Don't Lose New Fertility Patients Before the First Visit: 9 Steps of IVF Center Lead Conversion

By Griffin Jones and Stephanie Linder

“Marketing throws the ball, but the practice has to catch it,”--Rita Gruber.

Digital marketing and physician referrals lead prospective fertility patients to contact you. Then what?

They move into the second phase of the Fertility Patient Marketing Journey, Leads (New Patient Inquiries) to Initial Consult. And just because prospective patients have submitted a web form or called the clinic, doesn’t mean they actually book. Let’s look at how to fix that.

You may use the term new patient inquiry instead of lead. They are the same thing. A lead is any phone call, web form, fax or chat requesting a new appointment or seeking information prior to scheduling. 

The way in which your staff responds to the first prospective patient interaction, determines the conversion to initial consultation.  If you don’t have the right processes and properly trained people, you lose new patients before they even schedule. 

And the point isn’t just to get them in the door, either.

Positive and negative patient experiences start at the first point of contact - often a phone call or the response to a web form/chat.  Expectations and rapport are built and broken from the very beginning. 

Fertility Bridge estimates that as many as 20% of negative fertility center reviews come from people who haven't yet had a consult. Patient dissatisfaction is often a result of unmet expectations that weren’t set early in the process.

MEASURING CONVERSION % FROM FERTILITY PATIENT INQUIRY TO INITIAL CONSULTATION

Two key performance indicators (KPI) measure how well your fertility center converts leads.

1)  Total # New Patient Appointment

2). Lead conversion % 

Lead Conversion % = New Patient Appointment / Total Leads 

One individual must be accountable for these KPIs.

The Lead Conversion System 

At least 50% of your leads should be converted to appointments.  If it’s less than 50%, you must analyze and revise your system immediately.  This is the system to increase that percentage. 

1. Dedicate a new patient line

2. Have a specialized new patient scheduling team

3. Unify scheduling across offices and providers

4. Answer the Phone

5. Offer the appointment 

6. Book shortest wait list 

7. Respond to voicemails and web forms within specified time 

8. Record Lead Interaction

9. Clearly identify next steps 

1) Dedicate New Patient Line and Form

Current fertility patients and prospective fertility patients have different needs. Having a phone line and an online request appointment form that separates new patient inquiries from current patient call backs allows your staff to better manage both patient types. 

2) Specialized New Patient Scheduling Team

Multi-tasking is detrimental to both lead conversion and patient satisfaction. It can cause frustration when a front desk person has to schedule a new patient call, fetch a medical record, and check in a consult simultaneously.

A dedicated role or team also decreases voicemails, unanswered phone calls and hangups. It reduces the time required for your staff to play phone tag and increases new appointments booked.

3) Unify Scheduling across offices and providers

When prospective patients have to be transferred from (or worse, hang up and call) one office to another, they often do call…another fertility center.  Your new patient call center is responsible for booking every office equally based on availability without preference to an assigned office or doctor.   

4) Answer The Phone

Missed calls are a great source of new patient appointments...for another fertility center. They are also as good for your patient’s experience as your cable company’s phone tree is for you.  Make a plan to hire the adequate number of staff and use data to ensure coverage during the busiest days/hours. 

5) Offer the appointment 

When prospective patients call with questions, most staff members answer the question at face value and go no further.  In order to increase conversion, mandate your staff “ask for the appointment” at least once with every prospective patient, regardless of the question being asked. Consistently offering and asking for the appointment makes an immediate impact on your KPIs, costs $0, and is a process that can be implemented today.  

6) Book Shortest Waitlist 

The longer the wait, the higher the risk of lost appointments, cancellations, and no-shows.

In a multi-physician group, when your waitlist is longer than 4 weeks it is the role of the call center to suggest a doctor with a shorter waitlist. 

Your call center won’t offer earlier slots with a different physician than requested without your blessing. Some docs cringe at this idea. Make sure your staff knows it’s OK and that the most important part is that the patient stay in your clinic ecosystem.  Do you want to be a single provider or do you want to be a practice owner? 

