Digital Profits Podcast – Episode 12: Case Study: Scaling Treatment Center Admits in 90 Days

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Get to know the basics of Pay-Per-Click (PPC) Advertising

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Build campaigns around those goals – choose ad networks, create targeted ads, and bid on relevant keywords

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Refine ad copy for better results and optimize campaigns on an ongoing basis

You know what they say: the devil is in the details. And when it comes to creating effective ad copy, that statement couldn’t be more accurate. Crafting the perfect message that resonates with your audience requires meticulous attention to detail, constant testing, and ongoing refinement. But don’t worry, with a bit of strategy and some expert guidance, you can optimize your ad campaigns like a pro.

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Tune in to the latest episode of the Digital Profits Podcast to learn the secrets behind transforming pay-per-click campaigns into roaring successes in the world of behavioral healthcare.

Join the Profit Squad and Sandstone Care as they share their expertise, guiding you through challenges and revealing strategies that boosted treatment center admissions by a staggering 134%. Gain insights into aligning real-world results with digital platforms and discover practical takeaways to elevate your own digital marketing endeavors. Ready to revolutionize your approach? Listen today and unlock the power of mastering Pay-Per-Click!

Welcome to the Digital Profits podcast, where you’ll learn how to grow your business faster using paid traffic and SEO. Each episode will feature a breakdown of digital marketing trends and answers to your burning questions that will provide actionable takeaways to make your marketing better. So join us, Ben Page, Race Sawvell, and Blake John, as we guide you on your journey to higher profits. Remember to join the Profit and get ready to profit in three, two, one.

Ben Page: Hey, squad, I’m here with Ray.

Ray Sawvell: Hey, Ben.

Ben Page: Another special episode, kind of a new format that we’re going to test out again this time. And we are going to run through a case study, real results that we’ve achieved for one of our clients.

Ray Sawvell: So excited.

Ben Page: Yeah. And to set the stage here at 2100 Digital, we are focused on organizations helping people, and usually by providing services to people that make their lives better in some way. That’s kind of our core passion and our core niche, digital marketing for those folks. And so last episode, we talked about treatment center marketing, and we did a deep dive into some big picture challenges and strategies and so on. So today we’re going to go deeper. We’re going to double click on that, and we’re going to talk about how we were able to achieve transformational results for a treatment center’s patient acquisition with pay per click marketing specifically. And that’s why you’ll notice Blake is absent right now. Ray, Blake is here to talk about PPC. And so let’s jump into it. Ray, who’s the client?

Ray Sawvell: The client is Sandstone Care. Great client, great cause. Ben, why don’t you tell us a little bit about them, like what they focus on.

Ben Page: Yeah, I guess a little background on Sandstone Care. They’re a national behavioral health care organization that helps teens, young adults, and their families overcome challenges with substance use, addiction, and mental health conditions. So they’ve got over two dozen physical treatment locations in three different US. Regions.

Ray Sawvell: And growth.

Ben Page: Right. They’re in growth mode. Super exciting, really important services that they’re providing to people. And the other cool thing is that they’ve got multiple levels of care across that inpatient outpatient spectrum in each region, and then they’re investing a significant amount in pay per click. It’s kind of like we talked about last episode. Or if you look at the treatment center marketing page on our website, we talk about this idea of the importance of search for this industry.

Ray Sawvell: I think Spend is almost close to two X year over year. So we’re scaling, we’re scaling fast. And that is definitely part of the challenge as well.

Ben Page: Yeah. So why are we working together? Why did they bring us on? Well, they brought us on to help manage this PPC engagement, specifically Google Ads and Microsoft Ads. And they’re super heavy in search, paid search specifically. Right. But yeah, I mean, Ray, why don’t you talk a little bit about the challenges they were facing when they originally came to us. What did that look like? What were some of those pain points?

