/*Accordion Page Settings*/

166 100% Fertility Patient Retention? A Way To Guarantee IVF Patients Return After A Failed Cycle

Sharing financial risk while guaranteeing 100% fertility patient retention. Is it possible? Griffin talks about one of the biggest points of patient dropout--paying for treatment--with guests, TJ Farnsworth, founder and CEO of Inception, and Cheryl Campbell, Director of Operations at BUNDL Fertility. 

Listen to hear how others:

  • Ensure patients don’t leave the fertility practice for another following a failed IVF cycle. 

  • Increase access to care for patients, while lightening their financial burden and improving patient satisfaction

  • Increase IVF conversion with a step-by-step follow-through process (and how it differentiates from patient retention).

  • Dismantle billing woes that may be hurting your online reputation. (Approximately 25% of negative fertility reviews are based on billing!).


DISCLAIMER: This is a featured sponsor episode with paid sponsor content. Advertisements are not an endorsement from Inside Reproductive Health, nor their personnel.



TJ Farnsworth’s info: 

LinkedIn:vhttps://www.linkedin.com/in/tj-farnsworth/

Company: https://inceptionfertility.com/

Cheryl Campbell’s info: 

LinkedIn: https://www.linkedin.com/in/cheryl-campbell-24a23b58/

Company: https://bundlfertility.com/

Sponsored by: BUNDL: https://bundlfertility.com/


Transcript





Cheryl Campbell  00:00

I think that's what BUNDL does, it does give patients the option to really make a better informed decision. Because you know, when you like myself, I was a fertility patient, I experienced an awful lot of failure and miscarriage. And I think the next thing you think after that devastating feeling is, what is this? What is this going to look like financially in this next component. And when you've got something like BUNDL, it's really giving you that peace of mind and that assurance that you've given yourself that next chance in this, you know, daunting journey,


Griffin Jones  00:35

decreasing patient dropout, that's a good thing to do, because it makes life better for your patients, they have better access to care makes life better for you, because it helps your bottom line and practices are hemorrhaging patients. After a failed cycle. Most people aren't measuring their dropout, it's hard to measure. So we talk about ways that you can decrease your patient drop out rate of 100% patient retention, after a failed IVF cycle, you can increase access to care by scaling the pool of uninsured patients in a way that is localized practice or a single group or a smaller organization can't do improving patient satisfaction, so that they're not hammered with each little nickel and dime Bill $150. Bill here a $300 bill here $225 bill here, which is someone that helps with online reputation, I can tell you, it could be a quarter of negative fertility clinic reviews that are just about that are just about getting unexpected bills, or you can increase IVF conversion. Remember, increasing IVF conversion is not the same as decreasing patient drop out which is retention, you have to retain the patients in order to be able to convert them to treatment in order to bring them back to treatment if further treatment is necessary, when we talk about increasing conversion to IVF for those patients, for whom IVF is necessary with a system that nurtures them, and helps patients along the way. This is all in the conversation that I have with Cheryl Campbell who run BUNDL, which is a product of the inception, Family of Brands. You remember TJ Farnsworth, we've had him on the show before TJ is back on with us today. He's the CEO of inception. And today we talked about these challenges. We talked about how BUNDLfaces them in the marketplace. And this is a sponsored episode, but I look at it like where's the where's the reason not to try you tell me if you've if you've figure one out, but pay attention to these different points and ways that you can incorporate them into your practice. And let me know what you think. Enjoy this episode with TJ Farnsworth and Cheryl Campbell. Today's episode is a feature sponsor episode with paid sponsored content. Mrs. Campbell. Cheryl, welcome to Inside reproductive health. Mr. Farnsworth, TJ, Welcome back to Inside reproductive health.


TJ Farnsworth  03:10

Thank you, Griffin, excited to be back in talking to you. Again,


Griffin Jones  03:13

I'm excited to have both of you on the show. We're talking about something different than you and I talked about last time, TJ, which is not we're talking about I want to talk about financing in the practice, I want to talk about where practices and patients get stuck. And I want to invite Cheryl to speak on some of those points a bit. But I'm curious. From an entrepreneurial standpoint, I see a lot of entrepreneurs in different industries and verticals, acquire or build companies in adjacent verticals that make sense. And so for you, what was it about the financial piece that you thought this is something that's missing in the marketplace? That? Yeah, we want to bring it to others. But we also we just need it for ourselves?


TJ Farnsworth  04:05

Yeah, I think when this was always sort of part of the plan, we were originally mapping out, you know, the inception, and it's in its family of brands and family of companies. It's all goes back to the server part of the original mission when Margaret, my wife and I were talking about starting this business, and our journey and our experience. One of the things that was incredibly troubling to me I know it is for for Sheryl. And and that's really all of us, I think within this industry is the access to care question. And it shouldn't be the patients who don't have appropriate insurance coverage have to be as fortunate as I am, and in order to have the family of their dreams. And so we're constantly thinking about ways in which we can improve access to care and we would love to see universal coverage by insurers that would be That's a dream of ours. I think all of ours. And I think that's ultimately where we want to go but that's gonna be evolutionary, that's not going to happen tomorrow, it's not gonna happen overnight, and we have to have a solution for those patients who do have to come out of pocket for this. And I think, you know, we were trying to think of this is what can we do, that gives patients peace of mind as the it makes the financial leap necessary along with the clinical leap, to move forward with their, their treatments, and it can reduce that and eliminate that barrier to them having the family that they want. And I think, you know, original idea behind BUNDL was, was giving that level of comfort and flexibility with patients that to give give them the ability to kind of say to themselves, okay, I have an option here, yes, this is expensive, but I've got somebody who's willing to share the risk with me with regards to the success of my fertility journey. And if I'm not successful, you know, maybe I can I can absorb, I can stomach that a little bit better, knowing that it didn't actually have the same level of financial burden to me, that it would have had otherwise.