7) Respond to all voicemails and digital inquiries

Avoid being nailed by a negative review that comes from people who’ve never even seen you for a consultation.  Set specific expectations of call back time on your online contact forms’ thank you pages and voicemail. The sooner you respond the better, but you must be able to exceed the expectation. It’s far better for their perception of you to say “you will hear back from us in 72 hours” and get back to them in 48 than to say “you will hear back from us in 24 hours” and get back to them in 36.

You should always follow up more than once, but the cadence of lead nurturing is a topic for another article.

8) Record Lead Interaction

Document your interactions in a customer relationship management software (CRM). Using this data will help you identify drop off, automate follow up, and nurture prospective patients with helpful information.

9) Clearly Identify Next Steps

Before ending the interaction, your new patient team should set three clear expectations about what happens between now and the appointment:

• Welcome Sequence Correspondence

• Medical records and patient portal

• Appt time, correct patient info and acknowledgment of next steps 

CONVERT MORE INQUIRIES TO NEW PATIENTS

We’ve given you an actionable process for converting new fertility patient inquiries to new consultations, but we didn’t talk much about what your team needs to deliver concierge service. How your team responds to these patients is likely even more important than when they do it. 

If you would like Fertility Bridge’s help in improving your fertility center’s lead to new appointment percentage, or how to implement the steps listed above - book a Goal and Competitive Diagnostic meeting below. 

Fertility Company Profile: The New Marketplace for IVF Patient Acquisition

By Griffin Jones

Consolidation.

If you had to reduce the water-cooler talk of our field to one topic, it would be exactly this: the consolidation of IVF centers, fertility pharmacies, brokers, genetics companies and others, purchased with private equity money.

I wrote about these players, and the collective unease about them, in 2018. I have talked about it on the IRH podcast with guests such as doctors John Storment and David Sable. I hear the apprehensions and I share some of them.

Are we capable of betraying our patients’ best interest because of obligations to financial stakeholders?

That’s a very sound concern for the delivery of fertility care. Furthermore, it’s very likely that there are examples wherein this concern is justified.

I own Fertility Bridge outright, 100%. I often make decisions based on what I want for the relationships of our clients and employees. If I had to answer to many different shareholders, we would likely do things very differently.

Conversely, I also see examples where this pressure disrupts the status quo and forces innovation and efficiency when we have to compete to earn patients’ selection. Sometimes, the independent centers with the least competition are the least likely to invest in patient experience and team culture.

Either way, I do not see the consolidation of REI practice groups as the single greatest disruption coming to the field. Not by a long shot. In 2018, I also wrote that technological revolution dwarfs any disruption caused by the sale of IVF practice ownership to private equity.

While others are looking to Wall Street, I have my eye on Silicon Valley.

Consider it this way:

The independent REI practice is the local, 100 room hotel.

They’re worried about the Marriott building a 1,200 room, mid-rise on the waterfront.

I’m worried about AirBnB.

One view looks at larger and more dominant competitors in the same marketplace. I’m looking at a whole new marketplace.

The model for the delivery of healthcare, including fertility care, has become too estranged from the conveniences that patients are used to when researching, considering, receiving, purchasing, and evaluating goods and services as consumers.

Our patients under age 30 have conceivably never called by phone to invite a friend over, break up with a significant other, or even order food. Yet, for virtually every fertility center, there is ultimately no other way to schedule a new patient visit.

Please take my next admonition as commentary on the mechanics of patient relations and not on providers’ devotion to service; I know the depth and sincerity of so many practitioners’ vocations.

We’ve been too slow to adapt and have grown out of touch with our patient demographic. For some, it’s already too late.

I don’t envision large fertility groups or boutique REI practices going away, but another class is emerging to capture the middle, the entry, and everything around.

There is a wide opening to provide the user experience of patient acquisition and patient retention that the current demographic demands. With the right application, and/or scaled acquisition strategy, one or two platforms can become the gateway through which patients enter. Many companies are jockeying for that position. Some of them may win, or the winner may not yet be in the marketplace. The extent to which they’re able to scale is the degree of leverage they have over providers.

Put frankly, someone is building a better mouse trap than you have so they can sell (who would have been) your own patients back to you.

Many have tried and not (yet) succeeded, but it would be hubris to think that others won’t.

