Aspire to Be A Disruptor - Alex Frommeyer, CEO of Beam Dental

Hi, I'm Shiv Gaglani and today on Raise the Line, I'm really happy to be joined by Alex Frommeyer, who goes by Fro. Fro's the CEO and co-founder of Beam Dental, one of the country's fastest-growing dental benefits providers that offers employers a unique approach to coverage by incorporating dental hygiene behavior into policy pricing. The behavior is determined using artificial intelligence to interpret data gathered from the smart toothbrushes used by members.  Beam also has a national network of dentists and is bringing other innovations to the employee benefits market. So, Fro, thanks so much for taking the time to be with us today.

ALEX FROMMEYER: Thanks for having me, man. Good to be with you.

SHIV GAGLANI: Yeah, good to reconnect. I know your story, your background, but for our audience's sake, can you tell us a bit more about how you got into this business to begin with?

ALEX FROMMEYER: Yeah. A question I get a lot, because the dental industry isn't the first one you usually think of for tech entrepreneurs to go into, and that's certainly been the case from my perspective as well. We're actually now happy that there are lots of people innovating in the dental industry, which wasn't true when we were first getting started. My co-founders and I actually met in engineering school. So, we're all engineers by background, but we have a ton of family members in the dental field. My sister is a dentist. She ended up marrying a dentist who comes from a family of dentists himself. One of my co-founders, his mom's a dental hygienist, has been one her whole career. So, he grew up in the dental office with her every day. And so, we had some reasons, some influences, early in our lives to actually kind of peek under the covers and look at what the dental industry was.

What we saw was a gigantic market. It's very fragmented and lacked a lot of innovation. The joke in the dental industry is that it's 10 years behind healthcare and the joke in healthcare I think is that it's 10 years behind everything else. And so, we saw strategically that there was an opportunity to bring technology and software and data into the dental industry -- which we do through dental insurance specifically today -- in order to build an industry that's more equitable, that's easier to use, that focuses on smart underwriting and an understanding of risk, and a fundamental focus on preventative care as well. That's what we do.

SHIV GAGLANI: That's awesome. We share some stuff in common already. My sister and her husband are dentists in Chicago, and we actually had them recently on the Raise the Line podcast as well, because we wanted to hear how the dental industry was changing as a result of COVID, which we'll get into in this interview. So, I first came across Beam Dental, I think, when you guys had released your smart toothbrush and I covered it for Med Gadget back when I was writing for that medical technology blog. Would love to hear how the company has evolved. And I think if I'm not mistaken, the toothbrush was the first innovation and then you got into the dental benefits.

ALEX FROMMEYER:  That's exactly right. We launched the first connected toothbrush back in the 2012, 2013 timeframe. At the time, what we were most fascinated by, my co-founders and I, is what we would now call digital health. But at the time, there was a ton of really interesting activity brewing around the intersection of healthcare and tech, especially hardware. Fitbit was a very new company at the time, but they had really, I think, got wheels turning -- both us and lots of others -- around personalized health and how you could better diagnose, predict illnesses by just measuring the body.

There was a whole movement that was around the measurement of your body. It was called quantified self. And we thought that was really interesting as the future of healthcare. To us, it was very clear that the more you could kind of measure about your daily activity and see those long trend lines, maybe even over decades, you could then predict that heart attack and that getting diabetes, et cetera. You could figure it out way earlier in life. You could see the trends. We thought there was an opportunity to bring that idea into the dental industry. And so, the smart toothbrush was the way to do it. We had initially envisioned that the business would provide the technology -- the hardware, the software, the data, and the analytics -- to then serve it to insurers, who could then use that data to better predict who has good preventative care habits, who doesn't, who's more likely to get a cavity filled, therefore, in the next couple of years, who's totally on the happy path toward great long-term dental health. And that was what we took to market. 

What we found is that the large insurers are not actually focused on innovation in the way that we hoped they would be. And so, we pivoted or expanded the business's ambition to actually go into the insurance industry ourselves. We ended up building the entire infrastructure of our own insurance carrier to be able to do the entire customer journey. Now the smart toothbrush, the Beam Brush as we call it, is getting ready to go into its third generation of hardware, which we're really excited about. And it's still an integral part of the business's customer experience, even though it's now just one of many things that we do, delivering an end-to-end insurance experience to our members.

SHIV GAGLANI: That was really fascinating. A couple of points on that. So around that time, I totally remember Fitbit was big at Ted Med. I had done something at Ted Med called the Smartphone Physical. Another guest we've had recently is Eric Topol, who I know you know.

ALEX FROMMEYER: Legend. Yeah.

