiologist three weeks ago, and the cardiologist told her she was going to live to be 100 years old. Now, and she always suffered with bad breath, bad perio, and she married to a dentist. Okay, now, was it a direct causal relationship the \u2026 that killed her? She did a lot of other stuff, okay? She grew up in the 60s. But it got me thinking, got me going about the relationship, guarantee it played a part in how, why she died and died at such an early age. So that task force prompted me then to go to a basically a marketing company, because I wanted to see if there was a business here, would consumers understand this, and would clinicians gravitate to this? They came back with a report about took about nine months and said, absolutely. Consumers love this concept of dental medical integration. Being able to go to one location and get most of their primary care. They also told me that the biggest problem you\u2019re going to face is the clinicians, because dentistry has been siloed for so long for whoever took the mouth out of the body way back when, I\u2019d love to meet that person, give them a piece of my mind. So we\u2019ve been separated for so long, so to integrate was going to be very hard. I\u2019m always up for a challenge. And so we learned, and we started our first integrated practice in 2017 with one physician in a busy dental office in Summerlin. So that\u2019s kind of the passion side, but also the business side of it.<\/p>\n

Mariya Filipova: <\/strong>
Healthcare is always personal. I\u2019m glad.<\/p>\n

Stephen Thorne: <\/strong>
It\u2019s local.<\/p>\n

Mariya Filipova: <\/strong>
\u2026 your personal. Yeah, thank you for sharing your personal motivation. We all have our own healthcare experience, and we\u2019re all touched as patients when we are another, and that\u2019s what really, really drives us well.<\/p>\n

Stephen Thorne: <\/strong>
Also, Mariya, it also caused me to look at myself, and I learned that I have all the bad genetics for inflammatory disease. My perio was a mess, we started the oral bacteria test, and all my IL1, IL6, everything. I got, every bad gene you could get, I got them both from my parents, so I have to go to the dentist like six times a year, get my hygienist dentist to take care of my mouth, and I learned all that from.<\/p>\n

Mariya Filipova: <\/strong>
Silver lining of all of this is that you are now an activated, engaged patient that is very much engaged in their own health, which is unfortunately not the majority of patients, but it\u2019s a big piece into moving the field forward and advancing integrated care. Steve, I\u2019ll jump in here, and I know, Jonathan, I know you have something on your mind as well, but tell us a little bit about that integrated model, right? You got inspired. You did your homework. You had a task force. Tell us how this actually works today. And frankly, what took to convince that first dentist in that first clinic to try it out?<\/p>\n

Stephen Thorne: <\/strong>
Yeah, so with disclosure, we\u2019re still trying to figure it out, full disclosure, okay? We figured out a lot.<\/p>\n

Mariya Filipova: <\/strong>
Yes.<\/p>\n

Stephen Thorne: <\/strong>
One of the, ask a couple questions there. How it works in the in the office in the operation. So patient comes in, take their blood pressure, it\u2019s 140 over 100, so they\u2019re full hypertension patient. What does the typical dentist do? Most dentists don\u2019t do anything. What they should do is refer them to their PCP. You have high blood pressure, and the patient always says, oh, I\u2019m nervous.<\/p>\n

Mariya Filipova: <\/strong>
The white coat syndrome.<\/p>\n

Stephen Thorne: <\/strong>
It\u2019s the white coat syndrome.<\/p>\n

Mariya Filipova: <\/strong>
Yeah.<\/p>\n

Stephen Thorne: <\/strong>
So what, you\u2019re going to die on my chair? That should be the response. But now it can walk over if the physician or nurse practitioner is available. In this case, it was a physician, grab the physician, go talk to the patient. Or do you refer them over, walk them over to the physician? So that\u2019s a very base level one example, but we do that with diabetic patients, we do that with mental illness patients. We do, all of it, it\u2019s right there. We all know how important it is when patient can activate into care at the moment. And that\u2019s what it was all about, activating into care at the moment. What we learned too, at the time we put in, we had an old dental system only running our company, and we put in a medical system, medical EMR. That was a major roadblock to them, helping patients get healthier for a major roadblock for the work between the dentist and the physician.<\/p>\n