Ray Sawvell: Yep, absolutely. As you know, they’re in hyper growth mode right now. And with the new treatment centers, new levels of care, they’re investing a lot more to fill beds today. So with scaling, it doesn’t always scale one to one. So one of the major issues that they were facing was an unsustainable cost per admit. The cost in the ad account was increasing, but they were also seeing the cost per admin increase as well. So we were seeing the price increase, but also the cost per admin increase at the same time. So it was kind of like growth pains as they were beginning to scale there. Also with that, growth became more competitive issues as well. So they’re going into new markets. There’s competitive issues and pressures that they haven’t faced before. So we’re seeing an increase in cost per click. We’re seeing issues with increase in cost per admin. So as we’re starting to scale more, we’re seeing that kind of go up across the board.

Ben Page: Yeah, I would agree with everything you said and yeah, just kind of mirror that idea. It’s not as though if you get one lead or one admission for $100 that you could assume you’re going to get ten for $1,000. It doesn’t work that way. Like you said, it’s not one to one. And the reality is, as you’re scaling, or even just even if you have a single treatment center location, there’s a certain amount of capacity you have at that center and you need that to be so full. You need a certain amount of heads and beds, to put it that way, to make it just viable and kind of sustainable. And so there’s real pressure to fill these and reach people in need. And part of that too, which we’ll kind of dig into, is as you go upstream, as you’re pouring more ad dollars into these platforms, you have to change and broaden some of the keyword targeting and things that you’re going after.
So what we’re going to do to kind of set the table is we’re going to talk about we’ll just highlight the results that we achieved for them in 90 days and then we’re going to really deep dive into how we did it at kind of a high level and then we’ll kind of go from there. And if you have any questions about the approach, we would love it if you reach out to us because we love discussing all of this and strategy in particular. So here it is. In 90 days, comparing year over year, we were able to increase treatment center admissions sourced from PPC campaigns 134%. But it gets crazier, right? The plot thickens while decreasing cost per admit by 25% at the same time. Insane how well I know we’re going to get into that. And the other thing is that alone is a great story for efficiency and scaling and kind of wrapped up in there, or you can kind of infer it, but we did that while spending 75% more year over year on PPC. So really cool.
So let’s talk about how were we able to do this big Picture, it’s like simple but difficult is kind of how I think about Know. We focused on our principles of paid traffic that we’ll deep dive into, and we took daily actions that were aligned with the end in Know, to use that Stephen Covey reference. Begin with the end in, you know, one of our core values. It’s customer obsession and something that also, I think, sets us apart. So I think our aligning their digital marketing and their campaigns with the reality they were facing on the ground is one of the number one things.

Ray Sawvell: Yeah, that was probably the biggest piece that helped move this forward.

Ben Page: Yeah, for sure. Aligning ourselves to that reality which we’ll talk about. And then like, Big Picture, we came in and like we always do, we’re looking for quick wins. And it was like, all right, let’s eliminate obvious waste and then begin the hard work of restructuring. And once you kind of restructure and get efficiency in a good spot, that’s when we began to really scale up, or kind of smartly scale based on census numbers and so on. All right, but Ray, four pillars. What are the four pillars? Let’s just refresh the audience on those.

Ben Page: Yep.

Ray Sawvell: The four pillars that we consider when it comes to paid advertising campaigns is your data component. Then we’ve got structure, targeting, and creative. And when we started to think about Sandstone, one of the first pieces that we did look at was data. So we’re going to kind of double click in on data specifically. And Ben, you sort of mentioned this earlier, but we really had to ensure that we were aligning what Sandstone was seeing in what was actually happening in their centers versus what the platforms were reporting. Because if you don’t have as close to parity between what is actually happening versus what is happening in the account, things are not going to look great. Because what we ended up seeing was that in platform we were seeing things like conversion rate conversions were reported up, but in actual centers, there were some issues with getting heads and beds, as you mentioned before. So I think the first big piece is ensuring that the cost per admin data that’s actually happening in centers is closely reflected, or you’re getting the appropriate conversion signals into the ad account. So that’s like one of the biggest pieces when we first started to ensure that we have proper data within the ad accounts.

Ben Page: Yeah, and to kind of go deeper there, our ability to operationalize census data and to make this real. So what we’re talking about here in real terms is every single day receiving census counts for each treatment center and then using that data to inform decisions about where we’re going to place budgets, how aggressively we’re going to bid based on reimbursement rates and level of care and capacity and all these different factors.

Ray Sawvell: That’s been a big that was one.