Griffin Jones  06:05

So what was it that was missing in the marketplace? That why were lenders and other financial channels just insufficient? Yeah. So


TJ Farnsworth  06:15

you know, we weren't really trying to solve the problem of being a lender, it's really trying to solve the problem of the risk of maybe being unsuccessful. And so we worked with a number of different lenders in but what none of them were really doing was was thinking about the uniqueness of a fertility journey. And the fact of the matter is a patient who go through two, three cycles of IVF be at the end of their journey emotionally, and at the same time not have the success at the end of that they was out for success being a healthy baby at home, and, and then all of a sudden, now they're faced with the burden of the cost of all of this. And you know, maybe it's finance, maybe there's a monthly payment, maybe they're paying it back every five years or something like that. And every month they make that payment and and they're reminded about the the the lack of success of their journey. And just like, you know, the the, I think, incredibly valuable interview that Jennifer Aniston did recently, you know, not every one of the patients are going to go through this are going to have the outcome that my wife and I were fortunate enough to have. And and I think they're aware of that. And there's more awareness around that. And I think that's oftentimes a barrier to people getting started. And we have enough data, as a you know, as the largest fertility network in North America, we have enough data to know sort of, okay, how can we spread the risk among a larger bit and patient population, share that risk with that patient population, and make this an easier decision for both patients to move forward?


Griffin Jones  07:44

Cheryl, can you talk a little bit about that economic risk that a prospective IVF patient faces and it sounds like I shouldn't have to ask that question on a show where the audience is practice owners and fertility providers. But I, as a lay person, hear constantly, we have 70% 80% success rates, if a woman comes to us 80% chance she's gonna get pregnant. It's like, yeah, Asterix. So can you talk and I think I understand why they're coming from that perspective. They seen the field grow tremendously. They've seen the advances. And after multiple cycles of certain things are true. Yes, the success rates are eons better than they were a few decades ago. But I think when you when you phrase it that way, to a patient, it's like, oh, yeah, like, there's a lot in that aspect. So can you talk a bit about what the financial burden is for the average? IVF? Patient? Right. Are they the risk? I meant to say?


Cheryl Campbell  08:47

Yeah, I mean, the risk is, is big, you know, and I think strategic point is the emotional and physical toll, the fertility journey is one thing, but you know, what we hear from patients all the time is, you know, am I going to be able to afford this? What is what is that going to look like from a, from a financial standpoint? And I think that, you know, at the end of the day, patients want options, right? They want to know, what they're faced with, as far as you know, what does that financial peace look like? And I think that I think that by us, sharing the risk with them, they're being well informed about where they're putting their fertility dollars, you know, there, it's a big lift, I think, to afford to afford the fertility world and I think that they just want options to be able to move forward and just say, right, you know, do I need a loan? Do I need to take a, you know, a look at other avenues of payment? And I think that, you know, it's just, it's just being well informed on that piece. I think that's what BUNDLdoes. It does give patients the option to really make a better informed decision. Because you know, when you like myself, I was a fertility patient. I experienced an awful lot of failure and Miss carriage. And I think the next thing you think after that devastating feeling is, what is this? What is this going to look like financially in this next component. And when you've got something like BUNDL, it's really giving you that peace of mind and that assurance that you've given yourself that next chance in this, you know, daunting journey. So


Griffin Jones  10:17

people might think, well, we have a multi cycle guarantee program, but it's often just a discount after the first cycle. Can you talk a little bit about what makes shared risk different from something like that?


Cheryl Campbell  10:35

Yeah, I think I think of what we're doing with BUNDLin terms of, of a multi cycle shared risk program is that we're really getting the patient to take that, that keep that the stressor off upfront, right, by buying the package up front, by assuring yourself that you you've entered into the multi cycle road, it's not saying okay, well, if you fail one cycle, then we're going to give you this, you know, additional benefit, I think it's knowing that the patient has given them taking that stress off of them, so that they can concentrate on the on the clinical piece and on what they need to to cycle. And I think, with BUNDL, we're trying to just give them that assurance upfront they've purchased and, you know, a multi cycle works differently in terms of you know, rather than just an assurance program, I think, you know, like I said, we're we're sort of looking for that assurance for the patient, that they've capture that upfront and for the practices as well, that they are gaining the retention out of the fact that a patient has, you know, bought those two cycles up front, we've got 100% retention with the patient, that patient is going to stay there to cycle and and to move forward with their journey.


TJ Farnsworth  11:47

Yeah, and I might use add that I think one of the benefits of, of a, of a business like BUNDL and the ability to use the data and share the risk around or under broader patient base allows us to have a more aggressive position when it comes to qualifying patients for the refund program, because we have a larger patient base to to share that risk among Americans. That makes sense.


Griffin Jones  12:13

Tell me more about that, TJ, because I think a lot of people might be hesitant to implement a shared risk or multi cycle guarantee program on their own. For that reason they have, they have a more limited patient population to be working with.


