DSOPro: Tell us about your backgrounds.
Blake Hibray: It’s been a circuitous path for my career to eventually land within the dental industry. Previously I worked for ROi, a provider-owned Group Purchasing Organization (GPO) in healthcare. Gene Kirtser, who is now the CEO of Affordable Care, was CEO of ROi. During our time at ROi (now part of HCA-owned HealthTrust Purchasing Group), we grew the GPO from supporting the supply chain needs of a 40-hospital health system that covered a 4-state footprint to national prominence, with more than 200 commercial hospital members and several billion dollars of contract spend managed by our GPO team. ROi’s focus was not limited to just supply contracts, as the company spearheaded the development of a self-managed distribution center model within the healthcare industry and established a custom surgical pack commercial business that provided nearly every tool and supply that a surgeon would need to complete a surgery. I spent much of my 13 years at ROi leading multi-disciplined on-boarding teams to implement the contract portfolio and supply chain solutions across new health system members, with three or four large implementations going on at any one time. Before ROi, I served for 20 years with Sigma-Aldrich Corporation (now Millipore Sigma), a global leader within the life science R&D industry where I built supply chain, quality, e-commerce, national sales, and global account teams to meet the needs of scientists across the academic, government, research hospital, and biotech/pharma sectors.
I like building things, so when Gene called in 2018 and asked if I’d be interested in helping create a GPO model within the dental industry that is similar to what we did in healthcare, I jumped at the chance. With so much consolidation going on within the dental industry, the time is right for a true GPO model within the DSO space. I joined Affordable Care in February 2019 and founded the GPO later that summer. The pandemic brought everything to a halt, but we started up again at the end of 2019 and began bringing experienced leaders on board with GPO, healthcare supply chain, and of course, dental industry experience.
I have two titles: I’m Vice President of Supply Chain for Affordable Care, the largest DSO in the nation that is exclusively focused on tooth replacement solutions, supporting more than 400 practices in 42 states. We have an outstanding supply chain team that serves the existing Affordable Care supported practice network, and all the growth stemming from the denovo and M&A activities of Affordable Care. In addition, I also serve as President of Sevāredent, and my primary focus is to build the organization to support our GPO members.
Angela Miller: I have 30+ years of experience in supply chain and contract management functions starting with the U.S. Air Force in the Medical Logistics field. Following my military career, I helped stand up MediGroup Physician Services, a GPO focused on the surgery center and physician practice markets. This endeavor was extremely rewarding as it exposed me to all the functions needed to run a GPO and support its members. I eventually took positions with two other GPOs in the medical space, Intalere, formerly Amerinet, and ROi, which is where I met Blake.
At ROi, I led the contracting verticals for medical surgical supplies and equipment, medical devices, and laboratory contracting. I spent 9 years at ROi before being recruited to join Kindred Healthcare as a DVP of Strategic Sourcing in 2019. I helped build out a supply chain team and led the sourcing vertical, which supported 89 long-term acute care and rehabilitation hospitals.
In the fall of 2021, Blake reached out about an opportunity that would lead me back to the GPO space but this time in the dental market. I have a passion for GPOs and, while leveraging key best practices from multiple industries, I enjoy leading successful sourcing teams. My role as Vice President Strategic Sourcing is to lead a team of sourcing professionals and a clinical resource in the development and management of a contract portfolio, while leveraging the voices of our members throughout the process. I’m thrilled to be part of this team and excited to drive value for those we serve.
Amanda Lisle: My career started in hospital marketing and PR, and I found myself migrating into sales. I started in dental sales about 15 years ago with Philips Oral Healthcare. I was there close to 5 years when I was recruited to join a start-up dental buying group for independent dentists based in Texas. We grew that from 30 doctors to over 700 when I left the company. A friend of mine told me some healthcare executives were starting a GPO in dental and then introduced me to Blake. I was so intrigued as I have always been aware of the precedence of GPOs in the medical space.
I thought it would be fantastic, because I could see the evolution of dentistry moving away from the private practitioner to DSOs. Also, DSO growth was being fueled by dentists coming out of dental school with half a million dollars of debt and other dentists who just did not want to own a practice. I wanted to be a part of something to help change the industry.
