The Quiet Disappearance
of Substance Abuse Marketing
In the 1980's, when health care marketing first blossomed as a major industry--complete with its own publications, convocations and gurus-- no specialty area commanded more marketing dollars than substance abuse treatment.
The ads were everywhere--TV, print, radio, and especially the Yellow Pages. A competitive institution--either free-standing or hospital-based--would often buy a half page or more of Yellow Page space under both "drug treatment" and "alcohol treatment" (thereby doubling the Yellow Page ad revenues in one clever stroke). Whatever the media, the ads were consumer-driven and results-oriented. The goal was to fill the generous supply of inpatient beds with paying customers.
No more. Today, the collective space among all providers dedicated to drug treatment amounts to less than half a Yellow Page, and most of that is for outpatient services. The same is true for alcoholism treatment. Gone altogether--not just from the Yellow Pages but from the Metropolitan Area--are any number of once celebrated institutions, among them Charter Hospital, North Hills, and the Kansas Institute, the last once considered "the Cadillac of inpatient psychiatric care."
The glory days of substance abuse treatment are over.
And the marketing dollars are long since gone.
Today, the national Addiction Resource Guide lists only three non-hospital based facilities in the greater metropolitan area: Atchison Valley Hope in Atchison, Mainstream Kansas City, Inc. in Bonner Springs and Two Rivers in Raytown. Each of the three has a small display ad in the Yellow Pages, and only Two Rivers still maintains a consistent TV presence.
So what happened? One could more easily reconcile the near disappearance of so flourishing a market if the disease had disappeared the way, say, polio did in the 1950's. But there is little evidence that chemical dependency has diminished in any meaningful way.
What has changed is the way care is managed. When managed care companies entered the substance abuse scene in the late 1980s, they applied a long overdue dose of scrutiny. What they found was an excess of beds, an excess of cost, and, from their perspective, an over reliance on inpatient care. Eric Schmidt, CEO of CommCare, a managed care entity that deals exclusively in behavioral health, has watched the transition with a keen eye. As he notes, the substance abuse field has gone from a buyer's market to a seller's almost overnight. There is little need to advertise anymore, as Schmidt points out, because "patients have such limited choices." Despite the tight market, tightly managed care has minimized the benefit to the seller. Schmidt observes, "More and more mental health providers are getting out of the business."
Jeff Benz, the CEO of Mainstream K.C., Inc., the only remaining inpatient center dedicated primarily to chemical dependency in the five county metro, affirms Schmidt's observations. "Managed care has no interest in us," he admits. By all accounts managed care screeners prefer outpatient care, and today they monitor virtually all insurance-driven decision making.
Benz has staked out his institution's position in the narrow no-man's-land between state-subsidized care and privately managed care. 80% of his patients pay their own way, and this is possible only because Mainstream K.C. charges $3,600 for a 30 day stay, a fraction of what inpatient treatment centers traditionally demands.
Given his narrow margins, however, Benz can afford to do almost no consumer-oriented marketing. Instead he markets directly to intermediaries like hospitals and behavioral health counselors. Those substance abuse centers, inpatient or out, who depend on managed care understandably direct much of their marketing attention to its decision makers. As a result, the consumer is left with fewer options and less control over the options he has.
So where have all the patients gone, the ones that passed through the area's numerous inpatient centers? Schmidt suggests that to a certain degree demand during the 1980's was heightened by the advertising itself and by substance abusers' consequent willingness to open up and seek help.
Benz fears that many of those who have been turned away from inpatient treatment have found their way instead to prison. On a more positive note, benz believes that many others have found help through more traditional resources like Alcoholics Anonymous.
In any case, the glory days of substance abuse treatment are over. And the marketing dollars are long since gone.