Mariya Filipova: <\/strong>
You need the data.<\/p>\n

Stephen Thorne: <\/strong>
You need collaboration. They needed the data. They needed to work in the same chart. So we started looking around, and at that time there was only one option, and it was Epic. Epic had the, is the largest health record on the planet. 270 million Americans have some of their health information in Epic. 150, 160 million, maybe more, have a Mychart app on their phone. So it didn\u2019t, and yes, it is a little bit more expensive than a dental-only, whatever we call it, system, whatever you want to call it, but Epic is so much more than that. Epic is the now for us. It is the backbone to the entire company because everything we do runs through that system in order to help the clinicians understand more about their patients, which is key, that health history, but understanding more about the meds they\u2019re on, you know, what other problems they may have.<\/p>\n

Mariya Filipova: <\/strong>
Co-morbidities, everything.<\/p>\n

Stephen Thorne: <\/strong>
All the comorbidities, all of that. And so we have, we now have that information at their fingertips. And we\u2019re building the menus and the popups and the alerts and all that into the system now, because we can, we have the data, we share, I don\u2019t know what the, probably up to 100 million records now that we have that have been shared. So there\u2019s two things on Epic. One is interoperability. You hear that term a lot, right? And think it\u2019s mandated by law to be interoperable. That\u2019s important, but that\u2019s not the most important thing. The most important thing is the chart reconciliation.<\/p>\n

Mariya Filipova: <\/strong>
Interesting.<\/p>\n

Stephen Thorne: <\/strong>
So Epic is the only company I know that has done a good job of that, of taking all this disparate information that the clinicians have put in the system. Let\u2019s say a patient has gone to 15 different systems or physicians and been able to put it all together in a pretty seamless fashion. It\u2019s not perfect yet, but pretty seamless fashion for a dentist like Doctor Levine to look at and understand about that patient. So we made, that was, in my 35 years, the biggest risk I\u2019ve ever taken as a CEO. That was my biggest risk I\u2019ve ever taken is converting the company to Epic.<\/p>\n

Mariya Filipova: <\/strong>
And I can imagine it\u2019s probably too soon to tell if it\u2019s paid off yet.<\/p>\n

Stephen Thorne: <\/strong>
Oh no, it\u2019s not too soon.<\/p>\n

Mariya Filipova: <\/strong>
Opportunities to, oh, okay. You think you put it off already? Yeah.<\/p>\n

Stephen Thorne: <\/strong>
Oh, you look at our performance since we finished last, last six, eight months. I don\u2019t know if I\u2019ve paid for the system yet, but we\u2019re on record pace. We\u2019re having the best six months in the history of the, and we\u2019re on track this month too,<\/p>\n

Jonathan Levine: <\/strong>
And Steve.<\/p>\n

Stephen Thorne: <\/strong>
In company.<\/p>\n

Jonathan Levine: <\/strong>
With Steve, stay there for a second, because a lot of times the KPIs and the metrics are just the result of doing all of these great things first.<\/p>\n

Stephen Thorne: <\/strong>
That\u2019s what\u2019s key.<\/p>\n

Jonathan Levine: <\/strong>
Right, so talk about that a little bit. Let\u2019s unpack that a little bit.<\/p>\n

Stephen Thorne: <\/strong>
Yeah, so you nailed it, okay? It\u2019s not just the system. It\u2019s not just the KPIs. So education leads to awareness, which leads to activation for many people, those that care. Education to awareness to activation, that goes for clinicians also. We\u2019ve had to go through a massive change in our whole education program, an onboarding program at PDS, for every team member. So I don\u2019t care whether it\u2019s an oral surgeon all the way down to somebody that\u2019s coming in to do accounts payable. We educate everybody on the mouth-body connection, and we\u2019re not done yet. We\u2019re not done yet. But, and we have different levels of it, Jonathan, where somebody working in accounts payable gets a base level understanding, a dentist gets a much deeper understanding of all the world bacteria, the tests we can do. Just, there\u2019s so much happening right now. Yeah, it\u2019s, that education component was, is still critical to driving the behavior change, and we know how hard changing a clinician\u2019s behavior is. We both know that. It is so hard, but it\u2019s working, it\u2019s working. And so now when a patient comes in the doctor actually talking about their A1c and you have diabetes and you know, there\u2019s a correlation between your oral health and diet and your diabetes, and we can help.<\/p>\n

