SEARCH ENGINE MARKETING IN ADDICTION TREATMENT: PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

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1 SEARCH ENGINE MARKETING IN ADDICTION TREATMENT: PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

2 INTRODUCTION Marketing in the drug addiction treatment field is one of the most expensive propositions a company can undertake. Why is that? The primary reason is that the customer lifetime value of a person receiving addiction treatment far exceeds that of most other industries. Undoubtedly, this has led to three of the most common words used in the addiction industry recovery, rehab, and treatment landing within the top 20 most expensive keywords on the internet. But it could always be worse. Insurance, loans and mortgages are the top three most expensive key words and all relate the financial services industry. Marketing on the internet follows the same rules of increasing costs, but there is hope. With effective marketing portfolio management, an addiction treatment facility can: Win the marketing game Fill its beds Help people kick addiction At the end of the day, a facility can make money while at the same time treating all patients with the respect and dignity they deserve that will enable them to live better lives. The greatest driver of marketing cost inflation is competition, which can come in many forms. It could be fewer potential customers, more competitors, fewer marketing channels or some combination of all of them. It has been well documented through various government sources that many more people need addiction treatment then are receiving it today, which allows for a large pool of prospective customers. But over the past several years, the addiction treatment industry has seen the influx of money from Wall Street and private equity as well as the expansion of many well-established brands, which has served to increase overall competition. Consequently, the overall cost of marketing in the industry has gone up and will continue to do so for the foreseeable future. SHOULD I INCLUDE THE INTERNET/DIGITAL IN MY MARKETING BUDGET? Yes, but admittedly, I am bias on this point. The most successful addiction treatment facilities utilize multiple marketing channels, optimizing each channel to obtain the lowest cost per admission, at the highest quality and lowest risk. The five primary channels used are: 2 PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS 1. Direct Sales Force: Salespeople are very expensive but can be extremely effective. Facilities can best leverage this channel by focusing efforts on channel partners such as hospitals, other treatment facilities, interventionists, psychiatrists, employers and unions. 2. Alumni: Even for new facilities that are just welcoming their first patients, the need to nurture this low-cost, high-conversion channel is critical to a facility s long-term success. Studies have shown that after a stay with an addiction treatment center, 49% recommend family, friends and colleagues to the same facility, 16% posted social media reviews and 19% posted a review on a website. 3. Television and Print Advertising: This channel can take many forms, from running TV or radio commercials, print ads in newspapers and magazines to the use of outside billboards. 4. Paid Leads (Calls/referrals): This channel involves some ethical dimensions that are beyond the scope of this paper. Nevertheless, many facilities choose to purchase leads via intermediaries or directly from providers that forward calls or submissions garnered from their own nonbranded marketing initiatives. 5. Internet/Digital: This channel includes all types of online and digital marketing, including websites, mobile apps, , tweets, social media ads and posting, videos, podcasts and anything that can be provided via electronic means. With the first four channels sounding so robust, who needs to worry about the internet/digital channel anyways? Everyone! A whopping 86% of patients use the internet to research and/or find the addiction treatment facility they chose to go to.