Here are some of these players now, and what they’re up to.

Important disclaimer: Neither I, nor Fertility Bridge, have a direct commercial relationship with these companies at time of writing, though we certainly may in the future. No information in this article comes from conversations that I have had with the executives of these companies. This profile is not a revelation of insider knowledge. Rather, it is a curated synopsis of public information. My observations and opinions are exactly those, based on information that has been publicly released by these companies or covered in the press.

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CONSUMER APPS:

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GLOW

The tech-forward platform for serves fertility patients and connects them with clinics by providing:

• Glow- Ovulation and fertility tracker

  - Includes:

  • Fertility Calendar

  • Daily health log

  • Health insights

  • App syncs with partners app

• Glow Community

• Glow Nurture - Pregnancy app

• Glow Baby - Baby Tracker

• Eve by Glow- period tracker and sex tips

Glow Fertility is segmented into a direct-to-consumer programs and a separate employee benefits program.

1. Direct-to-consumer programs:
   Glow predicts ovulation patterns and fertility probability based on user data inputs and supports women with services such as egg freezing and IVF. In addition to helping clients navigate the process of getting pregnant, Glow also facilitates access to healthcare providers (with whom the Glow team negotiates discounts to reduce the financial burden of historically expensive fertility treatments).

2. Employee benefits program:
   On the employer side, the Glow Fertility Program negotiates contracts between employers and fertility care providers.

Millions of women input data on menstrual periods, doctor visits, sleep habits, sexual activity, and birth control (in addition to over 35 additional basal health data points), and Glow has all of that data.

Although Glow does not publicly share the full details behind it’s business model, the firm charges businesses for the employee benefits program, and is also able to charge a fee for facilitating access to services from preferred healthcare providers. Glow also offers women personalized consultations through its direct-to-consumer channel, offering one free session before converting to a charge for service model.

History and Funding:

• Launched in 2013 by Max Levchin (co-founder of Paypal)

• Glow originally spun out of PayPal Co-Founder and CTO Max Levchin’s business incubator, HVF.

• According to Crunchbase, Glow has raised over $23 million in venture capital, $17 million of which was raised in a 2014 Series B round that included Founders Fund and Andreessen Horowtiz, reports Vox.

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EMPLOYEE BENEFITS:

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CARROT

Carrot is a startup out of Y Combinator working with employers to offer fertility care like egg-freezing and in vitro fertilization (IVF) as a workplace benefit.

Provides affordable options for those struggling with infertility by partnering with employers to add coverage for fertility services. They offer customizable plans to employers to include varying levels of fertility coverage at a sliding, per-employee dollar amount.

Founded by:

• Tammy Sun, CEO

• Dr. Asima Ahmad, Medicine

• Juli Insinger, Growth

• Arun Venkatesan, Engineering

Funding:

• Total funding: $15.2 million

• According to CrunchBase, Carrot has raised $15.2 million over four rounds, one angel, two seeds, and a series A. Their lead investors have been UnCork Capital with 3.6 million and CRV with $11.5 million.

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NU BUNDLE:

A benefit system employers can add to attract top talent.

Also offers services to help members understand their options, with guidance before, during, and after treatment. Services for members include:

• Their family planning concierge, which reports to provide members with caring, live guidance, and support at every stage of the journey.

• Help for members maximize existing benefits.

• Access to preferred pricing at top clinics and pharmacies.

• Access to customized fertility payment options.

Nubundle offers its products as a voluntary employee benefit, limiting the costs to employers. Employers pay a flat annual admin fee.

Founders

• Chris D'Cruz

• John Ciasulli

Funding

• Total funding: $1.5 million

• In a seed round, NuBundle raised $1.5 million from three investors led by Lightbank.

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STORK CLUB

Family/fertility benefit suites for companies.

In 2018, Stork Club expanded their core offering by introducing a comprehensive suite of Flexible Family Benefits that include both Fertility and Parental programs designed for large enterprises.

Stork Club advertises to be the only enterprise-ready family benefits provider designed for self-funded employers. They process claims and pay providers directly, letting your team focus on more important goals.

They have employee-facing web and mobile apps to help employers on-board, manage, and validate new programs with vetted provider partners.