TJ Farnsworth  12:29

So if you let's imagine you're a medium sized practice, and you've you're doing five or 600, retrievals a year, and you are you create your own shared risk guarantee program, your ability to approve patients based upon their own clinical criteria for qualification to that refund program is going to be limited by your patient population, because you've got to spread that risk. You know, you can't it's like an insurance product. Oh, no, we can't it's not an insurance product, or you can't, if you if you are if your patient population is is that are going to enroll in this program is only a handful of patients, your your ability to take the risk on of those refunds becomes much lower than if you have a broader patient population. And you've got the ability to then be more aggressive with what you can do from a refund perspective. Because you're you're having to give a refund or two here and there is not as impactful across a broad network. And then if you're doing it in within an individual captive practice,


Griffin Jones  13:37

talk to me a little bit about how you work with lenders, because it might bear repeating that BUNDL is not a lender. So can we talk a little bit about how you work with lenders? Yeah,


Cheryl Campbell  13:50

the lenders that we work with, you know, we have relationships with to offer patients the best terms and conditions we've worked with the premier lenders in in the fertility space. And, you know, our, our relationship with them is that, again, they they know the space well, there, you know, there's lots of I don't want to say bells and whistles, but a lot of really extensive benefits and brakes that lenders are giving to patients. Some of our lenders have built in kind of communication with nursing staff and and if a patient you know, forgets how to do a trigger shot or how to you know, they've got people on staff to help them so lenders are kind of getting a broader group of benefits to patients when they when they pull lending from them. So they're really kind of it's not just go to the bank, get the money. I think lenders are really feeling the space and figuring that they're trying to meet patients where they are. And so they're they're offering up a bunch of more opportunities for patients to sort of benefit from their lending space. And, you know, we've like I said, we've got great relationship Follow them. And I think that patients are turning to lending a lot, we see an awful lot of lending right now with BUNDL and in they need this kind of warmth as is, you know, not just the straightforward kind of cold lending piece that scares people. We work with patients that are fearful of their of their credit scores, and what can we do to help them and, and what is the lender going to reject me because I have a student loan, you know, just trying to soften that very kind of harsh part of it, right to think I'm going to take out a loan, and look, I'm gonna look like and some of our patients have had never done that. They don't know what that piece looks like. So it's really, the lending piece has gotten so much nicer for patients and the offerings are a lot calmer for patients again, in an already stressful time.


Griffin Jones  15:48

Well, I could see why it would come people down having a guarantee on the other end of it, when you're taking out a lot of money. It's like, okay, I'm taking out a home pay, I'm taking out a mortgage, am I going to be able to get into the house is a lot different than taking out a mortgage and having a guarantee that yes, you're gonna get into the house. And yes, you know, everything that was in the closing contract is being honored that that is a lot different than just having to take out a loan. I think that's that probably is one of the things that might stop people from just borrowing because they don't know. They don't know what the result is going to be on the other end. Can we talk a little bit about I want to dive more into that Cheryl. And I want to talk more about BUNDL’s process and how you work with financial counselors and how you educate patients. I do want to zoom in for a second, TJ on on the global side that I just can't resist thinking about the finance piece. If and when an economic downturn happens, so I don't know when an economic downturn is going to happen. I'm not Ray Dalio. i It sure looks like there's one upon us. But I've also said that before, and but I just see the finance piece as one place where patients get stuck. And not always because they can't afford treatment. Sometimes it's that but sometimes they just can't figure out a way to or it's scary, or they they put it off, and because they just don't see something as immediately accessible. So do you want first Do you think that a recession a downturn is going to be upon us? And then how, how is that going to affect how patients pay for treatment?


TJ Farnsworth  17:34

Yeah, I think the question, obviously, if I had a crystal ball that can say, when the recession was coming, or maybe you've already in one or not, I would I'd be doing I'd be doing something different, I guess. Right. But I think that economic uncertainty, which is certainly happening right now, whether the recession is, is coming or is already upon us, or not, it just inserts another level of uncertainty for patients, it's just one more source of stress, one more source of anxiety. And one more thing that is out of control. Patients who are going through this journey feel very out of control, and, you know, uncertainty about their job, uncertainty about their mortgage, and all kinds of other things, just add that level of uncertainty. And everyone has like a, you know, a maximum amount of ability to take on these things, right? There's only so so much burden that someone can take. And so I think for a lot of patients, they look at this and say, Is this something I want to take on right now? And can I wait skimmers, wait six months, can this wait a year? And those of us know that that's the time is not on the side of these patients? Right? So we're not, you know, when six months make an impact or not? I don't know, it depends on the individual patient. And I'm certainly not clinicians, I wouldn't opine on that. But certainly waiting a year or two or whatever it might be interesting. For interest in terms of people feeling like that uncertainty is behind them, no idea how long that takes. Can it can be very impactful. And so what I do, I do think BUNDL does is it gives patients the ability to take some of that financial risk and put it away. And I also think taking some of the just general concern about thinking about the financial component. off the table will be one of the things that when we were going through this was it felt like every time we turned around, there was another charge for something, there was another fee for something. And I think one of the advantages the BUNDL has is you know, you I pay for my two cycles or my three cycles, and I don't have to worry about this anymore. It's paced done. And I can just focus on what I need to get through this treatment emotionally to get to the family that I want. And I think in an economic recessionary situation, that's that's impactful. And I think, you know, we've all seen the data or on the long run around the the impacts that stress can have on patients as they're going through their for till the journey. And I just think that you know, and the economic uncertainty that we're heading into just continues to add to that, and I think just highlights the positive impacts that BUNDL can have on our fertility practice and our patients.


Griffin Jones  20:14

It relieves some of that uncertainty. And you talked about that not having additional costs. Does that mean that these costs for XC anestesia? The all of these costs? Are those are calculated in in the beginning?


TJ Farnsworth  20:29

Yeah, when a patient purchases their BUNDL? All the fees associated with the clinic are calculated as part of the part of their package.