I joined Sevāredent in October 2020. As Senior Director of Strategic Accounts, I oversee our GPO membership. We currently have 27 GPO members representing more than 1,900 locations. I and my small team of account managers have daily interaction with members, examining their overall spend, matching opportunities for the contracts that Angela’s team puts in place, and presenting opportunities for DSOs to switch to our GPO contracts for more savings and value.
DSOPro: What is a GPO, and what’s the difference between that and a buying group?
Blake: A GPO is an entity that healthcare providers such as hospitals, surgical centers, nursing homes, home health agencies, and now dental practices (through their DSO or DPO) can access to leverage their aggregate purchasing volume to obtain pricing on supplies, equipment, and services that they would not normally be able to obtain by themselves. Virtually all 7,000+ hospitals and 70,000 non-acute physician practices in the healthcare industry access some form of GPO. It’s a standard within healthcare, but until recently, dental hadn’t moved into this space. The growth of DSOs and DPOs are helping lead that charge.
Because some of our provider members participate in Medicare, Medicaid, or TRICARE—federally reimbursed programs—we fall under the federal Safe Harbor statute and must have a certain governance structure in place and operational guidelines for how we interact with our membership. Nothing too complicated, just formal agreements with our members and with our contracted supplier partners. Our business model is built on vendor-paid administrative fees, with no cost to participating DSOs and DSO-supported practices. A key difference between a traditional GPO, such as Sevāredent, and a buying club or the other types of sourcing clubs is that the clubs tend to rely on member-paid subscription fees, whereby the member pays a monthly or annual fee to access buying club agreements.
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Amanda: Buying groups are very appealing for independent dentists because they have no buying power. Joining a buying group and having access to a menu of vendor discounts is advantageous for solo practitioners. There are also dental buying groups that will negotiate on your behalf. That’s completely different from us. Our Sourcing team is contracting with a certain number of vendor contracts in each category. Other buying groups may look at what the DSO is spending and say, “We can renegotiate your contract with X, Y, and Z vendors.” We don’t contract based on each GPO member. We will keep each category to one, two, or three vendors in that space. So, those are some distinct differences, and our model doesn’t work for everyone.
We work best with groups that can implement change at the local level and drive compliance. That’s really the key for working with Sevāredent. If there is change management at the top, we need that to be communicated across the DSO network. We also work best for groups that have visibility to data – what each clinic is buying as well as those groups that adopt e-procurement systems. We’ve set ourselves apart as a GPO that you can insert your group into our over 1,900 locations and see savings and value.
Something else that sets us apart is that we have an entire operations and analytics team in house. Once we have visibility to a DSO’s AP spend, we run impact analyses to show exact-match savings opportunities. We then take it to the next level by suggesting conversion opportunities. For example, if the DSO is buying from one vendor, and we have a contract with another vendor and it makes clinical and financial sense to switch, we can lead those conversations.
Most dental groups just don’t have the analytics manpower to run all that data needed to show opportunity and spend assessments. We have a dedicated team that turns that around very quickly and it is included in GPO membership.
DSOPro: What types of vendors are you working with? How do you pick them and how does compliance play into it?
Blake: We have built the GPO from scratch, starting with many of the supplier partners used by our provider-owner, Affordable Care. As we have brought on new members that focus on different segments of dentistry (e.g., oral surgery, endo, restorative), we continue to broaden our offering accordingly to meet the needs of our members. Our shared vision is that “We aspire to create a competitive advantage for like-minded dental organizations through best-in-class vendor partnerships that drive supply chain value and efficiency.” That vision has taken Sevāredent well beyond traditional distributed dental supplies into product and service categories, to include implants, biologics, third-party labs, capital equipment, and a whole host of indirect-spend categories too numerous to mention.
Angela: The contracting strategy for the GPO is not to encompass every vendor available in the marketplace. We don’t drive value in that way. Our goal is to drive utilization of highly competitive contracts. As a result, we are selective in who we bring into the portfolio, and the number of vendors we bring into any given category. We make those selections by utilizing an advisory council structure made up of GPO members. Closely collaborating with our members so the portfolio reflects their needs is critical. Becoming a trusted advisor to those we serve is important and to do so we must engage them in our process.
Amanda: On the strategic accounts side, everyone wants to focus on dental supplies and equipment, but the Sourcing team also focuses on “indirect categories,” which are nonclinical by nature. That’s everything from pest control to patient financing, IT services, and all the other sides of the business that need attention. Money is always going out the door paying for these services. Our portfolio is inclusive of not just clinical supplies and capital equipment, but all the other services it takes to operate the dental organization.