History

• Founder, CEO: Jeni Mayorskaya

• Early Stork Club investors and advisers include key employees from LinkedIn, One Medical, and Facebook .

Funding

• They appear to be funded by slow ventures, but it is unknown how much money they have raised.

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PROGYNY

Right now, Progyny is the fertility benefits company.

They provide fertility solutions for self-insured employers.

Some may remember, Fertility Authority, the consumer facing company and fertility clinic review platform that negotiated reproductive health benefits. The company changed its name to Progyny in 2015 after acquiring, or being acquired by, Menlo Park-based Auxogyn, the inventor of Eeva. They quickly sprinted ahead to lead the race of fertility benefits broker.

In my opinion, this is a one-horse race at the moment, with their young, new competitors looking to be the person who can disrupt their early lead as Lyft did to Uber.

History:

• Founded in 2008 as Fertility Authority, became Progyny in 2015

• CEO: David Schlanger

• Headquarters are located in New York, New York

Funding:

• Total funding: $99.5 million in ten rounds from six investors, as documented by CrunchBase,

  • Who led the rounds has not been released.

  • Though we do know they raised $15 million in a new round in 2016.

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THE FINANCIERS

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Now this group is different. They’re not a new wave of tech companies launched from or by Silicon Valley serial entrepreneurs. However, by default, they do serve as lead generation and another entry point for patient acquisition from which they can bring new patients to fertility centers.

Also, I speculate a potential scenario in which one or more of these companies are acquired for easier, quicker, and more expansive entry into the fertility field.

Think about it. Many of these companies have an outdated user experience and some of the founders may be ready to cash out of the game rather than reinvest and overhaul. Again, this is Griffin Jones putting his Jim Kramer hat on and being purely speculative.

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WIN Fertility:

Maybe they belong in the employer benefit group, but a few things set them apart:

They have been in the field for two decades.

WIN offers benefits through employers and affordable options for treatment through practices for those without insurance or for those who have exhausted their insurance benefits.

WIN integrates with national and regional insurance carriers, as well as the nation’s largest pharmacy benefit managers to procure fertility services. WIN patients are qualified prior to fertility treatment.

Available 24 hours a day, 7 days a week, WIN’s Nurse Care Managers guide patients through every step of their fertility journey.

History

• Originally founded as an independent women’s health management company

• Founded in 2000

• President and CEO: Roger Shedlin

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Attain Fertility

ATTAIN FERTILITY:

Attain makes themselves known for being the original multi-cycle plan provider. They offer bundled IVF cycle plans, called Multi-Cycle Discount Programs, that include multiple IVF cycles for a one-time, discounted fixed fee.

Being owned by IntegraMed they are affiliated with 40 practices, 130 locations, and more than 180 Reproductive Endocrinologists in their US wide network.

How it works:

• Some patients qualify for their Multi-Cycle Discount Program + REFUND. This offers patients who meet certain criteria the potential of getting a refund if their IVF cycles are unsuccessful.

Estimated revenue:

• $15.4 million

History

• Founded by Pam Schuman

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ARC Fertility

ARC says they are the access point to the “nation’s largest network” of fertility professionals and offer innovative financing options.

More specifically, ARC offers fertility treatment packages, refund guarantees, and finance options to people living with infertility.

Value proposition to clinics and/or patients:

• Largest network

• Most trusted

• Doesn’t own/operate clinics -> looking out of patients best interest

ARC’s fertility care packages can be bundled with medication and genetic testing services and bundle the cost of services into one monthly payment.

History:

• ARC was founded by David Adamson, MD.

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THE WILDCARD

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Fertility IQ

The most comprehensive review platform for fertility specialists and fertility clinics.

With FertilityIQ, prospective patients search by location or by a specific doctor or clinic name. Doctor profiles are detailed with aggregated metrics including communication quality, degree of individual attention, responsiveness, and overall recommendation. Patients’ summarize their experiences with doctors and clinics -- from the doctor’s approach to diagnosis and treatment protocols, to the nursing staff’s level of organization, to the competence of the clinic billing department.