Griffin Jones  20:37

Cheryl, can you talk to me about how that calculation works? Is it is it fair? Is it does it differ from clinic to clinic? And how does how does one's BUNDL calculated


Cheryl Campbell  20:48

it does vary from clinic to clinic, we kind of start with the practice offerings. And we try to mirror that with your BUNDL packages. So if that would include, you know, anaesthesia, Ixy, assisted hatching, whatever is included in their global, we're going to include that in the BUNDL package so that the patient knows right out of the gate, that we're, they're getting, you know, apples to apples in terms of what their clinic would offer. So it makes them understand that we're just taking all of those pieces and parts and bundling them together to make it easier. So that, you know, to TJs point you're, you're not sort of feeling like you're nickeled and dimed all the way through the process, it's really pulling it all together, and including what's included at the practice level. And again, it does vary practice to practice, but we make those those practice offerings mirror, what the practice is doing.


Griffin Jones  21:44

As somebody that's been on the other side of that who's been responsible for clinics, online reputation management, that's a huge thing I probably a quarter of complaints have some are something in the vein of we just paid this big amount of money, and then we got a $275 Ultrasound bill or whatever it is. It's you know, it was some other it was an additional console, there was some other testing that was required. And, and often it is just a couple 100 bucks, it's usually not the bigger bills, but it's after you have paid some bigger bills and you get one of those in the mail. It's like you're you are not happy. So BUNDL helps to solve for the for for that piece of it, then how do how are people on boarded? Surely, if when a clinic starts with, you know, I want to come back to that. But first, I want to talk a little bit about how BUNDL relieves the economic burden for for patients. So let's let's just say I'm patient that's enrolled in BUNDL, what happens if I do go through three cycles. So and I don't have success, what happens? It depends


Cheryl Campbell  23:03

on the program that you're in, we've got kind of different flavors of BUNDL, so to speak, in our basic program, unfortunately, if you were to go through three cycles, and you didn't have a take home baby, then that would be an unsuccessful program, some of our patients will move into another program, they will sign up with fundal. Again, some of our patients know at that point that they may or may need to pivot into a donor situation or an adoption situation and go down a completely differently, but those three cycles have told them a lot and taught them a lot. And if you're in our refund guarantee program that at the end of all that the benefit is that you're going to get 100% of your money back. So it kind of depends on where you are within BUNDL. So you know, we're just trying to again, whatever program you're in, what we're trying to do is really alleviate that stressful financial piece. And I've had patients even at the end without success, say, you know, at least you gave me some peace of mind, you gave me an ability to really go through this exhaust what I needed to in terms of this and now I need to move into a different Lane within my fertility world, or I may just be done and and be at peace with that, you know, but that's kind of what Bundjalung is hoping to do is we're meeting patients where they are in their journey.


TJ Farnsworth  24:28

Yeah, and those patients that are gonna go through a three cycle program that are not using a refund guarantee. At the end of it, if they use all those services, they would have paid a discount over off the list price for those services. But for those who are patients who do qualify for the refund program, and as I mentioned earlier, more patients can qualify for our refund program than any individual single practice could even patients that you know will be considered on the older end of the spectrum. You know, one of the things that's unique about bond Will it get all the way to the end, and they've exhausted everything, they've all exhausted every FET that they can, and they're, they're done with embryos and no more embryos left. And if they are unfortunately unsuccessful, and there certainly are going to be those patients, they get 100% of their money back, well, we'll take that risk on completely. So it's not like they get a prorated amount back based upon how much of the services they utilized, or anything like that, it's you paid, you know, whatever that dollar number is, you get that dollar number in full and in refund,


Griffin Jones  25:31

I see the need for having this large pool across geographies, because I can think of some earlier clients of mine that were really lovely people that would offer discounts to people after the fact but it was too few for for probably also too little, even when they were they may have you know, thrown in a free cycle here or there. But if that was the case, and it was definitely too few people that they were able to reach and and if it was a discount, then it was likely not enough of a discount because they just couldn't spread the risk over an enough places. So you brought this in to be able to scale to practices, how many cycles have you done thus far with BUNDL, Cheryl,


Cheryl Campbell  26:22

we have upwards of 750 people enrolled in BUNDL at the moment. So that's across a network of I believe are at about 13 practices. So you know, we're only two years old going into our third year and we're you know, we're we're seeing a great some great traction on BUNDL really across all of our avenues, uh, you know, trying to pull the levers on all of our, with our website, with our social with our, you know, fertility groups, we're sort of touching as many people as we can to really get the word out. And of course, our clinics are phenomenal with their, you know, mentioning BUNDL and making sure that everyone that really needs to hear about BUNDL does,


Griffin Jones  27:09

and you're starting to work with more clinics. So it is am I correct and understand that there's no fee to clinics for for working with BUNDL, can you talk about how you work that out with clinics,


Cheryl Campbell  27:23

with there is no fee. But we do have a, you know, an agreement with our practices where we will pay at 80% for each of the services. So, you know, as services are performed, that's really the part that, you know, BUNDL is taking to be able to continue with the program to be able to spread this program out and reach as many people as we can. And you know, it's to, to pay for, you know, the 20% is really for us to be able to, you know, do the administrative side of things, the marketing efforts within BUNDL, but there is no upfront fee. I know some competitors out there in the space will, you know, charge that but there was no upfront fee for a clinic.


TJ Farnsworth  28:09

And while the clinics are receiving a discounted fee from us for the services, we are discounting them the fee to the patient, so the patient is paying a discounted fee as well. So it's it's a the onboarding of things, the patient, you're getting the clinic on the onboarding of that patient, onboarding, the club, the clinic on the BUNDL, all the work that goes into doing the evaluation of their packages, and matching up the BUNDL to that practice. There's no onboarding cost to the, to the practice. And, you know, they get to them see the benefits of the stickiness of patients to their practice, as well as I think we're seeing more and more patients come directly to BUNDL and then BUNDL directing those patients to our BUNDL affiliate practices. And I do think, you know, Griffin, as you're talking earlier about, you know, the economic situation, I think more and more patients, as they get ready to start their fertility journey, are trying to answer the financial question before they even go out and find the clinic. And, and you know, they by doing that they're looking at companies like BUNDL. And in, you know, north of 50% of BUNDL patients actually come directly to BUNDL before they ever even come to a clinic.