Blake: We are a provider-based GPO and there are some advantages associated with that. For instance, if we want to build a surgical instrument kit that is standardized across a company or perhaps part of the industry, we can very quickly get feedback and input from those clinicians and our head of clinical operations. If we were just a pure GPO with no real connections in the dental industry, it would be a lot tougher.
The connection that we have with the clinical side of the organization is invaluable. We can be much nimbler and more responsive in how we develop products and solutions within this structure we have created. Part of our growth strategy is building out a business development team that’s tasked with identifying new and novel business solutions and services that aren’t readily available today. We have also invested in a new Director-level position that is focused on clinical integration and formulary development.
Amanda: I’d like to add that we don’t offer membership to private practitioners. We work best with groups that are 20 locations or more, that can drive the decision-making process across the enterprise. When you look at our roster right now, we have one dental school partner, but an ideal member for Sevāredent is a true DSO, like our majority owner, or a DPO. But if the leadership, the corporate team, the finance team, and the procurement team are willing to look at the upside of savings and value and drive that change management compliance, that makes a very good member for our GPO.
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DSOPro: How does Sevāredent’s structure compare to your GPO experience in the medical industry?
Blake: Frankly, the medical side of healthcare is years ahead of dentistry in terms of supply chain sophistication. This is largely due to a general lack of industry consolidation across the supply chain stakeholders (manufacturers, distributors, providers) and dentistry has higher operating margins than what we see on the medical side. As a result, providers just have not felt the financial pressure to invest in Supply Chain capabilities, nor hired the right talent to drive innovation. Also, capturing “mind share” with DSO leadership is a challenge because leadership is really focused on top-line revenue growth and getting to the next chapter, whatever that might be for them. There’s not a lot of effort put toward supply chain best practices, so this has become one of our strategic focus areas for the foreseeable future.
Having ready access to transactional purchasing data is commonplace with the medical space, but within dental so many DSOs are reliant solely on vendor web portals. Requesting reports from dozens of vendors becomes a real challenge for an organization to get its arms around a supply chain strategy. Fortunately, there has been a recent surge of affordable, easy to install, network-wide e-procurement solutions that are beginning to gain traction within the dental industry.
DSOPro: What other technologies are going to be pulled in to simplify what you do?
Blake: Now that we have multiple vendors with different solutions, we’re looking at solutions to integrate them, so they talk to each other. Wouldn’t it be nice to have an inventory cabinet talking to the e-procurement solution so when that inventory level reaches the reorder point, instead of multiple purchasing orders going to a vendor there will be a link to the procurement system of record and the order will pass through that. We’re getting vendors to talk and work with each other to develop those solutions and perhaps integrate that into the practice management system of record within the DSO to maintain other records that would be of value.
Angela: As a result of adopting e-procurement technology, we now have tools that create a pathway for the visibility of data, which can be used to support a standardized formulary of products, services, and equipment that is clinically vetted and supports member needs. We’re able to help with that visibility and process. We’re working aggressively right now with Affordable Care on a formulary standardization process and have interest from other Sevāredent members for the same support.
DSOPro: What kind of trends are you seeing? Anything that would help our readers look into the future, too?
Blake: We’re seeing a large number of supply chain professionals from the healthcare segment make the transition over to dental. As the DSO segment of the industry continues to grow, the demand for strategic supply chain talent coming from healthcare will only increase, which will lead to quicker adoption of the supply chain best practices, of which Sevāredent Sourcing Solutions and our members will benefit.
Amanda: Agreed. One trend that I see and bring up when talking to prospective GPO members is visibility to data and/or do you have plans to adopt an e-procurement system? We’ve watched adoption of e-procurement take off and we promote the value of that because it can help the DSO with the pain of change management, it can help Sevāredent, and result in the adoption of contracts going so much faster.
Blake: Due to the pandemic, there have been tangible efforts by suppliers to onshore some of the manufacturing and services that traditionally were sent overseas. Third-party laboratories continue to consolidate and they, too, are faced with issues about offshoring or onshoring their solutions. Plus, the whole industry is very quickly moving toward digital. The acceleration of different technologies in either design or 3D printing is incredible. We’re careful not to overinvest in one particular technology because it may change tomorrow and introduce a better solution at a reduced cost, at better value.