Mariya Filipova: <\/strong>
\u2026 it to act on that knowledge, Steve, for both the patient and the dentist. Okay, we know this is a hypertensive patient. They\u2019re diagnosed as diabetic. What happens next? How does that knowledge change the workflow of the dental team and what patient what the patient does?<\/p>\n

Stephen Thorne: <\/strong>
So that\u2019s a great question. And we\u2019re, again, we\u2019re still figuring out some of these things, okay? I want to, I\u2019m going to back it up a little bit. We have a saying in our company, patients don\u2019t care how much you know until they know how much you care. That\u2019s patients don\u2019t care how much you know until they know how much you care. So the big bet for me as a CEO on the pattern recognition was that as patients believe that their dentist cares about them as an individual with individual needs and wants and cares about their overall health, not just fixing a tooth, right, that they will be more likely to engage in care for fixing that tooth, or for the scaling and root planing, or getting that implant placed to preserve the bone, whatever it may be, for that oral-systemic link, and that is proving out to be true. So the math equation people ask me all the time about Epic, man, you spent so much money. Not really, not really. It\u2019s like related to cars, I don\u2019t think, I don\u2019t drive a Nissan Sentra, and I highly doubt Dr. Levine does. So we\u2019re we probably have nicer cars, and we do that because we want the things that come with that nicer car. Epic is like a much nicer car. It\u2019s like buying a Mercedes or something like that, where you have more things that you can do and like. But if we can get a little bit of turn every year of more patients activating into care on our scale, it\u2019s massive numbers. So we will probably pay for the entire system in under three years for sure. I was going to say maybe even two years, the entire investment, and it was a nine-figure investment.<\/p>\n

Jonathan Levine: <\/strong>
Stephen, is there an opportunity outside of PDS, for you to have a greater impact on the profession than what you figured out at Epic? Does that get commercialized to a level where if somebody wants to look at what PDS has done as a model, that there is an opportunity to leverage these learnings, what that you\u2019ve done, and the technology together? How do you think about that as we think about future?<\/p>\n

Stephen Thorne: <\/strong>
Yeah, it\u2019s a great question. I\u2019ll personalize a little bit. I think people can probably guess I don\u2019t need, I don\u2019t really need to work anymore if I don\u2019t want. The business has been good to me, the profession\u2019s been good to me, but I want to change, change the world. I want to change how dentists are thought about. I want to get them to think about themselves differently as oral healthcare providers, as physicians, and mouth, and taking care of that whole patient and want to change the profession. So yes, I\u2019m working hard on that. We have, I think, now ten dental schools that have switched over to the Epic platform. I think we have 18 more in the queue that we\u2019re supporting to switch. So I think that\u2019s where it starts getting the dental schools to change over and start thinking more holistically about patient care, not reactive care, which is where dentistry has been forever since my grandfather graduated. I know you don\u2019t practice that way, but most dentists in America still practice the way my grandfather practiced.<\/p>\n

Mariya Filipova: <\/strong>
Yeah. That\u2019s right.<\/p>\n

Stephen Thorne: <\/strong>
Patient comes in, something\u2019s wrong, they see what\u2019s wrong, they tell the patient what\u2019s wrong, and they fix it, and they\u2019re great at it.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s right.<\/p>\n

Stephen Thorne: <\/strong>
That\u2019s a great service. That\u2019s not going away, though. We\u2019re humans. That be, that\u2019s not going to go away in our lifetimes. But we have an opportunity to do so much more as we engage in the oral-systemic way we call mouth-body connection, but there is an obstacle. The big obstacle is the reimbursement system. And I\u2019m working.<\/p>\n

Mariya Filipova: <\/strong>
\u2026 Again<\/p>\n

Stephen Thorne: <\/strong>
Yeah, it\u2019s hard because we\u2019re the only health profession that has our own coding system.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s right. And if I have to, yeah, and you have to bring the quality piece here. The coding system is not used for diagnosis. It\u2019s used for treatments, and it\u2019s very hard to be able to connect the dots.<\/p>\n