SHIV GAGLANI: Totally. That was a really fun conversation. But, we're seeing people like Inder Singh, who you may know, started the smart thermometer, and he's all over this year because the thermometer with their data can be used to kind of look at where COVID may be spiking. On the Beam toothbrush, how many people now have gotten a toothbrush? And could you give us a sense of the size and scope of how much data you've collected? What you can do with that data? I think our audience would really love to hear about that protectable asset that you've developed in the database.

ALEX FROMMEYER: So, the scale is six figures, in terms of the numbers of users. From like a amalgamated data perspective, I usually focus in on what the kind of net impact is to our business. And so when I think about that, it's usually in two pieces. One is, we're developing the data that we get as an underwriting factor so that way, we can offer premium discounts to people and businesses who are exhibiting the most engaged, preventative care habits over time, which also makes for a sticky or a higher retention experience as well, because it's a totally unique way to think about what I'm paying versus what I'm getting in the dental insurance equation. The second piece of it, which I think will be the more important piece on a go-forward basis, is leveraging that data to actually build new products and services. So, I think one of the most interesting opportunities Beam has is how do we take that little helpful action every day, very simply brushing your teeth -- something that nearly everyone's already doing at least to some degree -- and how do we activate it? How do we turn it into something that you have loyalty to, or that you get credit for? 

So here, the allegory would be now Fitbit and Apple Watch in many health insurance companies, wellness programs, but also think about credit card rewards programs. Every time you swipe, you're getting some cash back, or you're getting some sort of prize or reward, or you're making progress toward it. Airline miles programs work on much the same levels of gamification. So, your loyalty to the airline earns you free seats, big upgrades, affinity deals, other rewards over time. We think there's a big opportunity to use the simple act of brushing your teeth, preventative dental hygiene, in a similar sort of way. That kind of mechanization or gamification of the data that we have, but also that we're getting from our user base, will be used to create those affinity relationships and this idea that you can get paid to brush your teeth. You can get rewarded every day when you're just simply standing in front of the mirror for two minutes.

SHIV GAGLANI: Yeah. It's fascinating. What's an example of the data? I imagine it’s like how many times somebody brushes -- once, twice, three times a day, after every meal. How long they're brushing. Maybe where in their mouth. And then, I guess around flossing. My sister, as a dentist -- I don't know, hopefully she won't listen to this podcast -- but I think she knows that I don't floss regularly, which is a big issue. But, do you guys have a flossing thing in the works? I'm curious what other innovations are coming down the pipeline.

ALEX FROMMEYER: There is some stuff coming that's certainly adjacent to the flossing space, if not there directly. But we do have a lot of IP protection around connectivity in that zone. What your sister may have said, which is certainly kind of provable in the dental science space, is that the value of flossing is extreme. If you could pick should a person floss every day or brush their teeth every day, you'd probably take flossing because of its kind of value from a gum disease perspective. But, the real answer is both, right? That's what every dentist would say. What I think is fascinating though, is, as I look at the program, that the idea of that dental wellness program on a go forward basis, we want to get everyone in the country ideally to the point that they're using a high-quality electric toothbrush.

They clean better. They remove plaque better for a larger population of people than manual brushes do. And they do so in a way that's a little bit safer as well because manual brushing -- and I'm one of these people -- you tend to brush too hard and you can actually hurt your gum tissue in particular and get gum recession and other issues by using the manual brush. So, we want to get everybody onto electric brushes. We want to get everybody credit for it by using the connectivity of the brush in order to do so. And then, you've got to get folks high quality oral care products in general. So, that might be specialty toothpaste. Think about brands that focus on folks with sensitive teeth and more like clinical strength paste. It's about getting mouthwash and floss and other products that fill out that oral care aisle at your local CVS or Walgreens, right?

And being able to deliver it in a high-quality way that's actually giving people convenience, ease of use, low friction, and doing so in a way that's gamified and kind of fun, at least as fun as you can make brushing your teeth every day. The core data that we're using to drive though aspects though are what you mentioned. It's the behavior. It's when and how long you're using the brush and then the quality of your brushing, which is to give you a sense of like “are you covering all the teeth, insides and outsides of the teeth,” et cetera. So, that's kind of the basic intelligence that we're embedding into the program every time.

SHIV GAGLANI: That's, again, super fascinating. So, switching gears to COVID, right? This is the reason we launched this podcast -- how do we increase healthcare capacity in the age of COVID and beyond? How has COVID affected Beam's business? And what are some of the lasting changes you think will happen to both the healthcare system, and obviously within that, as dental care as a result of COVID?