Griffin Jones  29:23

Yeah, I want to talk about that, too. We see that all that we see IVF cost as a one of the top searches. But what's interesting is when you look at a clinic's website, if you look at their conversions in Google Analytics, IVF cost doesn't really convert the cost page isn't really leading to conversions. And if you look at their Google ads, for example, we often use IVF cost as a negative keyword because people are clicking on it. They're searching for IVF costs, but it's not actually it's not actually leading to a conversion. There's still a ring in the funnel that they want to solve. For more, and I suspect that that ring is growing in number of people where maybe 20 years ago, you would have just had someone call and say sure that I'll figure everything out once I get there, we even need to train call centers in the house to be able to answer that question. But people are really looking for, they're looking for a solution more than just prices, like they'll call and they'll get prices, but it then they're just kind of shopping. And they're back to square one of thinking about how they're going to pay for this to begin with. So I want to talk about how you use that as being able to bring new patients to clinics. But Shall we first talk about how when, like when a patient does start with BUNDL with without having a good clinic, how do you onboard the patient,


Cheryl Campbell  30:53

the patient generally is coming into, you know, through one of our lead generators, whether it's our clinics, or offer with page calling on the phone, and what they immediately will do is flow into our Salesforce world, we've built a customized system where all of our lead generation flows into the, you know, a sales funnel sense into the top of the funnel and into our Salesforce world. And we've constructed that world as a way to be able to put patients into certain cadences and then follow up as needed. So you know, a patient may come into our world as new patient or estimate. And then we'll do a series of follow ups, whether it's phone calls, or emails, or even texting, to be able to follow that patient through the sales funnel, and their journey, right straight through to payment enrollment, and then post enrollment, follow up questions. So that person will continue to resign the funnel, from the time that you're touched at the top of the funnel all the way through. And you know, it's our patient advocates on the phone, instructing patients about the program, that's our financial team, accepting payment and working with our practices to authorize services. And then it's just general post enrollment question patients calling to ask us about what happens if this stuff happens. And, you know, I just fell in the cycle. And what does that mean, and this process, this system in Salesforce allows us to really track and make notes on patients all the way through, so that they know that they're never without us, that we're a part of their team, their entire journey, that we partner with their practice, to help them through this entire fertility world and, and beyond. So that's, that's really benefited us. Because patients really automatically feel there's always a way for them to be in touch with BUNDL. And we always know as a team, we can share that information across our Salesforce platform. And we know where that patient is.


Griffin Jones  32:52

I want to talk about this more, because I think it is huge. And I think it's an area that clinics would love to be able to replicate for themselves in their own workflow. But it's very hard to do. And it sounds like you're doing at least some of that for clinics. And so I want to talk a little bit more about that. I do know one thing that always makes our clients freak out, or it makes the listeners freak out is that they always they very often think that if I work with this type of group that I might lose my patient with some other clinic that they work with. Are these are these transferable agreements. No BUNDL is


Cheryl Campbell  33:35

not transferable. So when you're signing the contract with BUNDL, you're doing your services at that practice. And that's, you know, an agreement that the patient realizes upfront. And, you know, we're we're going to maintain and promise that retention for that practice that that patient will cycle at that practice. So it's not transferable.


Griffin Jones  33:57

I could just hear a collective sigh of relief for those that are think, oh, this sounds pretty good. But I don't, I don't want them taking my patients and sending them somewhere else. And doesn't work like that. So if anything, you may have patients in an area where you're not working with a practice yet, but you're you work with a lot of practices. You're in a lot of places in the country, but you're not everywhere yet. And so what happens, Cheryl, if Are there examples where you have people that are coming to you, they're qualified, and they're in markets, that there isn't a partner provider yet?


Cheryl Campbell  34:40

Sure. And that's, you know, that's our marching order moving forward, right is that BUNDL has always been designed to sort of be at every practice we can possibly get into. And I think that you know, now that we're growing and we're seeing, again, entering into our third year, we want to be wherever we can be and we talk to patients, all the time when I always talk about my team is it's frustrating when we can't be in a market where we hear a patient saying, you know, I'm, I'm in Utah, I'm in the Nevada area, or I mean, you know, Southern California, we've got Northern California, but you know, when you're gonna have a presence in Southern California, so we are on a sort of trek at this point to be to increase our footprint across the country, and to really try to get fondle in as many markets as we can. And, you know, what we say to patients is, you know, be patient, we'll try to be there, but we try to sort of also guide them towards clinics where you'd be surprised patients will travel, you know, patients will make those plans that they need to be in a clinic that we might have a presence in, but we are really full press, you know, moving ahead and trying to get on them on as many clinics as we can, because we know that it would benefit so many patients. And we also use that as an option to make calls on on new clinics, when we know of a patient that is in an area that's really expressed an interest in BUNDL. It's a part of our in our national sales team, we use that as a means of saying, Hey, listen, you know, we've heard with patient your area. And we'd really like it, if you can, we can talk to you about BUNDL, because we've got patients that are interested in multi cycle and we're on the phone to them all day. So it's kind of working in an in it's advantageous in that way, too.


TJ Farnsworth  36:23

When I was going to add, I think you'll Griffin one of the things that you know, that I'm super passionate about was patient experience. And it's not a great patient experience for for patients in San Diego to call Cheryl and her team and say, hey, I'm interested in doing a BUNDL. And we say, great, you can but you've got to fly to Northern California to do it. So I think you know, for us understanding that, you know, we're trying to make sure that those patients who come directly to which we're seeing more and more than do so have choice when it comes to clinics and have something that's you know, geographically convenient to them?