Ben Page: Big piece and another piece that is still in progress. But I think we’ve seen some movement is improving our Salesforce attribution from PPC campaigns and obviously more recently it’s been the migration to GA Four and all of that which we can possibly talk more about. But yeah, so aligning our data that we’re managing campaigns on to real life, I think is one of the number one things. And then Raid, you want to talk about focusing on. Well, maybe we should introduce what the conversion actions are.

Ray Sawvell: The big three conversions.

Ben Page: Yeah.

Ben Page: Yes.

Ray Sawvell: So for Sandstone, specifically, their big three conversions are a phone call, somebody calling in, somebody filling out an insurance form verification.

Ben Page: Yeah.

Ray Sawvell: VOBs on the site. So verification of benefits. And then the final one was a chat component as well. So somebody engaging with the chat on the site. Now, the big three conversions, they’re not all treated equally. And the reason why is because you have more likely to get spam as you kind of move up from these big three. So, like chat, the way that we think about it can be towards the bottom of those conversions. There’s more chance for spam to come in from chats. Same thing with phone calls. You can get shorter calls or questions where may not align to exactly what Sandstone does. And then the final one is that verification of benefits. So those are like the big three conversions within the Sandstone account and how we sort of optimize for those specifically.

Ben Page: Yeah. And to just break that down a little bit further, I think there are two things to consider. It’s like one, the conversion rate in I’ll define terms conversion rate of a website visitor to completing one of those big three conversions. It’s relatively higher for chats. Right. It’s a lower friction action and the intent may be lower. Right. So we were seeing higher conversion rates for chats. And then you might see kind of a middling conversion rate for phone calls. And then you would see maybe the lowest conversion rate or lowest number of conversions for VOBs because higher friction, more personal information is required. It’s a high intent form and so on. So here’s the second thing. The reality of conversion to admission based on the action is also different. Right. So it’s almost the inverse where the likelihood of someone chatting in to turn into an admission at one of the centers is relatively lower than someone who completes a VOB or even time as.

Ray Sawvell: Well can take longer. So that’s like the other piece, somebody who chats in, it could take longer for them to turn into an actual head in bed versus somebody filling out a VOB, right?

Ben Page: Yeah, exactly. And so that looking at that data and realizing the relative value of in this case, calls and know led us to kind of orient our campaigns more toward those. I think one of our challenges on the PPC side, it’s kind of like managing visibility in the markets and managing competitive pressure while still trying to optimize for these hard conversions, for lack of a better term. Yep.

Ray Sawvell: And we continue to face like, that’s a challenging issue as we continue to scale, open up in new markets, and we face different times of the year. So that just continues to be a focus as we continue to grow.

Ben Page: Yeah. And then kind of last in this data pillar. I mean, these few things we talked about already were huge drivers of results. They really are enablers. They enable us to make better decisions. Performance tracking. Let’s talk about that. Our custom dashboard, Ray, what does that kind of entail on a high level, and why is it important, why is it useful versus just looking at pulling up Google Ads and popping in there and saying, well, what’s going on today? Yeah.

Ray Sawvell: Well, I guess kind of focusing back, like backing up a little bit, looking at the daily census data. That’s really great to kind of see how we’re performing in each center, but then having daily performance data from each platform, from Google, Bing, wherever we’re optimizing ads, we have that data kind of broken down by how do we perform yesterday versus the last 714 30. And then we have it broken out by conversions as well. So we’re able to kind of see by center, by location, how are we tracking, how are we performing, and then, more importantly, how are we trending based on what we’re seeing in the platforms? And then, as you mentioned, Ben, if we’re seeing one center be down in census, we’re able to really scale that and push that based on what we’re actually seeing in platform.

Ben Page: Yeah. So the way I think about our performance tracker, which is one of our internal tools that we build, it allows us to make faster decisions that are better informed because we can see trends over time, different time horizons. And we can more quickly kind of look at what’s the delta of the reality on the ground versus what’s happening in the ad platforms. And I think it’s a huge advantage, frankly, versus having to wait or trying to look at it in a big picture, fuzzy way in the interface. You can really get specific by breaking it down in these different ways that aren’t accessible right out of the box. So then kind of like building off of this and moving into the structural pillar. What was our approach, Ray, as far as structure know, we inherited campaigns in a certain kind of format, but what were some of the steps we did in restructuring, especially Google Ads at the outset to help unlock this crazy outcome.

