DSO growth over the next five years will be driven by oral-systemic health integration, rising demand for partnerships and continued de novo expansion, according to Mark Greenstein, the executive vice president and chief growth officer at Heartland Dental.
Mr. Greenstein recently connected with Becker’s to share his predictions for what the DSO field will look like in five years.
Note: This response was lightly edited for clarity and length.
Question: What will the DSO/MSO landscape look like in five years compared to today? What will we see more of, and what will we see less of?
Mark Greenstein: In five years, the wall between oral and systemic health comes down. The mouth-body connection moves from research finding to benefit design, and medical insurers build oral care into their products because whole-person care demands it. The two systems will look more alike than they do today.
Seniors drive the demand curve. Americans are living longer, more vibrant lives, and oral health is part of that equation.
DSOs continue to thrive because the math doesn’t change. Dentist supply stays constrained and expensive. More than half of graduates are women, and the rising generation wants models built for them: part-time flexibility, lower stress and real support through education and operating systems.
DSOs are also where dentists reach the top of their licensure. Heavy operational support frees doctors to do more of what they went to school for: patient care.
Offices get bigger, with hours built around patient convenience driven by an increase in the de novo model of growth by DSOs.
Invisalign embeds deeper into general practice as technology and acceptance grow, bringing orthodontics to more adults in an effective, convenient form.
Clinical AI becomes the great normalizer. Younger dentists gain diagnostic acumen years ahead of their experience, and every doctor catches disease earlier.
Hygienists take on a bigger role. Expanded scope and AI-supported screening make the hygiene chair the front door for detecting both oral and potential systemic risk, perhaps assisted by PAs.
The subtractions matter just as much. [There will be] less friction with payers on verification, adjudication and payment; fewer JV models in DSOs; fewer startup suppliers as consolidation shrinks the customer base; and less friction in specialty referrals as GPs and specialists adopt continuity-of-care platforms. [We’ll also see] less growth of DSOs through acquisitions.
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