History and Funding:

• The founders of Fertility IQ, Jake and Deborah Anderson-Bialis, say they will never take marketing dollars from clinics. Rather than seek capital from outside investors, the couple decided early on to self-fund FertilityIQ.

• Founded in 2015, went live in 2016

One of my clients once told me that they were weary of Fertility IQ because they thought they were building a mousetrap and they didn’t know what it was. I’m not weary because I believe Jake and Deborah have built their platform from an authentic ethos and are serving the market in a genuine and desperately needed way. Where the mousetrap will lead, I have no idea but it’s already a darn good one. Fertility IQ offers the best user experience for fertility clinic selection and has some of the best consumer generated data in the field.

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Conclusion:

Up to now, I have presented private equity backed consolidation and venture capital backed innovation as two separate phenomena, though they certainly don’t have to be. What will happen when the largest fertility networks, their parent companies, or private equity firms, acquire the largest scale platforms for patient acquisition, financing, distribution etc? Vise versa?

Resilient businesses survive revolution and later thrive because they adapt to capitalize from these disruptive forces rather than be replaced by them. There is more opportunity for the independent REI practice than there has ever been before, but it isn’t coming from doing business the same old way. It requires new strategy, paying close attention to the new players in the market, and using them for their benefit.

If you would like help in adapting to these forces and benefiting from the disruption rather than being pained by it, learn more about how to implement the Fertility Marketing System.

MRS 2016 Meeting Recap: How To Use the Patient Experience as a Business Strategy

By Griffin Jones

You could put summer-time Chicago against just about any city in the world, so we're all glad that Dr. Angeline Beltsos, MD doesn't hold the Midwest Reproductive Symposium international (MRSi) in February. From June 15-18, without a cloud in the sky and an oceanic view of Lake Michigan, we met at MRSi 2016 at the historic Drake Hotel in Gold Coast. The event boasted a Business Minds Meeting, a Nurses' Practicum, and a Scientific Program. I went back to Chicago this year for my second MRSi because it's just the right size. It's a great place to connect with colleagues who share your practice role and also for physicians, nurses, and practice managers to share programming and meaningful conversation with one another. If you haven't been, add MRSi to the list for next year. You'll be able to talk to people and listen to topics that you won't always be able to get to at ASRM.

Panel discussion at MRSi Business Minds Meeting

While I did attend some of Friday's Scientific Program, I'll use this post to run down Thursday's Business Minds Meeting for some of the things that you really need to know about utilizing different aspects of your clinic operations to grow your practice.

The ART of Incorporating the PATIENT EXPERIENCE as the Center of the Business Strategy

Janet Fraser, Board President of Fertility Matters and the COO of Atlantic Assisted Reproductive Therapies (AART), co-chaired the meeting with Derek Larkin, CEO of Boston IVF. 

“Improving our patients’ experience makes our patients happier and it’s better for our business”, Fraser mentioned of the day's theme. The thought was reinforced by all of the speakers; fine-tuning our operations so that our patients are more satisfied is measurably beneficial to the top line of the practice. Larkin emphasized the importance of continually adjusting to patient needs. "Patient expectations are continually evolving, and so must the experience that we provide to them. It's an unending process."

Incorporating Emotional Support to Decrease Patient Burden During Infertility Treatment

Dr. Alice Domar, PhD of the Domar Center for Mind/Body Health at Boston IVF talked about the importance of focusing not only on patient recruitment, but also on patient retention. “It’s human nature to pay attention to the patients in front of you, and not the ones who you don’t see (those who have dropped out of care). Studies have shown that people who were depressed were far more likely to drop out of their IVF cycle." Domar points to a 2004 Boston IVF study: Of 112 respondents, 40% displayed psychiatric disorders while going through infertility treatment. A separate 2011 study shows that care was significantly higher of a priority for patients, as opposed to physicians, for whom the greatest priority was success rates. "67% of people declined to fill out a survey on self-reporting depression because they didn’t want their physician to know how depressed they were," Domar adds. To date, four different studies show that infertility patients have the same levels of anxiety as cancer patients. 

