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Surviving the Squeeze: Decreasing Payouts, Increasing Marketing Costs… PRESENTER DANIEL GEMP, President, CEO Dreamscape Marketing Dreamscape Marketing is a full service marketing firm focusing on Responsive Site Design, Search Engine Optimization, Content Marketing, Social Media Strategies, Marketing Campaigns, Corporate and Brand Strategies with the express goal of increasing your marketing ROI. Dreamscape specializes in the addiction treatment industry. GUEST FINANCE GURU William McCormick, MBA Chief Executive Officer Medivance Billing Service, Inc. William McCormick is a highly experienced healthcare professional with comprehensive skills in strategic planning, sales, operational management and implementation. Throughout his professional career, he has demonstrated the ability to lead diverse teams of professionals to new levels of success in the highly competitive healthcare industry. William has a proven ability to successfully analyze an organization’s critical business requirements, identify deficiencies and potential opportunities, and develop innovative and cost-effective solutions for enhancing competitiveness, increasing revenues, and improving customer service offerings. TACTICAL GOALS 1. What is Causing “The Squeeze” From Regulation and Competition in the Treatment Marketplace? 2. How Can I Hedge Rising Costs In My Marketing Budget or Cost-Per-Admission? 3. Relative Size of Digital Market Opportunity 4. Difference Between SEO and Paid Search Tactics – Why Choose? 5. Ways to Improve Marketing Mix & Outreach Effectiveness 6. Using Content & Sales Tools as a Cost Hedge & How This All Ties Together THE SQUEEZE: WHAT IS HAVING EFFECT ON PAYOUTS? THE SQUEEZE MERGERS & ACQUISITIONS: • Anthem acquisition of Cigna • Aetna acquisition of Humana • AAC acquisition of Recovery Brands (~$60 Million) • UHS Acquisition of Foundations ($350 Million) • Acadia Acquisition of CRC ($1.2 Billion) • Merger and Acquisition Activity Consolidating Larger Operators Against Startups (~40 Known Transactions in 2014) • Following same path as other healthcare sectors, only new to YOU! THE SQUEEZE REGULATORY SHAKEDOWN: • Largescale Audits & Suits filed by Insurance Carriers • Carrier Response to Parity Laws is Simply to Control Duration and Level of Care (IOP vs. Residential/PHP, Shorter Term Payment) • Affordable Care Act -- Trend in previous PPO patient's & Employer Policies switching to Public Options for Cost Benefit • Compliance and Accreditation Costs THE SQUEEZE MARKETING MAYHEM: •Crackdown on Direct Sales of Insurance to Patients by Treatment Programs (Very Recent) •Patient Brokering & Kickbacks Continue via Contract & I.O.U.’s •New Facilities and Private Equity Rapidly Entering Marketplace • Veteran Enterprise Sales Forces • ‘Unlimited’ Startup Capital •Waitlists for Accreditation Reviews •Paid Search & "Googleflation" increasing over 12% yearly THE HEDGE: HOW TO FIGHT RISING MARKETING COSTS THE HEDGE DEFENSIVE MARKETING FOCUS: • • • • • Sales Team & Professional Partners Focus on Alumni Mobile Technology & Video Content Marketing & Thought Leadership SEO vs. PPC THE HEDGE OFFENSIVE MARKETING FOCUS: •Documentation to prevent audit; as well as compliance with EHR etc. •Outcomes Data Accumulation & Marketing •Grow NOW; it is an option and market share can be grown, or struggle later as M&A and Private Equity Peak •Get Accredited •Expand to addition levels of service •Set Realistic Admissions Goals •Make a Marketing Plan with Goals & STICK WITH IT! •TRACK AND ANALYZE ALL COST-PER-ACTION FROM MARKETING CHANNELS! MARKETING BUDGET • Admittedly, I am a LITTLE bias towards digital channels • Google influences between $5-20 BILLION of the $35 billion generated in the industry (86% of addicts use the internet for treatment research!) • The most successful addiction treatment facilities utilize the following marketing channels: MARKETING CHANNELS • Direct Sales Force – Focus on channel partners such as hospitals, other treatment facilities, interventionists, psychiatrists, employers and unions (mobile tools?) • Alumni – This is a low cost and high conversion channel (Aftercare communications? Outcome data?) • 49% recommend family, friends and colleagues contact the same facility • 16% posted social media reviews • 19% posted a review on a website MARKETING CHANNELS • Television and Print Advertising – Include running TV and radio commercials, print ads in newspapers and magazines/bulletins or even outdoor billboards • Paid