Unlocking Revenue: Glen Holden's Tips on Simplifying Patient Financing for Aesthetic Practices

Announcer (00:06):
You are listening to the Aesthetically Speaking Podcast presented by Nextech.

Robin Ntoh (00:13):
Hi everyone. Welcome back to Aesthetically Speaking Podcast presented by Nextech. I'm Robin Ntoh, your host, and today we're meeting with Glen Holden. He is the VP of Strategic Technology Partnerships at Synchrony, which we know more often as CareCredit. Glen, so happy to have you here today. Tell us a little bit about yourself and tell us a little bit about the Strategic Technology Partnership.

Glen Holden (00:37):
Thanks for having me, I appreciate it. Robin. Yeah, so Glen Holden, VP of Strategic Technology Partnerships. I actually started with CareCredit in 2007, so yeah, going back a few years. I started in sales. I was what they call a practice development manager. I would go out and visit practices, talking to them about using financing, how to get more patients to say yes to their care. Did that and then I became a regional sales manager, which managed a team of practice development managers. And from there I got into the training game and I led sales training at CareCredit for several years. And after that stint, I was able to get into this VP of Strategic Technology Partnerships. And it's a really unique role because you're not only dealing with c-suite types, but you're also navigating the internals of our internal sales teams, our marketing teams, working with different people inside the tech partners, doing a little BD work, trying to see if other programs would want to, other companies would want to partner with us. Really unique role and I'm really enjoying it.

Robin Ntoh (01:48):
That's exciting. Thanks for sharing that background because I think it lends itself to a little bit more about what we do together as partners, but more importantly, it really helps us understand where there is a sales component to what we see as financing. Glen, let's kick this off and talk about different ways that we see financing as a play for attracting new patients. Tell us a little bit about what your thoughts are on that and what you've seen in practices.

Glen Holden (02:15):
Yeah, one of the biggest benefits of financing is giving people a way to pay for the care that they want. If you look at some of the big box stores that are out there, I remember when I was in the retail business speaking with a gentleman who ran a furniture store, and the thing I thought was pretty surprising that he told me was, I can't get anybody to sit on a couch or lay in a bed or look at a dining room table unless I let them know how they're going to pay for it. And when he said that, I was like, wow, he hit it right in the head. However, when I went back to my healthcare roots, I looked at whether it be in the cosmetic, the derm, even when I was on the dental side of the business, nobody did that. The procedures were just as expensive as the, but nobody let people know how to pay before they came to the office for a visit.

Robin Ntoh (03:04):
It's pretty interesting that you say that because I start to see that more and more now. I see some of the other vendors in this space starting to offer different ways to finance and how they're focusing on that. So I think that we also think about the generations out there, and I've done a lot of reading how the Gen Z really focuses on the buy now, pay later and what that does to attract them to our practice. So I see that this is a big opportunity for practices. Where do you see that your practices are leaning in and using this, or do you think that they're just not really losing this as well as they could?

Glen Holden (03:37):
I think some of the more sophisticated practices do leverage financing and do put it in their ads, have things on their website, but there's still a big majority that just don't. Unfortunately, they don't let people know how you can make it affordable for them so that they can get the care they want and need.

Robin Ntoh (03:54):
Breaking down those barriers I think is going to be key. I think it's all about when I think you hit something. You said website, is it on your website's, it front and center? Do we talk about it before the patient comes in so that you can reduce that fear? But have you seen other creative ways or practices have actually been more strategic in how they actually represented CareCredit as an option or financing per se, before the patient even walked in the door?

Glen Holden (04:24):
Yeah, I've seen 'em put it on some marketing materials to let them know that we offer to 12 months, 18 months. I've even seen in the practice where they'll have signage. I've seen some customized signage. I've even seen pins and buttons, ask me how to finance this treatment today and that kind of thing. I've seen them get more creative there to let folks know how they can pay for it.

