Marketing as a MAT provider is much different than marketing for other levels of care, such as detox, residential, or outpatient.
Patients seeking help with an opioid use disorder have different circumstances and motivations that require the right campaign messaging and channel targeting.
Defining Our Audience for MAT Treatment
As always in marketing, we have to know who our patients are and what their needs are. MAT patients are those looking for relief from opioid use disorder (OUD). There is some experimentation with MAT for other addictions, but OUD is primary as of right now.
While some of the commercially insured seek out MAT services, most will go to a rehab with detox through outpatient levels of care or they will go to a private physician who writes prescriptions. So serving the commercially insured is a different setup compared to serving those on Medicaid.
There are many reasons for this, but two of the primary ones are culture and insurance coverage. For the commercially insured, most people think of detox through outpatient levels of care when they think of treatment for SUD. Their insurance also pays for those levels of care. For many on Medicaid, most programs don’t accept their insurance and they are more likely to seek out services with a less onerous time commitment.
Patients with Medicaid are the primary utilizers of MAT clinics with over 80% of patients on Medicaid at most clinics. This article will primarily focus on marketing to the Medicaid audience. If you’re looking for information on marketing treatment services, MAT or otherwise, to the commercially insured, see our article here.
MAT patients tend to be a 50/50 split between men and women and are mostly white. Even when zip code demographics are primarily black or hispanic, more than half of patients admitting into the clinic will be white. These demographics need to factor into campaign targeting, messaging, and imagery.
Now that we know who our patients are, what do they need? There are 3 things every MAT patient cares most about:
- The medication
- Speed
- Cost
We’ll take a look at each of these in turn as each factor determines a primary component of the marketing message and channel strategy.
A Prescription Is Concern #1
Patients want the prescription. That’s why they seek out MAT services. Patients are not looking for a detox, residential, or intensive outpatient level of care. If they were, they would be calling a provider that offers those services. The niche of the MAT provider is that their focus is on the ability to provide prescriptions for opioid use disorder. This is really important because we’ve found the MAT providers often confuse the two. MAT providers see themselves as a recovery provider first and foremost and only secondarily as a provider of prescriptions. Patients view MAT clinics in the exact opposite way.
Another fact to keep in mind is that at least 50% of patients have no interest in leaving drugs or alcohol behind. They want to get off opioids, which is why they’re coming to you, but that does not mean they have an interest in quitting all drugs. Opioid addiction can be a nightmare. Because of how sick users feel when withdrawing from the drug, their lives can become centered around acquiring and using opioids. And, when you’re living below the poverty line, finding the money to maintain a drug habit is not easy. Many users reach the point where the drug has taken over their whole life and all they want is for that to stop.
This doesn’t mean they still don’t enjoy getting high. Drugs and alcohol can make a boring life feel more interesting, are often a way to socialize with family and friends, and help one deal with the many struggles of life in poverty. In this way, a message around “comprehensive recovery” or “freedom from drugs and alcohol” doesn’t resonate with a good portion of patients.
All of the above tends to bother providers. Providers tend or want to view themselves as offering comprehensive solutions which help people find lives free from drugs and alcohol. Some providers don’t even want to use the words “Suboxone” or “Methadone” on their sites, or they use them as sparingly as possible because their focus is on recovery, not medication.
This is the wrong approach. We have to start with what the patient wants, not how providers want to see themselves. Like any product or service in the marketplace, we have to meet the needs of our customers, which means leading with the prescription.
Patients also usually know what prescription they want - Suboxone or Methadone. This is because most have either already tried both on the street or have tried other clinics before. Providers tend to see MAT as MAT, but patients are very conscientious of which medication is being provided. Patients who have chronic pain issues often prefer Methadone. Those with a preference for Methadone also feel that Methadone works better for them and they sometimes find value in the daily routine.
For those that prefer Suboxone, they have found it helps with cravings and withdrawal better for them and they desire the freedom and flexibility of not having to come to the clinic every day.
Whether the preference is for Suboxone or Methadone, both types of patients want the medication as soon as possible.