ALEX FROMMEYER: Great question. The dental industry has gone through a lot this year. There was a three-month period, basically March, April, May, where most dental offices were either partially or completely shut down. So from our perspective, it's been a tough year, and we have a lot of dentist partners, providers, all over the country that are in-network providers that have certainly suffered. And I know my sister and brother-in-law, their practice was shut down for a long period of time as well, and back up and running thankfully now. But I think the lasting effect is actually going to be really interesting. I think one of the things we've learned for sure is how much distribution matters. It's actually still amazing that six plus months after COVID became the only story in the news, it's still too difficult to get a test, which is wild considering the amount of money we spend as a country on our healthcare system.  It should have been a place where the healthcare system and the distribution system would have shined.

You would have thought it would have been a way to get tests on every corner, every pub, every YMCA. Every public meeting space in the country would have rapid tests and a volunteer army of healthcare workers ready and armed to help make sure everybody could have low cost or free access to testing at any time. It's still kind of tricky to get a test today and I think that's actually a signal that we still haven't nailed true distribution, and we still haven't nailed access to care as a country.

When I think about how that applies to the dental industry, I think that the industry is going to be stronger and better for it in the future because the PPE and the best practices that were tough for the mom-and-pop dentists to deliver to their patients is now a non-negotiable. It now has to be true. So, I think the quality of care is going to be better. I also think the digitization of the tools that dentists use, some of which is Beam's insurance platform, but it's also the ability to schedule and check in for appointments in a seamless way -- no more sitting there for 45 minutes looking at magazines in the waiting room, right? Because you have to be more efficient and structured now, because you can't have that many people in a cramped space. 

So, dental offices are getting smarter about how they schedule and invite patients into their environments. And I think interoperability is going to be another key component of this whole thing. We have to be sharing data better. We have to be actually understanding the patient journey. When I have a patient that we're insuring at Beam go to dentist A and then dentist B, we can see that happening, but those two dentists can't see that happening and that connectivity just has to be true for the kind of clinical component of the industry on a go-forward basis.

SHIV GAGLANI: Some of those examples are obviously very consistent with other areas of healthcare. One thing that has been happening, and I think COVID has accelerated some of this, is telehealth obviously, but also the direct to consumer -- whether that's telehealth or it's Walmart scaling out dental clinics -- direct to consumer companies like HIMS, HERS, RO et cetera. I'd love to hear your take, COVID or not, on concepts like tele dentistry, tele dental care, as well as direct to consumer dental care, which we've seen with companies like Smile Direct Club or Invisalign, which a lot of dentists haven't been the biggest fan of, because I think it turns patients into their own orthodontists to some extent. So, what are your thoughts on these trends? And as you would imagine, COVID has catalyzed some of them, but as a dental insurer, what do you think?

ALEX FROMMEYER: Well, it's such an interesting topic. The real big long-term vision of our business, even before we started Beam, was the personalization, the quantified self, the personalization of healthcare, and the more tailored health care experience that people have been asking for for a long time. And so now, we're in a place where you're starting to see some of it come true. It's tools like Fitbit and tools like the Beam brush that are out there, but it's also prescription delivery that's now happening on demand. It's now tele-health platforms that are exploding in popularity and usage. It's the mobile phone as your doctor. And we're still so far away from broad clinical applications to many components, but you can see it happening, right? More and more features, more and more use cases are emerging.

COVID has brought even more use cases and reasons to participate in that world this year. We think in the dental space that tele dentistry's super interesting. We think what Beam's already doing with the home delivery of high-quality dental care goods right to our insured members' doors, helping convert more people to electric toothbrushes, helping get people the products they need to have good dental hygiene over time, is super scalable and exciting because it's going to continue to happen more and more. And dental is further interesting to me because the equation in healthcare to really deliver someone an outcome in healthcare has so many variables attached to it -- genetic and behavioral and otherwise, environmental. In dental, it's a much more straightforward contract. I'm oversimplifying here, but if you have phenomenal dental hygiene, which Beam can help enable for one of our customers, you have a pretty good fighting chance at not needing seven root canals next time you go to the doctor, right?

And because of that, our focus on committing to our own members' preventative care, and then delivering them the tools and technology to be able to do so, we think is a great head start. And then, yes, as the industry continues to digitize, people are still going to need an expert in the mouth helping diagnose and understand and work on the teeth from a physical perspective over time. That's never going away. But what we will get better and better at is when to come in for the dental appointment. If you need to come in for a dental appointment, what are you going to receive from a services perspective, when you go there.

There's so much more intelligence that we can bring into the market. Some of that will be influenced by us as a carrier, as an insurer. Some of it will be driven by the member just demanding more. And some of it will be driven by the providers getting more sophisticated about having X amount of seat time and they want to optimize what patient they're putting in that seat based on the care that needs to be delivered and the outcomes that they're trying to create for their patients.