3 What does this mean to you and your treatment facility? Essentially, two things: 1. Offline Multiplier Effect: There is a well-known offline multiplier effect to all digital marketing campaigns. The actual offline sales impact to your business may vary greatly, but Google has previously pegged the marketing multiplier effect at 25%, but with so many of an addiction treatment center s prospective customers looking for answers online, more conservative rules of thumb may not apply. What this means is that for every $100 in sales that can be traced directly to your internet marketing campaigns, there is an additional $25 in sales that is generated in offline (in-person) sales. Intuitively, this makes sense. Not everyone who researches drug treatment services online will call you, you, or complete a submission form online. In fact, many will instead contact one of your partners, sales people or your intake person directly. 2. Improved Close Rates: Having an internet/digital marketing initiative enhances the close rate of all your other channels. Your website is basically a salesperson working 24/7 just for you. It is also a conduit that helps the others channels close sales by providing a medium where every prospect, alumni and partner can interact with you in real time. Your website provides information about your programs, describes your amenities, alleviates fear and, with the addition of mobile apps and , even reaches out to alumni, clients and prospects to provide encouragement and support. With the unlimited scope and reach of the internet and your website s ability to offer virtually unlimited sales assists to your other marketing efforts, the internet is clearly an important part of any effective addiction treatment facility s overall marketing program. Many facilities fail to take advantage of this amazing resource because the internet can appear so daunting. We all use the internet every day and it seems so simple, but how many of us really know how it all works? I can tell you that the internet is exceptionally easy to use, but it is not simple to master. The goal of any internet campaign is to garner traffic. Traffic can be obtained primarily in two ways: through an SEO or PPC marketing campaign. Both SEO and PPC campaigns (which Google calls Adwords) seek to target keywords and phrases that people search for and provide results. The higher a website page ranks in a search query results rank, the more people click on it. HOW MANY PEOPLE SEARCH FOR DRUG ADDICTION TREATMENT ON THE INTERNET? A lot! Looking at some key search terms related to drug addiction treatment and their annual volumes 1 : Drug Rehab(s): Averages more than 900,000 searches per year in the United States. Addiction Treatment Program: Averages more than 700,000 searches per year in the United States. Drug Addiction: Averages more than 500,000 searches per year in the United States. Putting these numbers in perspective: The above searches add up to 2,100,000 queries per year. However, since a person can search multiple times, how does this translate into addiction treatment prospects for your business? Although the number of search queries per day varies dramatically per person and situation, there are multiple studies/statistics 2 that show, on average, a person performs between 1 10 search engine queries per day. Let s be conservative and say that the average person does 10 searches per day. Taking 2,100,000 and dividing it by the number of days in the year (365) gets about 5,753 searches for the above terms per day. Assuming that only 1 in 10 of these searches is a different person, then at least 575 unique people were searching for addiction treatment services in the US each day using these keywords. This equates to nearly 210,000 per year and this is only with three keywords! Assuming that the average treatment (in-patient and out-patient) would cost about $15,000, this equates to more than $3 billion in potential sales. Not all of the 2,100,000 searchers will convert to an admission, but this represents $3 billion in sales that can be influenced in an industry that is estimated to be worth about $35 billion annually. The above is only a small fraction of the potential queries people considering drug addiction treatment search for. Google processes 3.5 billion queries per day in the U.S. 3, of which approximately 15% are new, previously unread or unheard queries 4. This means the market potential is growing and Google keeps looking for answers to these unknown questions. 1 Volumes taken from Google Adwords keyword search tool 2 See: ; Organic search results are located below paid ads, but garner a majority of search engine clicks (assumed to be around 80-90%) 3 PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