Stephen Thorne: <\/strong>
And I\u2019m on record.<\/p>\n

Mariya Filipova: <\/strong>
An implant is not a diagnosis. And you can\u2019t say what\u2019s the diagnosis for that patient on the oral health side.<\/p>\n

Stephen Thorne: <\/strong>
And I want to change that. And I\u2019m on record, and I think the ADA hates me for this, but I would like to eliminate the CBT coding system. And they go over the medical coding system so we have diagnostic coding and the treatment. So move over to the ICD ten coding system and CPT so that we can understand why that dentist is diagnosing what they\u2019re doing. And it\u2019s all there, we can do it, but there\u2019s a lot of, a lot that has to happen to make that change.<\/p>\n

Jonathan Levine: <\/strong>
Change so much.<\/p>\n

Stephen Thorne: <\/strong>
So much, so much, so much.<\/p>\n

Jonathan Levine: <\/strong>
I want to take us where you\u2019re going because, where you\u2019re really going, we believe collectively that dentistry could be the tip of the spear, that oral health is overall health. We believe that. And if we think about the medical profession and the approach and the sickness model, where healthcare spend is literally 20% of our overall GDP, so imagine, trillions of dollars. And what happens when we go upstream? What happens when we get more proactive and we know that patients go to the dental office more than they go to their physicians? And that\u2019s why your approach is so smart, because it\u2019s really the beginning of taking healthcare more upstream and saving trillions of dollars downstream. How do you think about that from a standpoint of the dental profession being more of that wellness model, getting to the diagnostics of all of these systemic inflammatory diseases early and really playing an important role there?<\/p>\n

Stephen Thorne: <\/strong>
It\u2019s a great question. And that\u2019s really the big idea from the reimbursement side and why dentists would do this. Because the question I get asked often is, why would I do it? I\u2019m doing fine, right? I tell them, number one, you\u2019re going to help people be healthier. That\u2019s number one. Number two, we got to think differently about the financial model, okay? Dentists can be, they need to be part of the primary care healthcare team. They can be the first line in assessments and early intervention. Let\u2019s just take cardiovascular disease a little harder because it takes longer for you to see the problem.<\/p>\n

Mariya Filipova: <\/strong>
High-risk pregnancies. That\u2019s one of my favorite.<\/p>\n

Stephen Thorne: <\/strong>
High-risk pregnancies right there. We can test right now, Mariya, if you wanting to get pregnant or are pregnant, we could test how active your periodontal disease is in your mouth with a simple \u2026 test. Then what we could do is if it came back high or elevated, we could test your oral bacteria right now and see if you have high levels of \u2026, one of the bacteria that are causal to preterm, low-weight births. Now, does that mean you\u2019re going to have one? No, but it increases your likelihood, and we both know that. And so why isn\u2019t every dentist ask their female patients, if you\u2019re thinking about getting pregnant or you are pregnant, let\u2019s do these tests. And what woman wouldn\u2019t do that?<\/p>\n

Mariya Filipova: <\/strong>
Let\u2019s just, you started with the reimbursement. Let me just finish that story and connect the dots. Having spent multiple years on the health plan side, we know that one preterm labor, mom and baby in the NICU, is on average $500,000, that\u2019s half a million. On average, we know that both mom and baby over their lifespan are more costly members in terms of total cost of care to treat, because they have all kinds of other risk factors. And we also know that, frankly, over the last years, because of demographic factors, socioeconomic factors, women are getting pregnant and choosing to have children later in life. So this whole term of geriatric pregnancy is anybody who is over the age of 35, which actually is over half of the pregnancies, if not more in this country, is a geriatric, aka high-risk pregnancy. And so that alone is a very important component in terms of bringing in the dental office, the dental team, into the overall care team. The only wrinkle here, Steve, is that the interventions that need to happen on the dental side, right? Treating your perio disease to reduce your risk of preterm labor happen on the dental side, yet the savings, in this case, would materialize. The big savings avoiding that half $1 million claim is on the medical side. So, somebody needs to talk to each other about the business model is you have to invest on the dental side, benefits on the medical, and these two teams need to share in the savings.<\/p>\n