Griffin Jones  36:57

Yeah, well, if you're in any of those areas, maybe you should definitely give BUNDL a call. Because sounds like there's already people in those areas that are IVF ready and ready to go. And doesn't sound like there's risk to the people that could try that out. So if you're in Southern California, Nevada, Utah, those are a couple places and then some other places in the country as well. It would make sense to reach out and see if there are already patients in your area that are ready to go because the these are folks that have thought about how they're going to pay for for this, they've committed to it, they've been qualified. And I constantly have people ask us, How do we get more IVF ready patients? And I often think I'm often annoyed by the question because I don't think they're doing enough to nurture, have a funnel, etc. Here's a way guys say, here's a way it's right in front of you, is there any type of minimum from the clinic that if we do, we're committing to do X BUNDL cycles in a year.


TJ Farnsworth  38:05

Now, if somebody can sign up with us and and use it once a year, you know, you just really never know what you want as you want choice and options for patients. If we if we require some type of a minimum it might require it might cause the patient caused that clinic to change their behaviors in terms of why they steered patients. We don't want them steering patients to BUNDL we want BUNDL to be a choice that helps them with their conversion. It helps them get patients who are on the fence about whether or not that they should move forward with their journey to move forward. And for them to be an option for us to learn to keep patients within their practice. And we don't want them creating sort of perverse incentives by having some type of a minimum with us.


Griffin Jones  38:44

I want to do a little bit of math for people listening because you there's there's no risk to do I like things where there's no risk to try something out. And there's there's only a little bit of upside at the very least. But if you take an average IVF conversion rate of 50%. Let's just take nationwide, some people are much lower than that, if they're in a non mandated, non mandated did state, if they're an area where there isn't a lot of employer coverage. Some people are higher that if they're in an area where there is a mandate, and there's a lot of employers with coverage, but let's just take an average of 50% of those that aren't moving on to IVF that need it. About half of them are for some kind of financial reasons, but only about half of them are because they really can't afford it maybe quarter to a half of them. So we're probably talking about at least 10% of patients that are just dropping off because they just don't have a solution right in front of them. This is a way to offer them a solution. And it is in such a way that the clinic can do it and just they can just test out what works I can say, Oh, you have patients in Southern California? Great, but let's do twos. Let's let's do two BUNDL cycles with, there are two packages a BUNDL with with these folks. And it's a way to be able to start it at a really low risk from, from my view, what am I missing? Like? Like, I feel like I'm the one. That's like, Yeah, let's do it. So, you guys be the skeptics? Like, am I missing something?


TJ Farnsworth  40:31

No, I think you're not. I think I think that the, you know, the risk to the to the practice is, is that they do the upfront work with us to onboard themselves with BUNDL, and then other patients end up actually engaging with BUNDL. And, and look, we're actually going to make referrals to practices sometimes that come through BUNDL that don't end up using BUNDL, they end up you just buying a cycle from the individual practice. And so that's, that's okay, we know, that's part of the cost of doing business. For us, it's, it's fine. I do think that one of the one of the major benefits, the practices beyond the conversion rate, which you do a great job of pointing out, is something that I think very few practices don't fully appreciate. And that's what I'll call, you know, their bounce rate, right? How many times when someone in their practice, do an IVF cycle, fail, and then go to their clinic across the street, because, you know, their cousin's friend, it was successful there. And the rally is what we all know the patient doesn't quite understand is that that's not a good thing for them. Number one is not great for the practice in the in the retaining patients, but also, the right thing for the patient is for them to stay with that practice. Because the practice can make adjustments to the cycle can, the clinicians can make adjustments to the treatment plan that can increase your chances of success versus another practice starting from scratch again, which may or may have an impact to the patient's chances of success. And so I think it's better for the patient to stay with the practice, it's obviously better if the practice was patients to stay, as you know, probably Griffin, as well as ideal when you talk to practices. Most of them think that's not a problem for them, they don't have patients leave them. We all know that's not true. And it's not necessarily because the practice is bad. It's just because, you know, not everyone's gonna get pregnant on that first cycle, right? That's just not, that's just not how the world works. Unfortunately, sometimes it's going to take two and sometimes it's going to take three. And so being able to retain those patients, I think, you know, customer acquisition costs, all the things you've driven, that you've forgotten more about than I'll ever know, I think are really, things I think these practices, you're better off retaining the patients that you already have, rather than have to go out and get more.


Griffin Jones  42:38

That's a really good point. So a lot of people don't even drop measure dropout, they don't know how to measure it. And they are losing lots of patients after their first cycle virtually every clinic has. So first is if they are thinking, Oh, we don't lose patient, they know that if they were to measure it, they would say it because anytime that it is measured, it's revealed. And the second thing is they might think, well, but we will do such a good job of caring for them that even if we have a failed cycle that they'll come back to us as opposed to going to somebody else. And I think people are just under estimating what it can feel like to be in that position. And it's not, it doesn't even have to be because a clinic let you down because they didn't have a great experience with the care team. They may have. But when you're when you're in a position like that, and you're just like, I'm not going to cuss on the podcast. But we're we have to do this again. It's been so long we then it's just like, Well, why don't we just try this place? Why don't we just try this other place? Why don't we just switch it up? It's because there when when you're desperate, you have to consider other options. What are the best ones or not they come to mind. And sometimes just choosing another option is what gives people that peace of mind. But Joe, you use the words you have 100% retention rate with BUNDL. So how does that work? Who reaches out to who after of a failed cycle? If someone is in BUNDL,


