Advanced Care Growth — Investment Case

The portfolio

Three practices, one bottleneck

Each already has the hard parts — demand and clinical skill. Each is capped by the same missing role.

New Horizons

Implant / full-arch center

~90 leads/mo at $28–45 CPL — plenty of demand
Once presented: 84–100% show, ~33% close
Sarah splits setter + treatment coordinator + front desk across locations — lead speed suffers
Strong months prove it: when Sarah is dedicated, bookings jump

Peak Family Dental

3 AZ locations

Flagstaff · Cottonwood · Sedona
Elite conversion: 90% show, 94% close in FY25
Office manager is TC and works leads — and isn't incentivized on performance
Notes say it plainly: "no outbound calls from the system"

MainStreet

Implant program — capital case

Dr. Jimenez places implants; practice historically referred every case out
39 implant referrals last year to one now-closed surgeon; 267+ since 2023
30–40 VA community-care cases already submitted
Needs an on-site CBCT to bring the work in-house

Where they are today

Elite where it's hard. Broken where it's cheap to fix.

Every funnel stage below, measured against SGA's own targets. The practices blow past target on show and close — and collapse at contact and booking, the one thing a dedicated setter fixes.

Funnel performance vs. target

New Horizons and Peak, trailing. Green = beating target · Red = missing it.

New HorizonsPeakSGA target

The leads are cheap and plentiful. The chairs convert. The phone is the leak.

At 80–100% show and 33–94% close, contact and booking are the only stages under target. That's not a demand problem or a clinical problem — it's a staffing problem with a known fix.

~5–13%

of leads contacted (target 60%)

~3–10%

of leads booked (target 25%)

80–100%

show rate ✓ beats target

33–94%

close rate ✓ beats target

Historical monthly revenue — an unmanaged pipeline

Revenue arrives in lumps because leads are worked in bursts, not as a system. FY25: New Horizons $158k · Peak $281k.

New HorizonsPeak

Where they've been

Proven economics, inconsistent throughput

	FY25 rev	ROAS	Close
New Horizons	$158k	2.9x	33%
Peak	$281k	4.1x	94%

Peak closed 94% of everything presented in FY25 — and still only got ~20 consults booked from 682 leads. The ceiling isn't closing. It's getting patients to the table.

The opportunity

A dedicated setter, and a pipeline we actually manage

Bring on a third-party setter (Briteline) dedicated to working leads the moment they arrive. Treatment coordinators stop chasing and start closing. The funnel becomes a managed pipeline instead of a to-do list.

The mechanism

Speed to lead

A dedicated setter calls leads in minutes, not days — moving booking rate from ~10% toward 27% (blend of the 25% internal target and a dedicated-setter benchmark).

The unlock

Fill existing capacity

Show and close stay at proven levels. Cases rise from ~1–2/mo toward the practice's own stated ceiling of ~8 arches/mo — the chairs are already there.

The discipline

Honest math

Modeled at trailing realized case value (~$16–17k), not the $40,500 full-arch case. AoF economics are upside, not the base. Kim Middleton (financing + coaching) is a separate lever.

Today ~1–2 cases a month reach the table. The setter's job is to make it 7–8 — filling capacity the practice already has.

The revenue opportunity

Same investment. Here's the range of return.

Conservative, base, and aggressive differ only in how fully throughput and case-mix land. Investment is identical. Toggle the scenario in the top-right — the whole case updates.

12-month incremental revenue by practice

Active scenario in full color; the other two shown faint for context.

Practice	12-mo incr. rev	Payback	24-mo incr. rev

Baseline = each practice's trailing status-quo run-rate. Incremental = modeled revenue above that baseline. Gross margin held at 40% (NH/Peak) and 45% (MainStreet implants), per the implant performance files.

The return

Payback inside 7 months at New Horizons and Peak

Cumulative incremental gross margin overtakes cumulative investment fast, because the setter fills capacity the practices already staff. MainStreet is a capital case — slower, but the CBCT itself pays back in under three months of implant margin.

Portfolio: cumulative incremental gross margin vs. cumulative investment

24 months. Where gold crosses navy, the program's margin has covered its investment.

Cumulative incremental gross marginCumulative investment

—

New Horizons payback

—

Peak payback

—

MainStreet payback

—

Blended incremental ROAS

40–45%

Gross margin held

—

24-mo incremental revenue

The investment

Where the $712k goes

Roughly half is media — the fuel. The setter is the thesis. MainStreet's CBCT is the one capital item. Kim Middleton (sales coaching + financing) sits on top as optional upside, not in the base.

12-month investment by category — all three practices

Total ≈ $712k. Media scales from $9k/mo toward $15k; the setter is a flat, high-leverage line.

Avenues of scale

Media: $9k → $15k → $21k

Base ramps media to $15k/mo. Every practice has room to push to $21k+ as capacity fills — the fastest lever to more leads once the setter is converting them.

Optional upside — not in base

Kim Middleton · $2k/practice

Sales coaching and financing setup. Lifts close rate and lets bigger (full-arch) cases through. Flip it on in the model to see the effect; the base case stands without it.

MainStreet — the capital case

Recapturing implants we already send away

This one isn't about a setter — it's a CBCT and an implant ramp. The demand already exists; the practice just exports it.

The recapture

39 implant-eligible referrals last year to one oral surgeon — who has now retired/sold
267+ referred out since 2023
30–40 VA community-care cases already submitted
The perio referral office closed too — that volume is unclaimed

The capital

On-site CBCT — $38k (open-box unit already sourced)
Surgical + restorative staffing and training
Conservative ramp to ~10 implants/mo at $4,500 each
Locator-fixed full-arch as upside from month 7

The return

Program payback ~month 13 (carries the CBCT)
The CBCT hardware pays back in <3 months of implant gross margin
45% gross margin on implants
Every case kept in-house is margin that used to leave the building

The ask

Approve — across the three practices over 12 months.

A dedicated setter at New Horizons and Peak, paid media scaled to $9k+ at each, and MainStreet's on-site CBCT. Base case: — in incremental revenue at — blended ROAS, with New Horizons and Peak paying back inside 7 months.

Contract the dedicated setter (Briteline) at New Horizons and Peak — non-optional; it's the whole thesis.
Scale paid media to $9k/mo minimum at each practice, with a path to $15–21k as capacity fills.
Fund MainStreet's CBCT and implant ramp to recapture referred-out cases.
Hold Kim Middleton (coaching + financing) as a fast-follow lever once setters are live.
Manage it as a pipeline: weekly lead-to-consult reporting, treatment coordinators freed to close.

Sources: SGA New Horizons Implant Performance & Peak Implant Analysis (Performance Funnel, Sale Waterfall); New Horizons & Peak Monthly Reports; Briteline rate card; Dr. Jimenez call notes & referral-recapture data. Gross margin per implant performance files (40% NH/Peak, 45% MainStreet implants). Figures are modeled and tie to the accompanying Excel model. Net margin excluded by design. SGA Dental Partners — confidential.