Stephen Thorne: <\/strong>
So what we\u2019re seeing happening, you hit the nail on the head. So what we\u2019re seeing happening is that plans that take risk are coming to us now. Medicare Advantage plans, I know that\u2019s not the pregnancy group, okay, but Medicare Advantage plans are coming to us in droves now because we can help intervene early. We can help get their, save them massive amounts of money by, say, the hypertension patient or a diabetic patient that didn\u2019t know they had diabetes. And then we also can bring up a level of service; dentists on the whole do a pretty darn good job on the service level, right? So we can help bring up their star rating. So we can help these plans by intervening early if we find a problem, let\u2019s say diabetics or maybe it\u2019s cardiovascular disease. They get a higher per member per month reimbursement. We can help them with their star rating where they get benefits for their star rating. Dentists need to play in that pool of money.<\/p>\n

Mariya Filipova: <\/strong>
Absolutely.<\/p>\n

Stephen Thorne: <\/strong>
Absolutely, dentists need to get reimbursed for this stuff. We\u2019re seeing that, we\u2019re seeing that with some employers. Now we\u2019re talking to some employers that are taking full risk, and they\u2019re really interested in this. We do it. I \u2026 15,000 people, have 25,000 people on our planet, and we do it, and I\u2019m trying to drive down our total cost. So yes, I think it\u2019s only gonna take a couple of these plans to finally go, let\u2019s go for it, let\u2019s get the dentist in the medical plan, and let\u2019s make this happen. Now, we\u2019ve also approached carriers that aren\u2019t taking risk, so that\u2019s a lot of people. And they say, yeah, and then when it comes to, it\u2019s nothing happens, because carriers that model has to change if we really want to have an impact because they\u2019re all about the spread, right?<\/p>\n

Mariya Filipova: <\/strong>
And you\u2019re all administrators.<\/p>\n

Stephen Thorne: <\/strong>
Yeah. And I\u2019m.<\/p>\n

Mariya Filipova: <\/strong>
I\u2019m not taking risk. It\u2019s hard.<\/p>\n

Stephen Thorne: <\/strong>
Yeah, I\u2019m not.<\/p>\n

Mariya Filipova: <\/strong>
It\u2019s hard to also do the model that Jonathan was describing. If you\u2019re a fee-for-service model you cannot do preventative care, and I think that\u2019s what it comes down to. It\u2019s much harder to be able to execute on preventative care and have a longer-term view. Please prove me wrong. I\u2019m open to it. Tell me if you see it work somewhere.<\/p>\n

Stephen Thorne: <\/strong>
We\u2019re trying, we\u2019re trying. We did a deal, it was publicized with Memorial Care here in California, in California today. And the CEO of that gets this, okay, so we did a long-term deal to develop 25 integrated practices. And they already have big commercial and AMA. And so we\u2019re providing the dental plan now for his employees, which is big, and we\u2019re co-designing the dental plan for his AMA pool. So I think it only can it take a couple of leaders like Memora care to step out and go, no, we can change this. We can do a better job, and then others will follow.<\/p>\n

Jonathan Levine: <\/strong>
Exactly.<\/p>\n

Mariya Filipova: <\/strong>
It\u2019s easier on the CMS side on the commercial side, that \u2026<\/p>\n

Stephen Thorne: <\/strong>
Correct.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s absolutely.<\/p>\n

Stephen Thorne: <\/strong>
On the commercial side, if you have one employer that\u2019s taking risk and they\u2019re just the TPA, it takes the employer pushing that.<\/p>\n

Mariya Filipova: <\/strong>
It has to be\u2026<\/p>\n

Stephen Thorne: <\/strong>
\u2026 To do it. It has to be\u2026<\/p>\n

Mariya Filipova: <\/strong>
\u2026 takes the risk. Absolutely.<\/p>\n

Stephen Thorne: <\/strong>
Correct.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s right.<\/p>\n