Ray Sawvell: Yeah, I mean, this was a big you know, this is a national provider. We have different levels of care audiences that we’re focusing on. So one of the biggest things that we did right away, and this took a while, was building out location specific campaigns. And it might sound really straightforward, but instead of having one Pmax campaign or one search campaign that is built out by market, it’s really getting into having very specific location campaigns. So then when we look back at the census data, we’re able to say, hey, in this market, we’re down. Let’s push here. By having the proper structure in place and having data alignment, we’re able to really scale based on where we’re seeing issues or being able to expand in specific areas. So really building out those location specific campaigns was crucial, but then down the line it was also building out specific audiences. So Samsung Care focuses specifically on young adults and teens, ensuring that we have those audiences built out.
So we have young adult coverage, we have teen coverage, and along with building out level of care so we might have like detox specific campaigns versus teen residential IOP. So we’re really able, if we see a specific program down now with the structure that we have in place, we can really scale by in a location and then also scale by the level of care and even by the audience. And there is definitely some overlap based on some of the search terms that come in, which is going to happen because the intent isn’t always clear, but we kind of are able to place our bets accordingly and be able to impact the census with our structure in place. It was a huge overtaking. And Ben, maybe you kind of talk about how we kind of started small before we kind of just rolled up the structure everywhere, right?

Ben Page: Yeah. Because they being sandstone care. Right. They existed first in Colorado and subsequently over time have launched in new locations and so on. But I think how we did it is we started in one physical area. We picked one of the higher traffic treatment center locations.

Ray Sawvell: Proof of concept before you blow it up.

Ben Page: Right. Because what we knew at the outset is we knew that from a user perspective, the way that people search for care, there’s going to be some overlap across the different locations. And we were pondering early days, we were already pondering this restructuring that would be by physical location first and then break down by audience level of care, et cetera. But the cool thing is, no matter which treatment center, as long as the levels of care are similar, there’s some base level of keywords that overlap, right. Like, I don’t know, rehab near me or whatever.

Ben Page: Right. So that kind of informs some of the structure. But then we also going this way helped us build out coverage that we might have missed otherwise too, with a more broad campaign structure, I guess, if that makes sense. In other words, there’s some keyword targeting carryover by location, but there’s also location specific targeting. But since we started in one area and we were able to map the known universe of search terms in that area and then we sort of categorized like, oh, this is a location intent search. It has a near me or a city or a suburb or like a county or a region type of modifier in that query. That led us to kind of like map the terrain. And then when we went to scale this structure elsewhere, we had already an idea of what it needed to look like from a keyword targeting perspective, which is pretty cool. Yeah.

Ray Sawvell: And the reason why you can’t we started small, obviously, with a proof of concept to make sure that this worked before we replicated it everywhere. But I think we talked about this earlier. One of the biggest challenges is competitive pressures by market. So even though you have relatively similar keyword volume by location, the competitors can vary differently drastically. And you’re bidding, you’re targeting. That’s where things get interesting because things that may work in one market, you may have to pivot slightly in another market based on what you’re seeing on the search engine result page.

Ben Page: Right. Like either a local only competitor versus national competitors that will compete with you in all of your treatment centers and so on. Yeah, kind of different pressures there, I guess. And I think too, it’s fair to say this is sort of moving into the targeting pillar. It’s fair to say that we started with more bottom of funnel, longer tail queries. The things that we knew we had to win is like, all right, if someone is searching with an audience in their keyword, like teen, like drinking rehab for teens or something like that, we better win that. So we’re like, all right, let’s become masters of bottom of funnel search first. And then as we needed more volume and just in general for testing, we started going after more progressively broader or less clear intent terms and found out what we could convert, what we couldn’t, what needed work and so on. But I think what structure and targeting have solved for us, it solved the ability for us to be able to affect change at the treatment center level based on the reality. It’s like, hey, we need to improve census over here at location X for.