Robin Ntoh (04:46):
Yeah, no, I think it makes sense. Breaking down those barriers is key, and I'll say practices where people will come in and they won't even think about financing because it maybe isn't something they're worried about, but as they're checking out, I think that's another way that we can actually make that more visible to people. Some practices, quite frankly, don't present it because I think they're more concerned about the cost of the practice. I think, well, maybe this is going to begin an opportunity for you as a business to sell more, to increase your ticket size, which we'll talk about in a minute. But I also think that financing has a play there because we call it financing, but maybe it's your own personal credit card or stash that you can use to actually pay for those procedures that become your own little hidden treasure that you're not sharing with your significant other.

(05:36):
I think that's still very common. I hear about it still in practices. I'll still never forget the day I was in a practice where a patient had said to the staff they were coming out of surgery, they said prior to going into surgery, they had said, listen, my husband's picking me up. They know I'm having X and Y, but they don't know I'm having Z. Please do not tell them that I'm having Z done today. I'm like, you mean he's not going to notice? But these are the things that I think we still come across within this space that in the aesthetics arena, people just don't necessarily want all of it to be known, and they're using their different financing options to do it. So I think that there's big relevance in it and maybe there's an opportunity for people to think about using that in some of their advertising as they're thinking about how they attract patients. From your perspective, just shifting gears a little bit, when do you think is a best time to actually talk about financing with a prospective patient?

Glen Holden (06:33):
As early as possible, to be honest with you. Let them know how they can pay for it as early as possible. One of the things that I wanted to share is money is a very personal item. Think about in your life, I mean, I don't know how much my best friend has in his checking account. I don't know how much my parents have in their bank account. I don't know, it's personal. These are people that I have good relationships with, I don't know. And so when you think about how personal money is, it's very good to have a practice open the conversation that financing is available so it doesn't seem like you're begging or, Hey, I can't afford this, because quite honestly, people won't say that they can't afford it. They'll say, let me think about it. That's them saying, I can't afford it. That's what it sounds like in real life. And so if you can bring that barrier down and let people know, Hey, look, a lot of patients do this, use that 12 months, 18 months, whatever works for your practice, it makes it so much easier for them to be like, oh, really? A lot of people do it. Oh, great. People don't like to be the first one. They like to know that other people are doing this, and it's very common.

Robin Ntoh (07:39):
I think you were sharing with me recently that I think 20% of the practices that you have seen that use CareCredit actually are using CareCredit for financing versus people paying cash. I thought that was a big number, meaning there's a lot of people out there using it. It's just giving permission almost to say to the prospect, Hey, listen, this is normal, don't think of it as something that isn't normal. We see this all the time. People are using financing all the time because they just want to hold onto cash.

Glen Holden (08:08):
That's correct. Or they're waiting for more cash to come in. I mean, some people are getting bonuses, maybe a tax return. I mean, I haven't gotten one in a while, but some people do.

Robin Ntoh (08:18):
Right, exactly. No, I think those are all good points. I think people get influxes of cash at different times of year, and so they look at this as, I want to do this now and then I can pay for it down the road. That does make a lot of sense.

Glen Holden (08:31):
One of the benefits too, to think about Robin, is as interest rates have gone up significantly over the last few years, a 0% promotional interest rate is very attractive. Maybe it wasn't so attractive when you could go to your bank and get three nine or four nine or something like that. Home equity could be a three nine or a four nine. But now when a home equity is eight nine, nine nine, sometimes even north of that, these promotional 0% paid in full are really, really attractive.

Robin Ntoh (09:04):
So funny you say this, I recently bought new living room furniture and they were offering 0% interest for X number of months, and I'm like, Hmm, do I want to think about that? Then I went back and thought, or do I want those frequent flyer points? So am I going to put it on my Delta credit card or am I going to finance it? What was more relevant or more important to me, so.

Glen Holden (09:24):
What's great about that, Robin?

Robin Ntoh (09:26):
Yeah.

Glen Holden (09:26):
You got the opportunity to make that choice. Many practices that I observe, they don't give them that choice, right? It's kind of like financing is the last ditch effort, and unfortunately when you offer it as a last ditch effort, you don't get the results that you were expecting before.