Jonathan Levine: <\/strong>
Yeah, it isn\u2019t, it\u2019s getting these proof points. So you take this objective, you create the strategy, you set up your tactics, and you prove it to work, and the numbers speak for itself. And then don\u2019t you, don\u2019t you get everybody\u2019s attention at that point because you\u2019ve taken that action? I think to date a lot of people are talking about it, and I, Stephen, kudos to you and the team. You\u2019re taking the action, creating the partnerships on the collaboration, and proving out these upstream moves that we\u2019re going to end up saving millions and billions of dollars downstream in healthcare, which is a runaway train, and it\u2019s a very reactive sickness model that needs to really change, and everybody is starting to build that awareness to that.<\/p>\n

Stephen Thorne: <\/strong>
Had a, had an, I agree, I had an MD tell me the other day at one of the larger vendors, he said, look, this is an MD talking, and he said, there is no better investment for these carriers or the risk-bearing, no investing in oral health or then oral investing in oral health. Maybe only smoking would be at a higher level. And he equated what we can do to maybe only one habit that people may have, smoking, that will do a better job in saving these carriers money. And all the science is there, Jonathan, we know, we\u2019ve seen the studies, we have the science. Oh, I\u2019m over that. It\u2019s like, now I\u2019ve got to get them to believe the science and studies. We have studies from the Mayo Clinic. We have studies from the New York Medicaid system where you are we have studies all around the world, thousands of them, thousands. We don\u2019t need any more studies showing that you guys help reduce costs and help improve care we don\u2019t need anymore. We just got to get them to go, oh, okay.<\/p>\n

Jonathan Levine: <\/strong>
Right.<\/p>\n

Mariya Filipova: <\/strong>
I actually think it\u2019s a bit more like, the first step is, aha, okay, wow. But the next step, Steve, and that\u2019s what I was asking you about, it needs to be easy to do something about. It needs to be easy to operationalize it. That\u2019s why what you\u2019ve built in PDS is what is pretty unique, because the ability to refer a patient who is either high risk or undiagnosed diabetic, to refer them somewhere where you\u2019re not just telling the patient and leaving it in their hands to say, go check in with your PCP. What if they don\u2019t have a PCP? What if they don\u2019t? They\u2019re uninsured, underinsured. And so we have to be able to connect the dots because that\u2019s where most of the lapses in care happen. And so I don\u2019t want to lose two things that came up in the last five minutes of the conversation. You heard it here first, folks. The dental team is part of the overall care team, and the two most immediate measures, if we\u2019re talking numbers here, are reducing total cost of care, and we\u2019ve seen that in total cost of care when it comes to treatments or conditions like diabetes, hypertension, cardiovascular, high-risk pregnancies, we see the numbers. Sleep, diagnosing obstructive sleep apnea and treating in the, or on the dental side with an oral appliance therapy. All of these conditions you could track, to your point, Stephen. Literature tells us that there\u2019s savings to be made on a total cost of care perspective. Now it\u2019s up to us, our leaders, our listeners, us, the folks on the call, to actually do something, operationalize all those clinical insights. And the other thing is you nailed it when you talked about. So the bottom, one is reducing the cost of Jonathan\u2019s favorite mission, How do we get this runaway train under control? And number two is increasing the revenue side. Because if you have as a plan, if you have higher star ranking, that translates in higher reimbursement rates from CMS. And so on both sides, both on the top line and the bottom line, there is a very meaningful connection on where doing the right thing also allows you to do well financially.<\/p>\n

Stephen Thorne: <\/strong>
You\u2019re nailing it. There is the money not only star rating, but the acuity level or the patient, right?<\/p>\n

Mariya Filipova: <\/strong>
Stratify patients by risk. That\u2019s right.<\/p>\n

Stephen Thorne: <\/strong>
So in our integrated practices, where we have either a nurse practitioner or physician, so the dentist does an assessment, let\u2019s take he has diabetes. We did we do A1c testing now in about 100 of our offices. So say the elevated A1c as a patient. Where did you know your A1c is very elevated? No, I didn\u2019t know that. Refer over, the patient if the patient is on that plan, and we caught it early, now we help that plan get a better reimbursement, okay?<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s right.<\/p>\n