Leads (Calls/referrals) – The channel no one likes to talk about – Not recommended, but people do it… (The irony is a mark-up on these leads which were likely generated with PPC/SEO) • Internet/Digital (Direct) – 86% of patients use the internet to research and/or find the addiction treatment facility they chose to go to MARKETING CHANNELS • Internet/Digital (Indirect) – The Ultimate Sales Assist – Enhances close rate of all other channels – Medium by which prospects, alumni and partners can interact with you 24 hours a day/ 7 days a week – Provides transparent information about your programs, describes your amenities, alleviates fear – Through mobile and e-mail can even reach out to alumni, clients and prospects to provide encouragement and support – Google’s marketing multiplier of >25% additionally offline (Spend $1 online, get at LEAST $1.25 worth of total marketing) SIZE OF DIGITAL MARKET SIZE OF MARKET • How many people search for drug addiction treatment on the internet? – Estimate total searches at 2.1 million from the top 3 keyword phrases alone!!! SIZE OF MARKET EXAMPLE • Keywords and Related Traffic: – Drug Rehab(s) – Averages over 900,000 searches per year in the US – Addiction Treatment Program – Averages over 700,000 searches per year in the US – Drug Addiction - Averages over 500,000 searches per year in the US Sums to 2,100,000 queries per year SIZE OF MARKET EXAMPLE • How does 2,100,000 queries translate into addiction treatment prospects for your business? • On average, a person performs between 1-10 search engine queries per day • 2,100,00 / 365 days in a year = 5,753 queries per day for the 3 key phrases identified • Assume that a person used up all 10 searches that day on these 3 keyword phrases • 5,753 / 10 searches = ~575 different people SIZE OF MARKET EXAMPLE • At least 575 unique people per day or 210,000 people per year were looking for addiction treatment services on the internet this past year FROM 3 PHRASES • Tip of the iceberg - This assumes that there search queries had at least 1 of only these 3 phrases in it • Google processes 3.5 billion queries per day in the US • On average 15 percent are new, previously unread or unheard queries DIFFERENCE BETWEEN ORGANIC SEO AND PPC SEARCH ENGINE OPTIMIZATION (SEO) • Focuses on making a website’s content easy to read by Google (Not YOU!) • Involves activities that produce content that most closely answer a search engine query (25%+ semantic Q&A structure now! Not YOUR opinion!) • Seeks to get your website and content listed in higher positions in the organic content section of a search result. Your duty is to help people -- Focus on THEM (Not YOU!) PAY-PER-CLICK (PPC) • Allows you to pay on a per-click basis (as the name implies) each time a search engine user clicks your ad • Ads are placed in the most highly viewed section of any search results (relevance matters!) • Can target certain geographies times of day, queries and set a budget (day-parting) BALANCING REGULATION & MARKETING ADVANTAGES TO PPC • MARKETING COST TRENDING • REGULATION TRENDING ADVANTAGES TO PPC • Can get immediate results • Purely pay for performance, you only pay when someone clicks your link • You set your time and amount of money to be spent • Ability to buy position in search engine query results • Allows for different formats and differentiated copy • Easy to get accurate statistics on performance • Display ad network as well DISADVANTAGES TO PPC • Price is based on an auction process whose ultimate winner is Google • Retargeting is not allowed by Google for addiction treatment so often times users click paid ads 2-3 times at premium prices for one qualified user's visits (avg 14 day decision time) • About 50-60% of all internet traffic is from mobile devices and many addiction treatment facilities present a weak mobile presence or call to action that lead to lower conversion • Mobile ads/sites need to be short and sweet! DISADVANTAGES TO PPC • No long-term value, once you stop a campaign, related website traffic will disappear, also pausing resets price • Competing over a smaller number of clicks – around 75% of all clicks are made on SEO results, and people trust organic clicks more • Larger bounce rate than organic search clicks – this means that traffic driven to your website by a PPC campaign, spend less time on your website learning about your company • Inflationary trend in Addiction Treatment queries ^ ADVANTAGES TO SEO • More cost effective in the long-term as search engines will rank a website