The Most Important Thing: Providing Medication Fast
Most patients seeking treatment for Opioid Use Disorder (OUD), particularly those on Medicaid, seek out treatment once they’ve run out of options or they’re at their wits’ end. Some patients simply aren’t able to find any opioids, so utilize MAT services as a way to hold them over that may or may not turn into longer term care. Others are so sick and tired of the opioid use rat race (get high, start to go into withdrawal, scramble to find money and drugs, do it all over again), that they are seeking a long-term solution.
Either way, prospective MAT patients know they are about to become violently ill and go through dreaded opioid withdrawal, so they want help now.
This situation presents a conundrum for many providers because there is a business model for simply providing prescriptions as fast as possible, and some providers do just that. Fast prescriptions with no additional requirements are available to patients through some brick and mortar clinics, individual physicians or nurse practitioners, and some telehealth MAT providers.
Money Matters
In the world of MAT, traditional supply/demand dynamics can be subverted because the patient really, really needs the medication. Before insurance covered MAT, patients would cough up $400 a month out of pocket or jump through a lot of hoops to obtain their medication. As we’ve pointed out, most of these patients are at or below the poverty line, so coming up with $400 a month wasn’t easy, which goes to show the huge value they placed on the prescription.
Yet, like any sane person, if they can access the prescription for free through insurance, they’ll obviously go to the provider that accepts their insurance. This is why all MAT providers today accept Medicaid and in-network insurance plans – they would have no patients otherwise.
But if there are multiple providers in the marketplace, patients will, first and foremost, choose the one that can get them in the fastest. Then, they will choose the lowest cost, least restrictive one. This is important to keep in mind. If your clinics are excellent at getting people prescriptions fast, then you may be the first stop for most patients. But if you have a higher cost or a lot of requirements related to receiving a prescription, then retention will be difficult as patients will gravitate away to competitors after their first prescription.
Channel Strategies
Now that we know who the patients are and what they want, the next step is to find them. Where are these patients and what messaging do we need to incorporate into marketing campaigns to connect them to care?
With data on over 600 MAT clinic locations across the country, we saw that provider growth was almost like clockwork. Census would climb 3% a month every month from opening until around month 18, at which point, depending on total capacity, clinics would start to arrive at what we call a steady state census where the number of new admissions equals the number of discharged patients. If demand was high, some clinics would break even or be in the black by the 6-month mark. This made it very easy to grow as an MAT provider.
Nowadays, that’s not the case. Baymark, Ideal Option, Community Medical Services, CleanSlate, BHG, Pinnacle, BrightView, Spero Health and many mom and pops are found throughout the country, giving patients lots of options. That doesn’t even count telehealth providers such as Bicycle Health, Groups Recover Together, BetterLife Partners, and others.
Like in any mature market, competition has become an important dynamic. Programs no longer fill themselves and steady state census occurs at lower numbers due to all the competition. So what is a provider looking to remain competitive or to grow to do?
There are 3 primary marketing channels:
- Community word of mouth
- Community referrals
Word-of-Mouth Is How Most Programs Used to Grow
Most MAT providers grew through word of mouth alone in the early days. Like other areas of behavioral health, there was low supply and high demand, so patients eventually found their way to any providers that were in the area.
Word-of-mouth works a bit differently in MAT than it does for other products or services. Patients do not go around telling people about this or that program because there is stigma around going to any kind of treatment. Going to treatment can be seen as an admission that one isn’t “strong enough” to handle the drug or that one is distancing themselves from the lifestyle of family and friends. Patients only make a recommendation when someone they know comes to them in confidence and tells them they want to get off of opioids.
As an example, we once interviewed a woman that had been going to a provider for 4 years. She eventually referred both her sister and her father to the program, but this wasn’t until years after she’d started. Her family did not know she was in a program and she only mentioned it when they came to her in confidence that they wanted to get off opioids. This is the norm as to how word-of-mouth works for MAT providers.