Ray Sawvell: Detox scale that here’s how we’re going to do it and where we’re going to do it.

Ben Page: Exactly. Whereas before it was more, I don’t know, amorphous. I’m speaking kind of conceptually, but the idea is like, you could put a dollar into the system, but it would sort of be diffused over a broader kind of targeting and geography and you’d kind of hope that it would trickle down into the right area. But it didn’t always work that way. And that was part of the driving force, I think, behind why the cost per admin was sort of creeping into the unsustainable level for some of the levels of care and so on. But then also Ray, I guess to close out the discussion on targeting, you want to talk about segmentation and taking a campaign, breaking it down?

Ray Sawvell: Yeah, absolutely. I mean, the tighter segmentation that we have now in place is really crucial to having high relevancy when somebody’s searching for something, driving them to the right landing page and having the proper ad as well. So it’s really just allowing us, and this is getting into the weeds a little bit, it’s allowing us to have higher ad rank and quality score because we’re able to have much tighter ad group segmentation. So we’re kind of staying away from like broad match in most areas and we’re really just focusing on exact and phrase match keywords, so it’s allowing us to really scale and then we have ad groups broken out by theme. So it’s just really kind of tying into the point where we have a very unique search term that’s happening and then we ensure that the ad copy match. It’s very basic. PPC. Right. It’s like you have a search query that happens, you better have an ad that is really close to that search term and you better have a landing page that is really close to that search term. Instead of going broad like we’ve been talking about before, where we might have like a Pmax or a broad type of term that’s covering a bunch, we’re really siloing it and breaking it down where we’re to the point. Now where we probably have hundreds of ad groups by each one of these campaigns peeled out everywhere, allowing us to have the most relevant ad copy and landing page that we think is beneficial by search term.

Ben Page: Right? Yeah. And the problem before was that I call it SQR pollution, which probably means nothing to everyone listening. But when we look at the reports of which user searches led to your ads to show up when we had a less segmented campaign that we inherited, you would go into an ad group and let’s just use the example again of, I don’t know, rehab fourteen s. And in there we would find like, twelve different ways that someone might search for rehab fourteen s. And the problem is that those twelve different ways would each have a different conversion rate, some of them different intent. Yeah, different levels of intent. Maybe they weren’t all reflected appropriately in the ad copy and stuff, so they’re just issues. And so going to this tighter segmentation like Ray mentioned, allowed us to improve click through rates, allowed us to eliminate wasted spend, allowed us to improve conversion rates. And so hopefully you’re seeing the culmination of all these small decisions is what led to the big outcome. Let’s talk about Creative, because now, Ray, we’ve got a structure, we’ve got the right data that we need, we’ve got better targeting. We’re really becoming masters of bottom of funnel search in these different markets. So what did we do with Creative to kind of take that to the next level?

Ray Sawvell: Yeah, I’m trying to think back to when we inherited this. Typically what we’ll do is most of these accounts will have some type of historic data. So we’re kind of peeling those best performers that have already been in the account. So we’re trying to find, like, top themes, combinations exactly, that are performed best historically. So we’re peeling those out and making sure that we have coverage for those top performers everywhere. That’s really crucial because if you’re running something, you already have some historic data that you can use to your advantage. But I would say the other big piece is really doing a competitive and SERP search engine result page analysis to ensure that.
What are your competitors going to market with? What does every SERP look like or the top SERPs look like for each one of your top performing keywords to ensure that? Are you, one, standing out in the SERP? But two, do you have a similar is it the same type of message? Are you able to really kind of capture what type of solution every search query is type of bringing? So I would say the biggest piece that we did was ensure that we had proper coverage when we first started for all the top historical performers and then start to peel out new themes and ideas based on what we’re seeing from competitors and, like, SERP analysis.

Ben Page: Yeah. And almost every time I audit an account and Ray, you tell me if this is true to your experience. Like, I feel like I’ve never once walked away thinking, enough ad testing has happened.

Ray Sawvell: Usually that tends to get lost.  I would say, if you don’t focus on it totally.

Ben Page: Yeah. And like, RSAs, responsive search ads, your paid search ads, in many cases, you’ll audit an account and just tens of thousands of impressions are accruing or more. Wow, this ad hasn’t been updated in two years or whatever.