Robin Ntoh (09:44):
Well, we kind of think of it as almost a taboo kind of subject. So let's talk about as the patient comes in, maybe they're a patient that comes in for spa treatments or maybe they come once a month or they come every few months for injectables, et cetera. How do we see that this can help increase ticket size? So thinking about they've come in with a budget, they know what they can spend, but maybe they could spend more, maybe they want to spend more, but they don't see those opportunities. Where have you seen this to become effective in increasing that?

Glen Holden (10:20):
So years ago, I taught sales training at our company and one of the things that I used to share a real world example, Robin, have you been to a Target within the last few years?

Robin Ntoh (10:32):
Yeah, absolutely. Who doesn't go to Target?

Glen Holden (10:35):
What do they always ask you at the register?

Robin Ntoh (10:38):
Do I want to apply for their credit card?

Glen Holden (10:40):
Apply for it or even do you want to put this on your red card? I mean, they are consistent about asking you, would you like to either apply for the red card or would you like to, I think they ask you first, would you like to put it in your red card? And you're like, I don't have a red card. Then they ask you to apply, and you probably know that their val prop is, they'll give you 15% off everything in your basket, everything. And I used to ask the folks that were in my class, why would they do that? Even stuff that's on sale, they're going to give you 5% off. What sense would Target do? Why would they do that? And the reason is is because they know that people that have that red card spend about 50% more than people who don't. People just come in like me, that has a visa or cash in my pocket, and they also make more trips to the store, so they visit more often. So when you're looking for good customers, it's a customer that spends more and visits more. Well, the same could be said in our practices. If you have a dedicated way for people to pay, it builds loyalty. So hopefully they come in more instead of getting Botox every three months, maybe they come in every two months. What would that mean over the course of that patient's career with you?

Robin Ntoh (11:52):
I can see it definitely increasing the lifetime value. Yeah, for sure.

Glen Holden (11:55):
Yeah, exactly, exactly. And because CareCredit is a revolving line of credit, that means if you get 5,000, you can use up until 5,000. If you have pay down a thousand, then you got that extra thousand back. So it's revolving so you can use it over and over. So it really fits nicely in the practices that have recurring folks coming in over and over.

Robin Ntoh (12:18):
It just spreads out the opportunity. I mean, if I think about what the average encounter value is, I think AMSPA just, they just released all of their numbers for the 2023 year, and it was around 500, a little bit over $500 is your average ticket. So I talk to practices all the time, and they're thinking about, well, how do I increase my revenue? Well, if you've got three providers and each of them increases their average ticket by $10, I mean that may not seem like much. Okay, let's just add $50 to that. And if they did that over the course of X number of people that they see, and if they did that over X number of months, that little bit that they're increasing their average ticket, their P and L is going to change dramatically at the end of the year. So think about it's all about what's in the patient's wallet and you're basically expanding opportunity because you're expanding their wallet.

(13:19):
So they can still use their credit cards, they could pay cash, but now they have another option that may have an opportunity for them to save that cash. Going back to what you had said before, now I can actually think about, well, I'm having a bonus that's coming up in three months, I'm going to go ahead and do the 0% financing. I really don't want to use my credit card. I'm going to pay interest on that. I'd rather do the 0%, three months, I'll pay it off. And voila, they actually spent more during their visit because they felt the freedom to do it. Yeah, there's a lot of studies out there that support that, but I think that the studies are there. We talk about it, but we just don't see the activity around it. I think there's this stigma around it and practices feel like they don't want to put that pressure on their staff to feel like they're salespeople and that they're trying to sell them to a credit card. When in effect, it really is just presenting the opportunity to the patients. Do you want to put it on your red card? Well, I can only imagine what that would mean in a practice. They'd be like, red card. What's a red card? Yeah, that makes sense. I think that someone should take that and run with it. I challenge a practice out there right now that's listening to this. Think about what that would mean to your practice. Take that and just run with it and see what that actually does as a benefit to your practice.

Glen Holden (14:31):
I agree.

Robin Ntoh (14:32):
What have you seen this creative and practices as you've worked in this space where they've actually worked to expand around that ticket size? Other than education, which I think is great, but anything creative you've seen that you can share with our listeners?