4 WHAT IS THE DIFFERENCE BETWEEN SEARCH ENGINE OPTIMIZATION (SEO) AND PAY-PER-CLICK (PPC)? SEO focuses on making a website s content easy to read by Google so it can be found when people search for it and works to produce content that most closely answers a search query s intended purpose. This allows search engines to distinguish your website and content from the billions and billions of other websites and content available online. An SEO campaign works to get your website and content listed in increasing higher positions in the organic content section of a search result. Adwords allows you to pay on a per-click basis (as the name implies) each time a search engine user clicks your Ad. The Ads are displayed on the top right hand side of the search results which is typically the most highly viewed portion of any search results, and account for the first three positions. You can target your Ad to only appear for certain search queries, certain times of day and up to a certain number of times based on your budget. The cost for each click and its rank within the top three spots is a function of your budget and what is called a quality score. A quality score is a rating by Google of your Ad s relevance to the keyword you chose and the website page the ad points to. For example, if you want your Ad to show up whenever the words Drug Rehab are searched for, but your Ad is about carpentry and people do not click on it, Google will penalize you by charging you more per click, dropping your rank to the last of the three positions or just choose not to show it at all. Generally, the higher a campaign s quality score, the lower the overall cost-perclick (compared to competitors). The higher the Ad ranking, the more times Google will choose to show it when the keywords you selected are searched. IS IT BETTER TO DRIVE TRAFFIC TO MY WEBSITE WITH A PPC OR SEO CAMPAIGN? It depends on what your goals are and the length of time you are able and willing to invest in the channel. Always remember that every business is absolutely unique, so what works best for someone else may not work best for you and nothing will work best 100% of the time. What are the pros and cons of using each? ADVANTAGES TO USING ADWORDS: 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 DISADVANTAGES TO USING ADWORDS: Price is set based on an auction process whose ultimate winner is based on the price a company is willing to pay. This causes consistent upward cost inflation. How much inflation? It varies dramatically across industries, keywords and geography, but studies have generally ranged in the 5 12% range. With search marketing generally growing at 16% per year, and the addition of new money into the addiction treatment field, cost inflation on many common addiction treatment keywords can increase 10 20% per year. This has produced addiction-related keywords with costs upwards of $70 $80/click. Remarketing is not allowed by Google for addiction treatments so you are not able to efficiently influence them throughout their research journey. About 60% of all internet traffic is from mobile devices and many addiction treatment facilities present a weak mobile presence or call to action, which leads to lower conversions. No long-term value. Once you stop a campaign, website traffic will disappear. Competing over a smaller number of clicks around 80 90% of all clicks are made on SEO results, and people trust organic clicks more. Larger bounce rates 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. 4 PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

5 ADVANTAGES OF SEO: More cost effective this occurs in the long-term as search engines will rank a website higher over time based on page content, quality links, credibility, etc. Builds a portfolio of durable digital assets The backbone of SEO is content. The more content you place on your website, the more likely that people will find the answers they are looking for when they perform a search query. You want them to learn about your facility. More importantly, you want them to understand why they should go to your facility rather than one of your competitors. Enhances credibility with partners As stated previously, about 80 90% of searchers click on organic search results as a paid ad implies that a website may lack good content because it must pay to show up in the results. Website can be designed for multiple audiences allowing you to target the appropriate content to the most interested searcher, enhancing conversion. Long-term results A first-page search query listing is not easy to obtain, and therefore is not easy to lose. Although sufficient content creation maintenance needs to be performed to remain in the rankings, lower, long-term costs will decrease overall cost per admission. DISADVANTAGES OF SEO: Takes longer to see results If you are unable or unwilling to budget for at least 6 12 months, your money might be better off spent on PPC or other marketing channels. Requires continuous, consistent work to produce results One of the hardest parts about an SEO campaign is that it is more of a marathon than a sprint. Results from an SEO campaign require consistent application of a well-thought-out strategy that produces a cumulative effect with lagged results. For example, did a prospect find your name and called you immediately because he/she saw an ad? Probably not, but most prospects take more than two weeks to perform research and visit at least two or more treatment center websites before scheduling an appointment. Many times they research a treatment center based on conversations with your partners, referrals, alumni and family who also use your website to judge your credibility and quality of your service. As stated before, this enhances close rate from all other channels. Greater depth of conversion rate optimization resources needed For an SEO-focused website to convert website visitors into admissions, there needs to be effective back-end coding, tagging and optimizing for search engine robots, callto-actions, call tacking and effective copy that makes people want to call you. All of this is not easy to accomplish. If done incorrectly, it may leave the website vulnerable to hacking, spam or loss of search rankings. WHICH SHOULD I CHOOSE PPC OR SEO? You should choose both. A PPC campaign is a critical tool that can help your website garner traffic that it may not typically get and help to jump start an organic SEO campaign by getting high-quality leads to you sooner. With the cost-per-click increasing at a rapid pace, sole reliance on this form of internet advertising will only lead to a higher cost per admission over time. However, by combining PPC with an SEO marketing campaign, an addiction treatment center can have its cake and eat it too, lowering the cost per admission over time, while also filling beds in the short-term. Regardless of strategy, to maximize return on investment, an addiction treatment facility should seek to be on the first page of as many search engine queries as possible. The reason is that a very small percentage of users actually go to page two or three of a search query. Studies vary, but, generally, the first page of query results get about 70 80% of all clicks with the first five organic (non- Adwords) results getting about 60 70% of the total. Results on page two and three account for only 5 6% of all clicks and the remainder are spread among all other pages. 5 PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