Cheryl Campbell  44:16

if they're in BUNDL, and they and they have a failed site, you know, though patients will contact us and say, you know, I failed my cycle. What does this mean? And we always are saying, well, you You ensured yourself that next cycle, you're fine. You're moving on to cycle again. And you're guaranteed if you know they think that there's some sort of do I have to pull the lever? Do I have to do something? No, you've done the right thing by coming in. It's exactly why BUNDL there because unfortunately, there is sometimes failed staples. And I think now that patients know they've set themselves up for that next round and they're ready to go and there's nothing that needs to happen except that they keep moving forward with treatment. They've learned lat from their first cycle, their physician has more information about how to achieve success next time around, patients will often just call and tell us that you know what my doctor said they're going to change up my protocol. And I'm going to do something different this time around. And but they know that they've already gave given themselves that ability to move into treatment, they don't have to think about, I failed that cycle, I took out a loan for that cycle. And now I can't get another loan, and I need another cycle. It's all these things that start running through their head, they don't need to worry about it, because they've guaranteed themselves upfront that they can just comfortably move in to their next phase. And we hear from patients all the time, but just want to let us know that and just say, Okay, I'm ready for that next cycle. And I'm ready to go. My doctor said this. And so it's, it takes that piece of work to go look for another practice. Do I have to, you know, should I start looking again, should I just I dig deep again, for for more finances, you know, its BUNDLis securing against reason, really why BUNDLworks so well for patients is that moment of oh, gosh, what do I do now? That goes away, and they can regroup and say, Okay, I've guaranteed myself this next phase, in my journey, and it's all set up for me and on the BUNDL, and we say, yep, that's exactly what you can do. And you move forward. And don't worry about that stress that you you know, it's hard enough to hear you feel that cycle, but to be thinking, you know, who authorizes the next thing and who pays for it, we've got it, we've got it a BUNDL, and we're taking care of it so that the patient can just focus on the next clinical piece, which is hard enough. You know,


Griffin Jones  46:36

we talked about how hard reporting can be. And so maybe you don't all have this yet. But do you have any reporting yet to compare, when a second cycle starts from for a BUNDL patient versus when a second cycle starts, for a non BUNDL patient,


Cheryl Campbell  46:57

you know, it varies patients often will move quickly from one cycle to the next. Largely because there's, you know, this Hurry up aspect to fertility, right, you're anxious to sort of whether it's, you know, you've got a diagnosis of a diminished ovarian reserve, you're older, you missed two years, because of COVID, whatever the case may be, you may be wanting to move very quickly. And a lot of our patients do, they'll fail a cycle, they'll regroup their doctors will change their protocols, and they're ready to move on to that cycle the next month. It's doable, it's hard. It's a heavy lift. But patients want to do that. And that's also the beauty and the flexibility of our program that allows them to do that.


Griffin Jones  47:39

And people don't have to go back through the financial counselor, as you said. So I'd love to wrap up with Cheryl, because I wanted to talk a little bit about the area where there is a lot of drop off. And that is just a lack of follow up from financial counselors from the clinic, because they just don't have that infrastructure. So I'd love to get your take on that show TJ, I know that you have to go, I just want to conclude about what you see as as the biggest change that could be coming from the payer field from the from the financial side, for patients as they pay for treatment.


TJ Farnsworth  48:20

I mean, from my perspective, I think the good thing for patients is we are seeing an evolution towards more universal coverage, which I think is great. I don't think that'll be revolutionary. I don't think that tomorrow, we'll all sudden wake up and we'll be all dealing with 100% covered services. I think this is going to be evolving as more and more employers adopt this type of services and see it as an essential service that we all know that it is. So I think that we are going to continue to see patients that are faced with large out of pocket expenses associated with these services. And that's where I think BUNDL can really provide a bit of it to financial peace of mind and simplicity of that process.


Griffin Jones  49:00

I'd love it. It's always good having you on and I like your like your takes on some things. football teams not so much. This I do. Sure you talked a bit about how your team works with patients and you have a sequence of a CRM and you talked about it a little bit and steps. But can you tell us more because this is an area where I've always pointed to as a bit of a black hole we we help people we've helped people have content on their website and make videos and put them in different parts of the welcome sequence so that people are ready to talk to the financial counselor so that they're not a deer in headlights. But then when it's come to the follow up we have just sort of said he should have a follow up sequence in place. But we have never built that out for someone that's where it kind of touches operations more than has been our field. And so you you have done that and Can you talk a bit about how BUNDL built that out because I think it is very relevant for any financial counselor that might be listening or any practice owner that wants their financial counselors to be able to retain more people to treatment.


Cheryl Campbell  50:17

I think Griffin It was born out of kind of how we felt the rhythm that we felt with patients, you know, fertility patients are facing so many things, right. They're talking to a lot of people, they're talking to doctors, they're signing consents, they're talking to pharmacies and meds piece and, and so you know, we don't want to flood or overflow the patient with so much follow up. So I think the system that we tried to come up with was really sort of a soft touch, so to speak, is it kind of a, you know, a natural rhythm to how we feel the patient is where they are in their in their journey. So if you're coming to us, sort of knowing nothing about the fertility world, and they need that kind of initial first conversation, you know, we feel like the phone call was always the best. And then beyond that, we think that, you know, we build a system where we're able to say this patient really knows, and it's flexible for us to say this patient seems to know a lot about what they want, they're actually ready to move into contracts. So we're going to our system allows us to kind of fast forward them into the contract mode, then to payment then to, to enrollment. So it doesn't lock us into having to do a string of the follow ups that don't make any sense for this patient. It's allowing us to be flexible, listening really to where they are in their journey, listening to the mile markers that they've got, I've got a follow up with my doctor on Monday, you know, please send me an estimate now, but I don't know where my start date is going to be. And even know if I'm going to need IVF in the next month or two months, being you know, that makes us kind of say, All right, you know, what, I'm not going to inundate this patient with a bunch of our system allows us to sort of tag that person up two months follow up, and it should be a phone call. And it's really just listening to every patient and understanding that everybody's journey is different, and what they're coming to us at all different parts in that journey, some that have already failed four cycles, some that you know, are exhausting their fertility dollars, I want to speak more about BUNDL, but move quickly some that have already started and need to really fast forward through the entire process, we need to get them to contract to payments. So it really that's kind of what our cadences and our women's with our with our system were born out of is really just knowing that the fertility patient comes to us at all different parts in their journey, and we don't want to be a call center or or, uh, you know, we're not selling discount tires, you know, we're not, we're not doing the the regular follow ups that you would see sort of in a retail mode, we're trying to really kind of understand what that patient is and tailor our systems to that. Because there's nothing worse than when a patient says to us, oh, gosh, that would be too much, or why are you? You know, I don't want too many follow up. We hear that. And we want to make sure that we understand that.


