This document summarizes a presentation about how addiction treatment facilities can deal with decreasing insurance payouts and increasing marketing costs, referred to as "the squeeze." It discusses factors driving this trend, such as industry consolidation through mergers and acquisitions, increased regulation and compliance costs, and rising costs of digital marketing channels. The presentation provides recommendations on using a balanced marketing approach combining SEO, PPC, social media, and other channels to hedge against rising costs. It emphasizes the importance of digital marketing and having a strong online presence to attract new customers and ensure long-term growth in a challenging market environment.

1. Surviving theSurviving the
Squeeze:Squeeze:
Decreasing Payouts, IncreasingDecreasing Payouts, Increasing
Marketing Costs…Marketing Costs…

2. PRESENTERPRESENTER
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.

3. GUEST FINANCE GURUGUEST 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.

4. TACTICAL GOALSTACTICAL 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

5. THE SQUEEZE:
WHAT IS HAVING
EFFECT ON PAYOUTS?

6. THE SQUEEZETHE 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!

7. THE SQUEEZETHE 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

8. THE SQUEEZETHE 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

9. THE HEDGE:
HOW TO FIGHT Rising
MARKETING COSTS

10. THE HEDGETHE HEDGE
DEFENSIVE MARKETING FOCUS:
•Sales Team & Professional Partners
•Focus on Alumni
•Mobile Technology & Video
•Content Marketing & Thought Leadership
•SEO vs. PPC

11. THE HEDGETHE 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!

12. MARKETING BUDGETMARKETING 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:

13. MARKETING CHANNELSMARKETING 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

14. • 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 CHANNELSMARKETING CHANNELS

15. • 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)
MARKETING CHANNELSMARKETING CHANNELS

16. Size of Digital Market

17. SIZE OF MARKETSIZE 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!!!

18. SIZE OF MARKETSIZE OF MARKET
EXAMPLEEXAMPLE
• 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

19. • 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 MARKETSIZE OF MARKET
EXAMPLEEXAMPLE

20. • 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
SIZE OF MARKETSIZE OF MARKET
EXAMPLEEXAMPLE

21. Difference Between
ORGANIC SEO
and PPC

22. SEARCH ENGINESEARCH ENGINE
OPTIMIZATION (SEO)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!)

23. PAY-PER-CLICKPAY-PER-CLICK
(PPC)(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)

24. Balancing Regulation
& Marketing

25. ADVANTAGES TO PPCADVANTAGES TO PPC
• REGULATION TRENDING
• MARKETING
COST
TRENDING

26. ADVANTAGES TO PPCADVANTAGES 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

27. DISADVANTAGES TODISADVANTAGES TO
PPCPPC
• 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!

28. • 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 ^
DISADVANTAGES TODISADVANTAGES TO
PPCPPC

29. ADVANTAGES TO SEOADVANTAGES 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

30. DISADVANTAGES TODISADVANTAGES TO
SEOSEO
• 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

31. PPC OR SEOPPC OR SEO
WHY CHOOSE?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

32. PPC OR SEOPPC OR SEO
WHY CHOOSE?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)

33. Ways to improve
Adwords campaign

34. WAYS TO IMPROVEWAYS TO IMPROVE
ADWORDS CAMPAIGNADWORDS 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

35. WAYS TO IMPROVEWAYS TO IMPROVE
ADWORDS CAMPAIGNADWORDS 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

36. Ways to improve
SEO campaign

37. WAYS TO IMPROVEWAYS TO IMPROVE
SEO CAMPAIGNSSEO 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

38. WAYS TO IMPROVEWAYS TO IMPROVE
SEO CAMPAIGNSSEO 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…

39. WAYS TO IMPROVEWAYS TO IMPROVE
SEO CAMPAIGNSSEO 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-level-
event’… prepare for it
– SEO is durable & holds long term
equity value

40. Bottom Line

41. 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

42. LITTLE DOUBTLITTLE 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!)

43. 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:
dgemp@dreamscapemail.com
Toll-Free | 1-800-571-8553 x 4
Questions?Questions?