6 KEY WAYS TO IMPROVE YOUR ADWORDS CAMPAIGNS Similar to an SEO campaign, start with researching keywords that you think your prospects are searching for. Then write Ad text that is specific to the key words you choose. It sounds simple, but many people use the same text copy for all campaigns. People are more likely to click on an Ad that is most relevant to what they are searching for, so write a lot of targeted copy. Assuming that someone clicks on your Ad, do not send them to your homepage. This may increase your traffic but typically offers much lower conversion because your homepage does not directly address what a person was searching for. For example, people searching for drug rehab in New York would be much more likely to call or submit a contact form if the web page that they landed on (after they clicked the Ad) addressed why they choose to go to your facility in, let s say, Florida, when they live in New York, then they would otherwise. The added benefit of doing this is that it increases your quality score, a key component of cost-per-click and ranking. In addition, make sure your call-to-actions, such as toll-free number, buttons and contact forms are prominently displayed, to encourage your visitors to call you. Use the filters on Adwords, such as dayparting, geo-targeting, device targeting and word exclusion lists (exclude the word free in all campaigns). This will lower the number of impressions you may get but increase the probability that the people who you are most interested in connecting with are reached. Google reps are not your friends so stop listening to them. After using Adwords for a few months, you have no doubt been contacted by your friendly Google rep. Google generates 97% of its revenue from advertising. Even with the best of intentions, there is an inherent bias that will occur when they seek to help you improve your Adword campaigns. At Dreamscape Marketing, we have found many clients who, on their own, kept on adding more and more keywords increasing PPC budgets, but wound up seeing little to no benefit or ROI. By using a marketing agency or other outside consultant, you will better be able to validate recommendations to ensure they will work best for your particular situation and goals. KEY WAYS TO IMPROVE YOUR SEO CAMPAIGNS Start with the foundation. Build a lead generation-focused website targeted at encouraging your prospects to call or submit a contact form. Many treatment centers focus solely on their brand and lose focus on their customers. People who suffer from addiction need help. A well-designed website that is targeted to meet their needs (not yours or your investors) will go a long way to enhancing your overall business. Focus on creating volumes and a variety of content based around keywords. At Dreamscape Marketing, we have a list of 10 phrases and keywords that we found most effective in the addiction treatment industry. We work with each of our clients to target these words in direct, long tail and alternative searches that will best meet the clients objectives. For those doing this on their own, the process is similar. Pick 10 keywords or phrases, target content toward them get ranking repeat. 6 PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

7 TYPES OF CONTENT THAT CAN BE UTILIZED TO DO THAT INCLUDE: 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 And many, many more. Create a link-building plan Having great content is only half the battle, the other half is distributing it. Dreamscape Marketing has identified dozens of both targeted and general directories and social media platforms to get your content visible to those that are looking for it. It is important to note that a social media presence within addiction treatment is different than most other industries. Due to the significant market stigma that still exists, a content push as opposed to community building-type approach to social media may be more effective. For example, alumni may Like and Share your page on Facebook, but those seeking treatment are less likely to contact you through the platform, unless they reach out to the alumni for help and support first. Stay current The internet is ever evolving. Google and the other search engines update their search algorithms constantly. The search updates that you may frequently hear about are just the tip of the iceberg and are signaling messages that Google uses to alter behavior. The most recent major update occurred in April of this year and was coined Mobilegeddon focused on the increasing use of mobile devices to access the internet. There are multiple online resources to help you do this and by doing so, you will mitigate the chances that one day you wake up and no one will be able to find you on the internet. CONCLUSION By using multiple marketing channels, supported by a strong internet presence, 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, lower its cost per admission and ensure a long-lasting stream of new customers will find them in any market environment. 7 PLANNING FOR THE RISING COSTS OF GOOGLE ADWORDS

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