Glen Holden (14:47):
Yeah. One of the things that I've seen is when I talk to practices about maybe there's some seasonality in the business where they may say, oh yeah, we're a little slower these months. Let's say beginning of summer, June and July we're slow. And I'll ask a question like, well, what have you done to try to fix that? And many times it seems like they're still kind of slow because a lot of times what their solution is is to just discount their products and services, which any doctor owner that I've spoken to, that's not usually something I love to do. But what I have suggested is, Hey, I see that you typically offer a six month deferred interest, zero interest if paid in full program. What if just during these slow months maybe offer a 12, right? Because if you're financing $5,000, okay, $5,000 and you're using a 12 month, it's $417.

(15:40):
Why do I remember that? I just remember it. But okay, so think of $417 for, that's your monthly payment on 5,000 at 12. If you offer 24, I know it's going to cost you a little bit more, but how many more people are going to be able to say yes, when now it's $209? It's way more affordable. And so during those slow times, maybe you offer a promotion that's a little bit more aggressive than you normally offer, and then you'll get more people to say yes and fill the operatories, fill the chairs, that kind of thing, so that you can move forward. And if you think back out, I give you a lot of retail examples. If you think when things are slow or right before the Super Bowl Best Buy is putting their TVs on sale. At the end of the year when the car dealers trying to get rid of the 24's and the 25's are coming on the lot, you're going to get a good deal on the 24 and you're going to get better financing deals. You won't get those deals in the 25's only on the 24's. And so we never want to turn our places into car dealerships cuz it's a terrible experience. But

Robin Ntoh (16:42):
Yeah, truly.

Glen Holden (16:42):
You do see where this works. Things are slow, let's offer a little bit more and get people excited. Again, put it on your website. If you're sending out flyers or emails, let them know, Hey, for a limited time, we are offering 24 months. I've seen people do it. I've seen them double sometimes even triple their acceptance rate.

Robin Ntoh (17:04):
I love that you call it a patient acceptance rate because it's true. I mean, we think about it as conversion, but in reality, you're giving them an offer and they're accepting it, and it's all about how we're expanding that opportunity back to that patient. Love the fact that you actually talked about the seasonality as well. I mean, I think about right now what's happening, this huge, huge change right now in the political arena, and it's a major election year, and those of us that have been around this for a long time, we've seen where this, every single presidential election has a slowdown in this space. And we don't necessarily talk about it, but it happens. I mean, people stop spending and they hold their money, I don't know why they do, and it doesn't even matter who wins the election because they still just, all of a sudden the floodgates open and then they start spending again.

(18:00):
But it's up to that point where things slow down. We generally see where in September there's an uptick in spend, kids have gone back to school the summer's over, and now we're ready to get back into the groove of things, and then right around the corners, all the holidays, and we want to take advantage of it. But right now, we historically see a little bit more of a slowdown, probably more so than some years because we're just heading into that whole election. And so that's going to impact practices. And I think what you said will be another way to expand that wallet for the patient to potentially get them to say, you know what, I'm going to do this. You know what, then we'll wait and see what's going to happen, and then I've got six months to make a decision how I want to pay for this. And I think it helps expand that opportunity for practices they're just not thinking about.

Glen Holden (18:48):
I agree.

Robin Ntoh (18:50):
You know, Glen, one of the other things that I think I hear about in practices is less about the patient, but staff. I mean, there's some resistance there sometimes into incorporating new processes that will actually afford the practice, more revenue share or opportunity to increase that ticket size of the patient. And I think about, well, why would that really be a burden or a problem with the staff? And then I go back to, okay, well, they've got their software that they use within their practice. I mean, I know Nextech, Nextech's a practice management software, and then there's things that are outside of the software that they're having to deal with as well, that become more clicks, more processes, more to manage. And I'm thinking, well, is that really what would be the stop end for them to not want to actually make this opportunistic for patients? But what do you hear in the marketplace when it comes to where there's resistance within the practices to actually offer this more?