SHIV GAGLANI: That is really, really interesting and fascinating. And what we're seeing across other types of insurance companies, starting with, I think, car insurance. Obviously, they had equivalents to what you've been pioneering at Beam in that you use this device that lets them understand your driving behavior. They'll reduce your premium, right, because they know you're a safe driver, or relatively safe driver. So, you're going to pay less for your insurance premiums. You're doing that with Beam. One other thing that we've heard from insurers this year is that because people haven't been driving as much because of COVID, because health insurers also have done this because people haven't been accessing healthcare as much because of COVID, they've done some rebates on premiums and been able to do some more innovation too around that. How has dental insurance, Beam or otherwise, adjusted to this? Is it similar?

ALEX FROMMEYER: So it is, actually and you're right. The telematics industry that started and is still primarily featured as an auto insurance component to their plan designs and how they think about underwriting the risk of a customer is very similar to what we do at Beam with the brush, but also just actually our overall underwriting methodology, which is an AI or machine learning driven approach to sussing out risk and personalizing it and tailoring it. And what I would say from a management of COVID perspective is that in the dental industry, what we're doing and what I think most carriers are doing is helping kind of manage folks' plans, because a lot of people have missed their regularly scheduled cleaning this year because they just haven't been able to get to the dentist or they're not comfortable going, which is reasonable. And so, there's a lot of elective dental work that hasn't been getting done.

What many carriers are doing is extending contract periods, giving people extra credit against deductibles, opening up the annual maximum of the plan to accommodate the catch-up of those elective procedures. A lot of them are screenings, checkups, preventative care, and just making it easier and easier to access that next appointment with the dentist. So, we've done a lot of work to just be there for our core customer, right? So like, if you can't pay your premium this month because things are difficult, we set up a forbearance program and that's been actually really smooth and really successful because it's helping us buoy our brand and also just again, be there, be supportive of our customers who've already entrusted us so, we have to pay that back, and this is a great time to do so. And then, second is just enable members to receive the care that they need.

I think this really accentuates why, years ago, we started investing in the smart toothbrush, the subscription of dental care toothpaste floss, replacement ends for the brush. In a moment like 2020, it now seems so obvious that, well yeah, we just ship it right to your door and you still have access to everything. But at the time, of course we didn't have global pandemics on our mind. We were just trying to build a more efficient way to get high quality dental care goods in the hands of all of our members. And so, it's, in some ways, really inspiring to see that in 2020, our business model is resilient to, and kind of compliments almost, the world that's changed so much in front of us.

SHIV GAGLANI: That's fascinating. That's really fortuitous and also good that you guys are there for your members in that way. I know we're coming up on time. So, my last question is, what advice would you give to our audience, which is current and future health care professionals? We work with a lot of dental schools, like University of the Pacific Dental School, as one example. What advice would you give to them about meeting the challenges of COVID and then moving forward the healthcare system as a whole?

ALEX FROMMEYER: I think they're coupled in one in the same, from my perspective, which is about thinking long-term and caring about innovation and advancement and the interoperability of health care, full stop. And what I mean by that is, I remember spending actually a lot of time when I was first getting started -- I was just finishing university in the engineering school and was going to my local university dental school -- actually meeting students and professors, and actually just trying to learn more about the industry, because I was learning a lot through my sister at the time, but just to increase the sample size of spending a lot of time in the dental school. And at the time, I felt like such an odd ball. I was an engineer that was trying to innovate in the dental industry and here were a bunch of people working on being career dentists that didn't have any notion whatsoever of how they might innovate or change the industry. They wanted to fit into the industry, not change it completely.

So, my greatest wish for someone going through school today or in the early stage of their career, no matter what part of healthcare you're in, is aspire to be a disruptor even if it's inside the walls of a big health system or inside the walls of your own dental practice or one that you join, because we're way past time on needing to innovate and disrupt and totally reformat how the healthcare system works. And if COVID was not the obvious alarm bell, it is now, right? Like, there's no going back on the idea that we just aren't there yet on distribution, access to care, how we pay for care, and the quality of that care. It requires people on the outside -- like an engineer that's trying to innovate inside the dental space -- but it also requires folks on the inside to push for better data, better understanding, better technologies, new ideas, and big risk-taking, big, bold, ambitious risk-taking.

So, I hope there are, and I think there are, actually a lot more people that are going into these fields trying to change them from day one. And then, the key is to think long term, right? You can't become jaded by the inertia of today's fire and the pandemic in front of us, et cetera. If you use that 20- or 25-year lens, you can actually get a lot done.

SHIV GAGLANI: That's really great advice. That's the first time we've heard that advice, I think, on this podcast. So, congratulations on all that you've accomplished and I really appreciate you taking the time to be with us today.

ALEX FROMMEYER: Thanks a lot, man.

SHIV GAGLANI: Awesome. And with that, I'm Shiv Gaglani. Thank you to our audience for checking out today's show, and remember to do your part to flatten the curve and raise the line, since we're all in this together. Take care.