Stephen Thorne: <\/strong>
And we help them that hopefully, the patient gives them the better star rating through press \u2026, which is what we use. And then the medical team, at the end of the year, shares in that value-based revenue stream. That\u2019s how the system works. So it\u2019s creating the alignment with everybody. Now, what\u2019s not there yet, it is there for us because we own both, but what\u2019s not there yet is that reimbursement back to the dentist. That\u2019s what we have to get. So the dentist should share in that \u2026 revenue to some degree. So you asked about, we can\u2019t do it all fee-for-service. There has to be some fee-for-service component, but then an alignment around the savings so it\u2019s in that dentist\u2019s head, If I intervene early and get the, make the referral at the end of the year or end of the six months, however, the contract works, they share in that profit.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s right. Steve, do you guys do anything in redirecting and avoiding ED admissions or readmissions? Because that\u2019s another area that\u2019s very rich for.<\/p>\n

Stephen Thorne: <\/strong>
Yeah, we haven\u2019t got quite that far yet. We\u2019re, yes, we\u2019ll get there. We will get there for sure.<\/p>\n

Mariya Filipova: <\/strong>
Over half a billion of ED admissions or admissions of folks who present with oral pain. Not much can be done in the ED if you present with oral pain.<\/p>\n

Stephen Thorne: <\/strong>
If you look back at the beginning at COVID, there was a massive campaign in the United States. Actually, it went virtual around the world, around staying out of the ER room. Go see your dentist for your pain, and you can track back who started that campaign.<\/p>\n

Jonathan Levine: <\/strong>
There you go. There you go. I think we\u2019re looking at him, and the science came out. If you have periodontal disease, you are five times more likely to end up on a ventilator. So people\u2019s awareness of the importance of controlling inflammation of the mouth, I think, is probably at the highest level that, than it\u2019s ever been. And as you were saying, Stephen, the science is so big, thousands and thousands of studies understanding that the body is a complete ecosystem and that the mouth, the inflammation of the mouth and the pathogens of the mouth, number one, helps seed the gut and help and cause really the issues of a leaky gut, and the science of a leaky gut where these pathogens get into the rest of the body, it\u2019s the same thing in a leaky gut.<\/p>\n

Stephen Thorne: <\/strong>
It is.<\/p>\n

Jonathan Levine: <\/strong>
Though our systems, they\u2019re all connected, similar mechanisms.<\/p>\n

Stephen Thorne: <\/strong>
So there are studies that, there\u2019s a couple different studies that now proven out which bacteria embed in our arteries to cause, that are causal to cardiovascular disease and which ones, and we can help you.<\/p>\n

Jonathan Levine: <\/strong>
The latest study came out with rheumatoid arthritis where we had a our, the researcher on that on our podcast, Dana, and she\u2019s at Rockefeller, and they were taking the bloods on a weekly basis in people with periodontal disease and testing it for PG. And PG proved to increase the likelihood of rheumatoid arthritis with elevated PG in their blood from the blood tests. And it\u2019s just one more connection of the, right, now 58 systemic inflammatory diseases directly related to inflammation of the mouth. But it\u2019s so important for business leaders like yourself to take action because it\u2019s taking this action, creating the, these proof points to say let\u2019s connect the dots. We will have a more efficient system, but at the end of the day, we\u2019re going to have a much healthier America. And I greatly share, I think, as we get older, the desire to have that legacy and to really help people and help the chosen profession that we\u2019ve gotten involved in. I love that you do that.<\/p>\n

Stephen Thorne: <\/strong>
Yeah, and on a second that I think you\u2019re spot on. There\u2019s some some things that are happening that are causing this massive shift too, right? Aging population, in the next 16 years, we\u2019re going to see a 49% increase of people over 65. And I know you and I are getting, we\u2019re not quite there, but we\u2019re getting there. So this aging population, that\u2019s happening. So oral health you said earlier oral health awareness is probably an all-time high. My opinion I don\u2019t have the data on this, is that it is at an all-time high since I\u2019ve been in this in 35 years. And then the tipping point of over 50% of seniors now on Medicare Advantage plans for Medicare fee-for-service. So I think that\u2019s driving a lot of this behavioral change, and we\u2019re feeling it because we\u2019re getting, our phone is ringing off the hook from these groups that want to partner to help where we they know we can intervene early because that\u2019s what it\u2019s all about for them, and we can help raise their scores. And lastly, identify the acuity level that has to go through the physician side, but we can do the assessment.<\/p>\n

