By Jamison Cocklin
new castle, pa.
Kenneth Cooper is a man who can talk at length about what he does.
He throws around words such as orthodontics and periodontics as if they’re commonplace, and he discusses Medicaid reimbursements and preferred provider organizations with ease.
Every week, Cooper, 41, who grew up in Columbiana and graduated from Youngstown State University, travels from his home in Canfield to New Castle, where he works in the sprawling Cascade Center at the Riverplex.
The building was empty for decades, having once served as a Warner Bros. theater. Today, it’s a newly remodeled 76,000-square-foot space where retailers and more restaurants will one day do business.
But the Riverplex is already home to the offices of Refresh Dental — one of the country’s fastest-growing companies — which Cooper co-founded in 2010 after a series of meetings with his business partners, Andrew Matta, 35, and Chad Wise, 39, both of New Castle.
Refresh recently appeared on Inc. Magazine’s list of the fastest-growing private companies in the U.S. That’s no small feat considering the magazine requires companies to demonstrate a 918 percent growth rate over a three-year period.
This weekend, Cooper and his business partners will travel to Washington, D.C., to accept an award that has gone to Microsoft, Oracle and Zappos, among many other powerhouses in its 32-year history.
In a way, Cooper, Matta and Wise were surprised to hear their company was named to the list, but in many regards growth was both a goal and a necessity in the rapidly changing dental industry.
“We saw what UPMC and the Cleveland Clinic were doing, what they had done, and a lot of similar companies were growing rapidly,” Cooper, who serves as the company’s chief executive officer, said. “But we wanted to be more focused and become the gold standard — or the Cleveland Clinic — of dentistry. We wanted to provide something more, and we knew that could be our niche.”
That mantra has guided the company since, the partners say.
Refresh Dental has its roots in Canfield, where Cooper started Dental Express in 2008. By 2010, the business had grown from one location to eight.
At the time, Matta’s brother — who was working for Cooper — urged the two to meet. Over lunch, the two discussed “the future of dentistry,” and Cooper said “they really hit it off.”
Within months Matta and Cooper had met with Wise, and Refresh Dental was founded in 2010.
Since then, Refresh has grown to 36 locations that stretch from Pittsburgh to Toledo.
There are eight locations in the Mahoning Valley. This year, the company will serve more than 250,000 patients, Cooper said.
Refresh Dental is not a major national corporation. Instead, it’s what’s known as a Dental Service Organization, or DSO, which are essentially individual practices banded together to create efficiencies, reduce patient costs and allow dentists to focus solely on their craft.
“We’re very localized — a community-based organization,” Wise said. “We create an opportunity for dentists to focus on their patients; not billing, human resources or the administrative aspects of the business.”
Refresh provides those services, taking care of administrative services, human resources, billing, accounting and other business, while paying its dentists a base salary and offering them a collaborative atmosphere to work in.
DSOs are ripe for growth. As Cooper explains it, a “perfect storm” of debt, retirement and an increasingly diverse workforce is making managed-care services the future of dentistry.
The numbers support that claim, too. According to the Dental Care Alliance, DSOs are growing at nearly three times the rate of the dental industry itself. By 2016, members of the Dental Group Practice Association are projected to surpass 60,000, and participating operations will reach nearly 40,000.
Just like primary-care physicians, graduates at dental schools across the country are facing mounting debt, making it difficult to obtain financing and start their own practice.
At the same time, retiring dentists need a place to turn when it comes time to sell their operations, and more dentists are opting for a steady paycheck than the uncertainties of running a full-blown practice.
DSOs can help a graduate pay down debt and earn the experience they need to open a private practice, while they also provide a market for retirees to sell and a way to exit the business.
“No physician says I’m going to start on Main Street anymore,” Cooper said. “They join these hospital networks, and what we have is nearly identical to that.”
Moreover, dental care is financed differently than medical care, with patients paying more out-of-pocket costs and insurance plans picking-up a smaller percentage of the bill.
Medicaid reimbursements have continued to decrease as well, failing to fully compensate traditional dental practices for their services.
As a result, the average American has reduced their trips to the dentist, and many private practices have been forced to turn down Medicaid reimbursements to avoid losing money.
DSOs have more purchasing power, more capital and a better ability to negotiate reimbursement rates. The industry is shifting toward the efficiency of the managed-services model.
Meanwhile, more dentists are clamoring to enter a managed-service organization.
“It all goes back to our core values and our vision,” Matta said. “Our model attracts strong doctors, and the culture of this company promotes strong business. We’ve been able to build on that momentum and energy over the years to the point of where it really has become contagious.”
The company also operates two other brands in Dental Express and Corner Dental.
Integrated services and advanced technologies have helped to keep growing the brands, Cooper said.
Nearly any oral surgery can be performed under one roof, and better technology helps to reduce the time it takes to care for a patient during a routine examination, he said.
The co-founders envision more growth for the company in the years ahead.
Cooper said Refresh is currently among the top 25 companies in the industry. In the next two years, he hopes to reach the top 10.
“The sky is the limit,” he said.