Glen Holden (19:48):
Look, there's always some hesitation about offering financing. One thing that becomes uncomfortable when you offer financing is if the patient says, yes, let's do that. And then you don't get approved. Like that's, because you're excited, hey, let's do X, Y, and Z. Okay, hey, let's do the application. And then it's like, oh yeah.

Robin Ntoh (20:09):
Big deflation.

Glen Holden (20:10):
Yeah, exactly. And it's like

Robin Ntoh (20:11):
Almost embarrassing, right? For both.

Glen Holden (20:13):
You've got to be really strong to be able to pivot from that, right? And look, there's ways to pivot from it. I know our company allows you to use a co-applicant, so that would be something that you're like, oh, is there somebody else that would like to invest in your care? And you can kind of pivot off of it, there's no doubt about it. Again, that's a tough part. And so go through a few of those and you get a little gun shy to offer financing, there's no doubt about it. So when you're picking a financing partner, approval rate should be one that you should be really concerned about because the less times you have to do that, the better.

Robin Ntoh (20:49):
I think that's a really good way to think about this, and that's probably why staff are like, I'm not a bank. I don't want to be the person that says, no, I don't want to be the bad guy.

Glen Holden (20:58):
 That's right.

Robin Ntoh (20:59):
Okay. So I go back to that's one of the key things that we've talked about here internally is how do we create that opportunity? And so now we've established there's a good reason why they probably don't want to do this. Is there a way to actually circumvent that? Can I get insights into potentially what might be available to the patient before we even have that conversation? And that's one of the things I love about integrations, and I go back to, and I learned about it recently, shame on me that there's this really cool, almost, it's like a report. It's a glimpse into what's available. And listen, I'm not able to talk to it, not nearly as well as you, so I'm going to let you kind of tell us more about what that is intended to do.

Glen Holden (21:45):
So you're referring to what we call our Batch Quick Screen Tool. And what the Batch Quick Screen Tool does is about five, six days before the patient's appointment, we take all the patients, let's say you got 20 patients coming in on Monday. So five days before they're going to take those patients, grab the information that you have in your software. So name, address, birthday, phone number, and we're going to first try to identify do they have a CareCredit card? And if they do, we will post that on the appointment on the ledger type thing so that you can see, Hey, Robin's coming in, she has a CareCredit card, she has $6,000 in available credit. Pretty helpful, right? Pretty helpful when somebody is coming in.

Robin Ntoh (22:31):
Yeah, totally.

Glen Holden (22:31):
Even if you're a new patient, even if you've never been there before, if you don't have a CareCredit card, we're going to take that same information that's in the software, name, address, phone number, birthday, and we're going to try to pre-approve this person, this patient coming in, no hit to their credit, it's a soft inquiry, but we're going to do that pre-approval process.

(22:51):
And then also in the software, it'll say, Hey, you're pre-approved Robin for $5,000. How helpful would that be? So if you have a card, you don't have a card, alright, we're going to pre-approve you. If you're have a card, you're not, it doesn't mean you're not going to be able to get any financing, it just means you're going to have to do the real application. But if you can identify these card holders and their available credit along with pre-approving the people that don't have a card, it's huge. I'm seeing in our Nextech practices, about 60% of the time we either identify a card holder or we pre-approve them. That's amazing.

Robin Ntoh (23:27):
Wow. That's impressive.

Glen Holden (23:28):
Yeah.

Robin Ntoh (23:29):
Well, I mean, it takes away the frustration of a staff member. I also look at this as we always lean in on patient experience. How great are we making it for the patient? Are we giving them that excellent experience? Because we think about differentiation, I mean, a lot of the tools that are made available today in practices are not just to help the staff, but about how we drive a better patient experience. And with that in mind, again, I go back to a tool like financing and think, does that improve patient experience? It should, but what if that patient who now looks at you as the gateway, I'm the patient coordinator, I'm the checkout person, I've now set you up for financing, you've gotten approved, you've had a great experience in the practice, and I forget to make my payment, and all of a sudden my interest rates go up.