Jonathan Levine: <\/strong>
Yeah, amazing. Yeah, \u2026, I don\u2019t know about you, but talking to Steve, I have tremendous hope that there\u2019s going to be this wonderful, positive wave of connecting these dots between, as they would call them, mouth-body connection or oral systemic medicine so that people\u2019s awareness increases, our delivery of care improves, dentistry becomes part of medicine, healthcare costs go way down: we save so much money downstream because of these upstream wellness and early diagnostic approach by connecting the professions of medicine and dentistry. I\u2019m very inspired by Stephen, by listening to what you\u2019re doing over at PDS, and what you\u2019re personally so inspired. It\u2019s inspiring for, I think all of our listeners. What would you say, Mariya?<\/p>\n

Mariya Filipova: <\/strong>
I\u2019d love to pick up on this note and note of hope in, knowing me, you wouldn\u2019t be surprised if I\u2019d like to add a bit of urgency to it. We are inspired, we\u2019re hopeful, but hopefully, also our listeners are picking up on all the nuggets of call-to-action items that Steve planted over the course of our conversation. If you are a dental school, a dean of dental school, and you are not part of those early adopters, or the list of 18 that are already signed up on being part of that medical record system tracking and integrating medical dental records, please consider getting involved. If you are a dentist who is practicing dentistry and is concerned or aware of the potential of helping patients and really treating the whole person in the chair, not only the mouth, please get involved. And if you\u2019re a patient who happens to be listening to our podcast right now, please ask your dentist about your sleep, about your heart health, about your lung health, about your brain health. Your dentist might have an answer or recommendation, and if not, then you probably want to consider if that\u2019s the right dentist for you. That\u2019s my personal opinion. And so, with that note of hope and urgency, Steve, is there any other call to action on your end that you would want our listeners to be aware of?<\/p>\n

Stephen Thorne: <\/strong>
Yes, there are. So in this area, dentists should be on the panels of all the medical plans. It should not be excluded from that. And that\u2019s a, I think that\u2019s a simple change for these carriers. I don\u2019t care what plan. And then, dentists should play a part in Medicare Advantage.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s right.<\/p>\n

Jonathan Levine: <\/strong>
They should be on those panels.<\/p>\n

Mariya Filipova: <\/strong>
That\u2019s a very tactical note, yeah.<\/p>\n

Stephen Thorne: <\/strong>
Very, those two are, I think, the easy low-hanging fruit to get dentists involved in the overall health of patients and get the reimbursement they do deserve for doing that.<\/p>\n

Mariya Filipova: <\/strong>
Absolutely. You heard it here, folks. On that happy note, yes, thank you for being part of this conversation. This is just the beginning. And let\u2019s roll up the sleeves and get to it.<\/p>\n

Stephen Thorne: <\/strong>
Let\u2019s do it. Thank you.<\/p>\n

Jonathan Levine: <\/strong>
Stephen. Thank you so much for joining us. This was fantastic.<\/p>\n

Stephen Thorne: <\/strong>
Yeah. Hopefully, it\u2019s good and we\u2019ll see you soon Jonathan.<\/p>\n

Jonathan Levine: <\/strong>
Thanks for listening to the Think Oral podcast.<\/p>\n

Mariya Filipova: <\/strong>
For the show notes and resources from today\u2019s podcast.<\/p>\n

Jonathan Levine: <\/strong>
Visit us at www.OutcomesRocket.Health\/ThinkOral.<\/p>\n

Mariya Filipova: <\/strong>
Or start a conversation with us on social media.<\/p>\n

Jonathan Levine: <\/strong>
Until then, keep smiling.<\/p>\n

Mariya Filipova: <\/strong>
And connecting care.<\/p>\n

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