Griffin Jones  53:14

Well, I could see you also being really good at that too. Because when follow ups are done correctly, it's more of a of a service toss. It's more like a concierge service, as opposed to, Hey, are you ready to do it's it shouldn't be like that it should be the patient feeling cared for. I see you having a natural knack for that as the rest of your team like you.


Cheryl Campbell  53:43

They are very much they are all like I said, we all come some of us come from a fertility journey ourselves. But there just is that level of compassion, I think that we're all a team that kind of understands that. Yeah, there has to be a level of of empathy and compassion in in where we are because you don't know who's on the other end of the phone, you don't know what that story is going to be. And so you have to be poised and ready for what that might mean. So we're sort of park counselor apart friend, Park, fellow warrior, or however you want to put it, you know, that's, that's what our team is. And that's what we tried to devise with our processes.


Griffin Jones  54:25

And you know that about each patient because you're recording it in a CRM because you have people whose job is to know that and record that about prospective patients. It's so hard for financial counselors at a practice to be able to, to maintain a CRM like that's the reason why most don't and they are losing people because they might have some to dues. They might even have a project management software that has their tasks of oh, I follow up with this person, but then it's really just, you know, it's like one follow up and If there's nothing to nurture the patient with, after that they don't have any automation like that. And then they don't have good records to say, Oh, I talked to this person on this day about this. And you all have that, how much do you do for for clinics? So if if we're a clinic, and we're like, I just don't know about, if this patient's going to be able to afford treatment, or I, I'm just worried that they might, I can tell they're worried. And so I'm going to send them on to BUNDL because I think that's a good option. We're going to try a BUNDL here. So what are you able to do for the financial counselors? After that? What do you take off the clinics plate,


Cheryl Campbell  55:47

I think what we're doing is we're really basically taking it from that point on, I think the patient has probably gotten a very good understanding of what the practice is like, you probably know a physician or have been to a physician there, they probably had a maybe a bit of counseling, on the single cycle cost or the actual cost when they cut over to BUNDL, we're basically going to take them through the entire our entire process of who we are, but also just kind of lend some hand in. If this happens, that happens, we're kind of helping them understand, sometimes understanding IVF in general, a lot of my team, like I said, we're X patients, but we're also some of my team has actually worked on the clinical side, they've worked in the financial piece. So we're able to kind of advise, essentially, with whatever the patient wants to know. So we're another source of information for the patient or another source of comfort for them. We're an overflow as such as a financial counseling unit that works in conjunction with the with the practices that we're partnering with. And I think we also can, if they become bungle patients, we're there for them whenever they need us. So we're going to be the one that they talk to, we're going to be the one that they come to. And that does alleviate that at the at the clinic side. So we always sort of say that we're kind of helping to be an extension on that financial counseling piece. And, and we hope that that's part of the service that that we're given, when we're in partnership with a practice,


Griffin Jones  57:17

show, you've given us so much to think about with regard to how we help to move patients through the treatment journey, how we help to assure them how we help to expand access to care, and TJ gave us a lot to think about with certainty with the need in the marketplace for this kind of scale. So it can provide a nationwide scale that a single practice just can't do. How would you like to conclude? And I might steer the question, but I could just tell that you're really passionate about that. Even when we were prepping for this interview, it was it's not something that you did because your boss has asked you to do it, I could see the passion coming out of you. Why are you so passionate about this, and maybe we conclude with that thought, you know,


Cheryl Campbell  58:09

I just feel so strongly about options through for what we call our you know, our fertility warriors, when, when people are faced with fertility journey, it's not a club or a group you thought you'd ever be a part out, right? I myself with my own story, I just never thought I would be faced with, you know, that wasn't the plan. The plan is not to, you know, to physically and emotionally be put through the fertility process. But I think what we're trying to do is with BUNDL, and we're so passionate about it, because we believe it is such a really positive program that can help patients and I think we're just trying to, to sort of shine light and make it a lighter feeling for patients. It's daunting, it's hard. But if we can make one patient really say to us, gosh, she just made it that much easier. You just took that stress off of me. I just want to thank you so much. And that just means everything. And again, being a patient I just I an X patient, I just feel such passion for it and people struggling everyday with this journey. We just want to make it a little bit easier. And you know, a little bit lighter for them.


Griffin Jones  59:23

So Campbell, thank you very much for coming on and said reproductive health.


Cheryl Campbell  59:27

Thank you for giving up giving us the opportunity to talk about it. Really appreciate it.


59:33

You've been listening to the inside reproductive health podcast with Griffin Jones. If you're ready to take action to make sure that your practice thrives beyond the revolutionary changes that are happening in our field and in society. Visit fertility bridge.com To begin the first piece of the fertility marketing system, the goal and competitive diagnostic. Thank you for listening to inside reproductive health