The Future of DSOs: Capitalizing Patient-Centered Care

Written by Sepand Hokmabadi, D.D.S., Founder & CEO, Total Health Dental Care

The dental industry is experiencing a significant transformation, as traditional insurance-driven models increasingly prove unsustainable. This article explores the future of Dental Service Organizations (DSOs) in adopting a more patient-centric approach that also drives improved financial performance. The key pillars of this model include Fee-for-Service (FFS) retention, multi-specialty integration, technology enablement, and strong branding.

Fee-for-Service (FFS) allows dental practices to set their own fees while still billing and accepting insurance payments, without being limited by contracted rates. This flexibility is increasingly vital amid rising wages and interest rates, enabling practices to adjust fees accordingly to manage costs and maintain financial stability.

Total Health Dental Care , a tech-driven DSO thriving in the nation’s second most competitive market, has proven the success of this innovative model. Founded in 2011 and headquartered in Oakland, California, the organization has strategically built a tightly integrated regional network, operating 13 fee-for-service offices across Alameda County in the Bay Area.

Pillar 1: The Shift to Fee-for-Service: Prioritizing Retention Over Upselling

Historically, dental practices have depended on insurance reimbursements, often at the expense of patient experience and business viability. This has all changed with wage inflation and interest rate. The Fee-for-Service (FFS) model is both inflation and interest proof as it sets fees that can be increased.

Why FFS Works:

Enhanced Patient Experience: Eliminates insurance-imposed restrictions, ensuring high-quality, patient-first care.
Increased Lifetime Value: Retention strategies, such as in-office dental plans, improve long-term revenue stability.
Streamlined Operations: Reducing reliance on insurance minimizes administrative complexities.

Proof of Success:

According to the American Dental Association (ADA), implementing in-office dental plans can help practices retain and attract lifelong patients.

Pillar 2: DSO Multi-Specialty Integration: Convenience is Key

Today’s patients expect comprehensive care under one brand. The traditional single-service model often leads to fragmented care and patient attrition. By offering multi-specialty services—such as orthodontics, periodontics, endodontics, and oral surgery—practices enhance patient convenience while maximizing revenue.

Benefits of Multi-Specialty Practices:

Higher Retention: Patients prefer continuity of care without external referrals.
Higher Margins: Specialty care provides high ticket, high margin services.

Industry Insight:

A study on service quality in multi-specialty dental clinics emphasizes that providing comprehensive services is crucial for patient retention and satisfaction.

Pillar 3: Technology: Driving Convenience & Reducing Costs

Automation, artificial intelligence (AI), and digital tools are revolutionizing dental practices, enhancing patient experience while significantly reducing operational costs.

Key Technological Advancements:

Workflow Automation: Automating repetitive tasks can reduce head count dramatically improving bottom line.
Online Scheduling & Patient Portal: Offers conveniences consumers demand.
Digital Scanning & 3D Printing: Simplifies and enables faster, more precise dental solutions.

Supporting Data:

Implementing automated appointment reminders has been shown to reduce no-show rates by nearly 23%, enhancing practice efficiency.

Pillar 4: Branding: The Key to Organic DSO Patient Growth

In today’s digital age, successful practices build a recognizable brand that attracts new patients organically, reducing the need for extensive marketing efforts.

How Branding Strengthens a Practice:

Community Presence: A strong brand fosters patient loyalty and word-of-mouth referrals.
Increased Trust: Recognizable brands instill confidence, leading to higher case acceptance rates.
Higher Valuation: Branded practices often achieve higher valuations during acquisitions.

Case Study:

Practices that implement comprehensive patient engagement strategies, such as the “7/12” touchpoints approach, have seen an 87% increase in active patients and a 38% rise in new patient acquisition.

An Example of the Future DSO Model: Total Health Dental Care

In the nation’s second most competitive market, Total Health Dental Care has successfully implemented a tech-enabled, fee-for-service, multi-specialty group with 15 branded dental offices.

Founded by Sepand Hokmabadi, D.D.S., whose background in economics and passion for dentistry shaped his vision, Total Health Dental Care was built on the belief that capitalism can drive superior patient care. This philosophy has delivered impressive results: practice-level margins have risen from 15% in 2022 to 20% in 2023, 25% in 2024, and are on track to reach 30% in 2025—all despite wage inflation and rising interest rates.

By leveraging both proprietary and third-party technology, Total Health has significantly boosted operational efficiency, increasing revenue per employee from $165k in 2021 to nearly $2750K in 2024. Dr. Hokmabadi envisions this model as a blueprint for the future of DSOs, demonstrating that profitability and an exceptional patient experience can—and should—go hand in hand.

The Future is Patient-Centered & Business-Savvy

The future of dental practices lies in embracing patient retention, comprehensive care, technological innovation, and strong branding.

DSOs that adopt Fee-for-Service models, integrate multi-specialty services, invest in advanced technology, and cultivate a strong brand identity are poised to thrive—achieving financial success and long-term patient loyalty.

The imperative for dental professionals is clear: Adapt swiftly to these evolving trends to stay ahead in the competitive landscape.

Sepand Hokmabadi DDS. is the founder of Total Health Dental Care and an economist. Going by Doctor H, he has combined these two passions in building a private DSO that has successful capitalized better patient care. Interested parties can reach Dr.H via LinkedIn or by email at drhokmabadi@totalhealthdentalcare.com.