higher over time based on page content, quality links, credibility, etc… as opposed to paying for it • Builds a portfolio of durable digital assets that hold value • Enhance credibility with partners, alumni & other audiences • Website can be designed for multiple audiences • Provides long-term and lasting results DISADVANTAGES TO SEO • Takes longer to see results – from 6-12 months in this ultra-competitive space (shorter if you have a good start) • Requires continuous, consistent work to produce results • Difficult to discern direct and indirect admission effects of campaign • Requires significantly more back-end coding, linking, tagging, load speed, and optimizing to ensure search engine robots can quickly and easily find and index website PPC OR SEO WHY CHOOSE? • Jumpstart an SEO campaign with PPC to garner high quality and relevant traffic to your business faster than SEO alone • Pull back on PPC spend long-term but keep SEO constant • As your facility ranks higher for valuable keywords, decrease PPC spend if needed and to counter the effects of seasonality • When beds are full, decrease SEO spend to maintenance and ramp up only as needed PPC OR SEO WHY CHOOSE? • Pull back on PPC spend long-term but keep SEO constant • As your facility ranks higher for valuable keywords, decrease PPC spend if needed and to counter the effects of seasonality • If PPC spend stays the same annually, expect 10-20% fewer admissions than the previous year (Google Inflation) WAYS TO IMPROVE ADWORDS CAMPAIGN WAYS TO IMPROVE ADWORDS CAMPAIGN • Research keywords that your think your prospects are searching for (substances, locations, etc) • Write targeted ad copy & geography based ads • Develop separate landing pages for each PPC campaign and track results • Do not send PPC traffic to your home page WAYS TO IMPROVE ADWORDS CAMPAIGN • Use filters – such as day-parting, geo-targeting, device targeting and word exclusion lists (exclude the word “free” in all campaigns!) • Your Google rep is not your friend (THEY ARE SALESPEOPLE!) • Demographic targeting from data provided by Google tools WAYS TO IMPROVE SEO CAMPAIGN WAYS TO IMPROVE SEO CAMPAIGNS • Build a lead generation focused website targeted at encouraging your prospects to call or submit a contact form. “Call-To-Action” – Identify who they are shopping for • Focus on creating volumes and a variety of content based around keywords • The “other” search engines like Bing, etc WAYS TO IMPROVE SEO CAMPAIGNS • Different types of digital content: • • • • • • • • • • Blog – can be current events, specific or general Targeted landing pages – pages that have content targeting a specific topic or key demographic Videos – including testimonials Infographics Ad Images Slideshare/presentations Wordle/Tag Cloud Ebook White paper Long-form content – a blog or other form of content that is greater than 1,000 words • • • • • • • Press release Case study Podcast Listacle - An article presented in the form of a numbered or bullet-pointed list. Interview Quiz *The list goes on, but this stuff isn’t easy… WAYS TO IMPROVE SEO CAMPAIGNS • Create a link-building plan/partners • Use social media to push content • Stay current – Google and the other search engines update their search algorithms constantly – Don’t fear a ‘Mobilegeddon-levelevent’… prepare for it – SEO is durable & holds long term equity value BOTTOM LINE By using multiple marketing channels, supported by a strong internet presence and credibility strategy, enhanced by a long-term SEO marketing campaign and supported by Pay-Per-Click advertising an addiction treatment facility can: • mitigate the rising cost of Google Adwords™ & Increasing regulatory and merger activity • Decrease cost per admission (or hedge against rising costs that competitors WILL incur) • ensure a long-lasting stream of new customers will find them in any market environment LITTLE DOUBT The internet should be a significant part of your overall marketing budget to fight “The Squeeze”… • As an INVESTMENT, not cost • EXTREMELY difficult to stay up to date internally • Investments require risk mitigation to be effectively managed (i.e. hedge funds) • Key Risk: Novices WILL be taken advantage of by competitors (i.e. SHARK TANK!) Questions? To receive a copy of Dreamscape Marketing’s white paper on this topic or consult with Dan Gemp: (877) 958-9180 for Appointment Go to: Our Website to download whitepaper FREE* *On or after Wed. June 17, 2015!! e-mail or call Dan Gemp at: [email protected] Toll-Free | 1-800-571-8553 x 4