(24:22):
Okay, well, I would expect that to be with any credit card, not just a CareCredit, credit card. But I think a lot of times what I hear practices say is that represents us poorly because it looks bad to the patient. And I say, well, okay, but that would be true for any credit card. And so I think about that is that's not really a bad experience because of what the practice did. It's because the patient made a mistake. But I also go back to it and think, well, does the practice have any recourse? Can they help the patient and can they ultimately become the hero here?

Glen Holden (25:00):
Absolutely. And if you look at our 35 plus year history at CareCredit, we've always tried to put the card holder and the patient first. We've waived fees. We have tried to keep them on the promotion. Even if you've missed a payment, if you get to the end of your 12 month and you've forgot to pay your bill or whatnot, if you call in, typically they'll give you a month extension because ultimately we want people to use the card again. And if you're supposed to pay on July 10th and you forgot and you pay it on July 13th, if you call us, they're going to take care of you. They're going to take care of you on that. And one of the things is, I remember we did a study, where would you recommend this to a friend or a family member? And it was like 90%. Don't quote me exactly on it. It was like 89, 90, 91, whatever it was. It was very high. And I always love to quote that one, why? Because if you were going to recommend something to a friend or a family member, you'd have to think you were pretty proud of it. And typically people that have used it are pretty happy about it and will recommend to a friend or to a family member.

Robin Ntoh (26:08):
Glen, I just want to circle back here. We've talked about where this is going to help us attract new patients. It really helps us increase revenue for practices because we're expanding what we can do for patients. But then we've talked about the staff and what we can do for them. We know that an integration is going to help staff. I mean, Nextech has the stats. It's more than three times faster to process directly from the software, reduces fraud, it reduces all types of risk within the business. But how do we help our practices overcome some of the understanding of this? Do you have resources that can help practices learn how to tactfully have conversations about the financials with their patients?

Glen Holden (26:53):
So first I'd like to highlight, we have an external and an internal sales team. So we've got probably 130 people out in the field that can help practices when they're out there visiting them in person. We also have about 80 folks inside a call center. Technically, they're all remote now, they don't actually work out of a call center like they used to. So you got a good 200 plus people that can help. We also have an abundant amount of training materials to make sure you're explaining things correctly, you're not saying it's a no interest loan because that's just not true. It's a deferred interest loan, right? It's no interest if paid in full. But we just want to make sure that we're very clear on how our practice promote this so that the patient doesn't have a bad experience. We actually have a CareCredit certification training course that practices have to do every two years, but the people that are talking about financing and talking about specifically CareCredit would really benefit from that to make sure that their patients have a good experience and therefore they feel like they had a good experience in the practice.

(27:58):
Because I think you mentioned it earlier, if they have a bad experience with CareCredit and the practice is the one that said, Hey, would you like to put this on your CareCredit card? Or would you like to apply for this? They're going to be pointing fingers back at the practice as well, and we want them to have a good experience, and so we want to make sure you've got the right information so that you're saying the right things, how it works. And it's simple. It's not hard. I mean, again, we got almost 250,000 practices that use CareCredit across the nation, so it's not difficult. But that 12 to 15 minute investment of time should really set you up for success for your practice.

Robin Ntoh (28:39):
Absolutely. I think it goes back to financing is here to stay. It has been part of our consumer spending history for years and years and years. It has been kind of under the covers when it comes to aesthetics, is becoming much more predominant. I think that generationally, we see that younger generation that is absolutely focused on that buy now pay later, or the credit card type of aesthetics opportunity that's available to them. And so practices that are not looking at this holistically, I think are absolutely not just losing, but potentially losing opportunity on patients that they could gain as just new patients overall. So a lot said here. I loved talking to you today.

Glen Holden (29:23):
Thank you. Thanks for having me.

Announcer (29:26):
Thanks for listening to Aesthetically Speaking, the podcast where beauty meets business, presented by Nextech. Follow and subscribe on Apple, Spotify, YouTube, or wherever you like to listen to podcasts. Links to the resources mentioned on this podcast are available in your show notes. For more information about Nextech visit nextech.com, or to learn more about TouchMD, go to touchmd.com. Aesthetically Speaking is a production of The Axis, theaxis.io.