Angela: The advisory council structure drove the contracting process, efficiencies, and cost savings we were able to generate for members on the medical side. It made complete sense to set up a similar structure at Sevāredent for dental. Understanding what keeps a member up at night and their specific needs/wants allows me to direct my team’s efforts to support. The advisory council approach allows all GPO members to reap the rewards of best practice sharing and, collectively, negotiations.
Amanda: We watch trends very closely. Dentistry follows medicine. Pharmacy followed this model years ago. Optometry is the same. Dentistry and probably veterinarians are still on this upward path. DSO growth is being fueled by dentists coming out of school with a lot of debt, but it’s generational as well. Younger dentists don’t want to own a practice; they don’t want the headache of staffing and payroll, and they don’t have as much access to capital. They just want to be a dentist. Now, for the first time in history, half of dental students are women, and some women don’t want to own a practice. Also, many independent dentists are retiring, and DSOs provide a good exit strategy.
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DSOPro: How did you come up with the company name, Sevāredent?
Blake: At the life science company I was with in the 90s, I had responsibility for a third-party purchasing operation for the R&D divisions of two Swiss pharmaceutical companies, Sandoz and Ciba-Geigy. Later, the two companies merged into one, and they relied on the Latin dictionary to derive a new corporate name that everyone now knows as “Novartis,” which simply means “new arts.”
We wanted to come up with something that was novel, trademarkable, and had an Internet domain name that was available. Inspired by Novartis, we ultimately landed on our own Latin-derived company name by combining Servare, which means to protect or save, with Dente, which we all know means teeth. We mushed the two together, changed the spelling slightly, and voila, Sevāredent was born! You can interpret the name as “to save teeth” or how I like to look at it, “to save our member practices money and build better products and services to support them.” Sevāredent gets excited about savings just as our member dentists get excited about teeth. It’s a perfect match.
DSOPro: How do people find you?
Blake: Up until now, it has been purely by networking and word of mouth. A satisfied member telling another group to check out what Sevāredent is doing. We’re focused on slow, steady growth and giving our business development and GPO operations teams time to build the infrastructure to properly support the organization. We’ll probably top out membership at around 3,000 locations. We’ll have scale and good buying power for our active, highly participatory members, but remain nimble. That’s important for us.
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Angela Miller is the Vice President of Strategic Sourcing. She is responsible for leading a sourcing team and clinical utilization role to develop and maintain a comprehensive contract portfolio for direct and indirect spend categories and supporting members in their product formulary journey.
Previously, Angela was the Division Vice President Strategic Sourcing at Kindred Healthcare, an 89-location long-term acute care and rehabilitation hospital group. She led a sourcing team who worked closely with stakeholders to develop and implement contracting and utilization strategies for a variety of products and service across the organization.
Angela also worked at ROi, a medical GPO, where she served as Executive Director of Medical Contracting and led a team responsible for over $1.1B in spend across 280 acute care hospitals and 2,800 non-acute members. Angela’s GPO experience also includes leadership roles at Intalere and MediGroup Physician Services, in addition to serving 9 years in the Medical Logistics field in the United States Air Force.
Previously, Amanda held leadership and business development positions within various sectors of the dental industry. Amanda’s natural affinity for developing relationships as well as a work ethic of integrity is part of what helps her succeed in the business of dentistry.
After graduating from Iowa State University with a B.S. in Microbiology and Biology, Blake began a 35+ year career, starting with Millipore Sigma (formerly Sigma-Aldrich Corp), a global life science company headquartered in St. Louis, MO, as an industrial microbiologist. He held executive positions in sales and marketing, national/global accounts, e-commerce and supply chain, to include third-party purchasing services for Novartis, a global pharmaceutical and animal health company.
Previously, Blake was Associate Vice-President at ROi, a provider-owned healthcare GPO and supply chain solutions company servicing over 200 hospitals in the United States. His experience at ROi serves as the model for what Sevāredent is, and what it will bring to the dental industry.
About Sevāredent
Founded in September 2019, Sevāredent Sourcing Solutions is a group purchasing organization (GPO) focused on the DSO/DPO segment of the dental industry, headquartered in Morrisville, NC. Through the power of data, a professionally managed negotiation process, and a strategic relationship with their membership as a means of advancing supply chain best practices, Sevāredent aims to provide its’ members the opportunity to enjoy significant savings across virtually all spend categories, leading to meaningful margin improvement and efficiencies.