Boston IVF tested retention techniques in a 2015 study that was published in Fertility and Sterility. Drop out rates reduced 67% in the intervention group."If you have effective communication with your patients, they perceive that you spent more time with them". Domar brings to attention the dollar amounts that practices spend on marketing to new patients, and how little is spent on retaining them by responding to trends in drop outs. 
 

Getting Staff Buy-In On The Importance of The Patient Experience

Hannah Johnson speaking on patient retention, courtesy of Vios Facebook page

“Intrinsic motivation tends to be lost when we only focus on the extrinsic motivators, so we have to focus on activities where the reward is inherent in what we’re doing". Hannah Johnson, Director of Operations at Vios Global dives deep into how we motivate and empower our team members to take personal interest in each of their patient interactions. We need to allow our team to step back to appreciate the positive difference they make, including making sure they are aware when they are named in positive patient comments. We also need to empower them to correct errors. "It’s okay for your staff to make mistakes. Let’s talk about how we can make the patient feel really good about what happened.”

The Magic of Using the Patient Experience as a Focal Point of Your Employees' Day

“People don’t do what the mission of the organization states, they do what their managers pay attention to.” Lisa Duran is the CEO of Reconceived and has trained dozens of fertility centers in North America on how to build a patient-focused culture. Duran says that when many practices don't feel like they're fulfilling their mission statements, it's often because of a breakdown in the details of execution. We broke out into separate teams to identify challenges that different members of our team face in their day-to-day duties, and how we might be able to support them. Departments and staff need reinforcement and understanding from one another. “I want to know that my opinion matters,” Duran says of the most common desire that staff report before going into training.

In their own words

We had the privilege of hearing the first hand account of a couple who has gone through infertility treatment for many years. When asked what would have most benefited them to know when they first began their treatment, they each replied
"Don't be complacent if you're not getting the answers you need. Keep asking". 
"I wish that I wouldn't have waited so long. I wish I would have sought out treatment much earlier".
Hearing from patients in panel-form was a first for me at MRSi, and should be common practice at our conferences...imho.

Strategic Planning: Folding the Patient Experience into Your Business Plans

"Perception is reality. What patients feel is what they share." Rick Dietz, Chief Business Officer of Boston IVF, spoke in detail about the constant feedback loop of implementing and adjusting to patient input. Dietz says that practice strategy should be informed by a number of different metrics, and that self-reporting from patients is only one method at our disposal. "We can use patient surveys to give us clues and direction. But they don't tell the whole story."

Never Underestimate the Role of the Nurse in Patient Retention

"Nurses need proper training of how to talk with patients or you're going to get a lot more questions." Lori Whalen, RN, of HRC Fertility spoke about the importance of nurses as agents of patient retention. Whalen reminds us that nurses frequently have the most contact with patients and can be excellent sources of what patients want or what about our operations might be frustrating them. They can even find other solutions to patient problems, such as helping them find ways to save money. "Shared donors can cut costs in half for patients who wouldn't be able to afford it otherwise," Whalen says.

The Vital Role of Digital Media in Recruiting New Patients 

It was my first time speaking in the field and I was very pleased to have a great audience that asked meaningful questions. What can I say in this single post that isn't better summarized in greater detail throughout the blog? Suffice it to say that I reaffirmed what matters above all else in fertility marketing: the attention of people dealing with infertility. When we know what people with infertility are paying attention to, then we can measure how we will increase IVF cycles, increase patient-to-patient referrals, and improve our conversions of prospective patients to scheduled patients. You can view the first half of my talk here:

It takes a village

The strongest recurring theme of the Business Minds meeting was the critical involvement of everyone at the practice. I frequently see public feedback when patients are happy with their physicians, but not their staff, and vice-versa. Patients form their opinions about their experience based on every interaction they have with us; from the receptionist who greets them, to the medical team that cares for them, to exceptional customer service both online and offline. When we support all of the role players on our team, and learn about best practices from clinic groups across North America, we can dramatically improve both our delivery of care and patient satisfaction. Now that's an excellent foundation for growth. I recommend that at least once a year, you accompany a few of your team members to an inter-role meeting like MRSi to identify how you can improve your practice operations. You might be pleasantly surprised by what you learn from your own team, and what they learn from you.

See you next year at MRSi 2017!