Ray Sawvell: Yeah, we have that conversation a lot. Like, I would say, a key action for listeners right now. If this sounds like maybe a point of frustration, log into your ad account, look at the ads tab, and see when the last change was made to your ad copy. That might give you some insight as to, like, hey, our ads being updated enough. And if it’s not a focus, they’re probably not, right?

Ben Page: Yeah. And so common, too, that maybe there’s something that’s working really well and it just was missed. Like, oh, we never took the learning from this one and applied it over here and like, wow, those are some quick wins. But then thinking a little bit more about on this point of creative trying to the way I’m thinking about it with Sandstone Care specifically is we’re trying to creatively kind of reframe or re, I don’t know, just engineer the copy a little bit to better explain the benefits to the user and the unique differentiators of Sandstone Care. So in their case, the audience specific focus is a big one. Evidence based care is a huge one.

Ray Sawvell: Comfort. Right.

Ray Sawvell: Another big one. There’s lots of themes, compassion, kind of.

Ben Page: Bringing in the human element, so, like, bringing in their differentiators. But then also, to your point, looking at the SERP and looking at themes and what seems to be driving the copy of others, and then just right. Continuously testing these new approaches has led to gains in aggregate click through rate over time, which is great for other technical reasons too. But then one of the other huge gainers for us in the creative department, I’m calling it I have a silly name for it, landing Page Arbitrage, but really it’s about looking at conversion rate by landing page. Again, kind of classic stuff, but just making sure, hey, now we’ve got this new structure, it’s more targeted, making sure that for an audience ad or a level of Care ad or a location ad, are we sending people to the most appropriate, highest converting, best user experience landing page available. And if something isn’t available, let’s have a conversation with Sandstone Care, which we do all the time about, hey, we think we’d really benefit from this update on existing page or building a new page because this is a user need that’s currently yep.

Ben Page: Yeah.

Ray Sawvell: Like, we’re literally in the middle of this right now, and it’s not easy to tell, but if you just do like and this is getting into the weeds, but if you do an export of your landing page experience, you can quickly identify ads and keywords that might need some help from a landing page standpoint. So you can find some quick wins just by looking at quality score alone, right?

Ben Page: Exactly. So four pillars. Right. So we went through, we made all these changes, and again, we moved fast. This was like daily hustle. And once we had proof of concept, we started scaling out this structure across all of their locations. And then we were able to add, spend or subtract know on a daily basis based on the census data, based on campaign performance and so on. So, I don’t know, let’s start to kind of wrap it up. Ray, I hope this was valuable, and we’d love your feedback squad if it was, or what you’d like to hear differently.

Ben Page: Right. This type of, you know, we tried to, I think, lay out the principles in a way that they could apply even to other industries, niches, et cetera, but it wasn’t all encompassing and each situation is different. However, I will say that using this principles led approach, we do achieve similar results for other clients, other verticals. So ultimately, if you would like to review this case study more in depth, you can visit our website at two one 2100 and get that case study. But if you’re unsure about the kinds of returns you’re getting from your pay per click campaigns, and this is you, and you’re in charge of marketing for a treatment center, I’m encouraging you to reach out. And some of the other things might be if you just don’t feel like the data or the results you’re seeing in Google Ads or in Microsoft Ads are really aligning with the reality of what’s on the ground, or if you’re.

Ray Sawvell: Unclear if there’s a mismatch there or.

Ben Page: You know, and whether you’re managing it in house or working with an agency. If you feel like there’s an opportunity to better align your campaigns with the reality of your organization, please don’t hesitate to reach out. So go to our website, click on Contact US, fill out the form, and we’ll get back to you right away to set up a free audit. And we’re deep diving on this industry for a reason. We really care about it. We think that the work you all are doing here is super important, super impactful, and we just kind of view it as our mission to help you do a better job at what you do by doing a good job at what we do. And yeah, just kind of aligning all of our efforts with yours in partnership. So if that’s of interest, please reach out and otherwise give us your feedback and we’ll be sure to incorporate that on an upcoming episode. See you, squad.

Ray Sawvell: See ya.

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