In the same way, those who attend MAT programs are from small communities, everyone comes into contact with everyone else. Listen to conversations in the lobby and you’ll often hear patients talk about other programs they’ve attended, the pros and cons. This is important to understand because it affects the census. If word on the street is that a particular provider is a hassle to get into or that they have a three strikes and you're out policy, you’ll see census drop. Patients are going to go to the provider that is most convenient for them.
Community Referrals Are Often an Area of Opportunity
The MAT space is strange in that they have not incorporated any best practices from other SUD or behavioral health providers. Part of this is because community referrals weren’t needed. As we stated, a few years ago, programs simply filled themselves with little to know effort. So a provider may have some kind of community outreach rep, but this person had no KPIs, didn’t track referrals, and spent most of their time engaged in goodwill activities in the community, often responsible for huge territories.
Talk to any psych hospital seeing as many as 600 Medicaid patients a month and they’ll tell you that most of their admissions come from community referrals. An MAT provider won’t see that many referrals because psych hospitals can see anyone and everyone for the gamut of behavioral health disorders. MAT providers can only see patients for SUD, and the small subset of OUD patients within that.
Remember that only about 10% of Americans meet criteria for an SUD diagnosis in a given year and only 7% of those seek treatment. 50% of those are struggling primarily with alcohol. According to JAMA data from 2021, only 2.5 million Americans struggle specifically with an OUD and, of those, only 22% seek medication-assisted treatment. That’s only 550,000 people across the entire country. We’re not talking big numbers here.
It’s important to point out that the above data does NOT indicate 78% of those meeting criteria for an OUD are out there waiting for access to care. As SAMHSA data has repeatedly shown, most of those using opioids are not looking for treatment even if they have been officially diagnosed with OUD.
The point here is that psych hospitals receive a very high volume of Medicaid patients from community referrals. MAT providers can only accept a very small portion of the patients that these community partners may refer, but that’s still a large number of patients in any given month.
Psych hospitals, traditional rehab providers, the judicial system, and harm-reduction-focused non-profits are all major sources of referrals for MAT providers. With the right outreach in a populated area, a single community outreach rep can easily expect up to 30 referrals a month from community partners.
However, this requires a very targeted approach to outreach that most MAT providers don’t engage in. See our article here for a full write up on what effective community outreach for MAT providers looks like.
The Patients Are on Google
The primary digital channel patients will use to find MAT services is Google. From a marketing standpoint, that means Google Ads or ranking on Google through search engine optimization (SEO).
An interesting marketing factor for MAT marketing is that most patients on Medicaid won’t pay anything out of pocket, so they don’t really care where they go as long as the provider can get them on medication in the next 24-48 hours. As we’ve said, time to medication access is the most important differentiator that determines new patient acquisition.
For this reason, Google Ads are extremely effective, since Google Ads are at the top of search results and most Medicaid patients simply start at the top and work their way down. This is unlike traditional levels of care seeking commercially insured patients where those patients are much more likely to skip over the ads and click on the organic search results.
Ad and landing page messaging needs to have speed of access prominently included in copy and should include the primary medication provided whenever possible (trademarked names can’t be used in Google Ads, for example).
Other channels, such as Facebook, Twitter, Direct Mail, or TV are not as effective for Medicaid providers as they are for providers that accept commercially insured patients. This is because Medicaid patients primarily seek care for OUD in crisis situations. Most Medicaid patients do not shop around comparing multiple providers. They simply go to the first place they find that has an appointment.
Keep in mind that this only holds true for the initial prescription. Once a patient gets on medication, they will begin to evaluate the program for other elements and may choose to switch to a provider that has less hoops to jump through or one that they feel provides more compassionate care. But that initial visit is almost always driven by a crisis call.
Understanding Your Audience: Reducing Barriers
Providers truly care about their patients and want to do more than simply help MAT patients continue to stave off or manage withdrawal symptoms. So most providers these days offer a variety of services such as therapy, case management, vaccinations, and physical health check-ups.
However, this is not what most Medicaid patients are looking for when they first enter treatment. Patients want medication. They want it fast, they want it cheap or free, and they want to have to jump through as few hoops as possible to get it, all in that order.
In the world of MAT, meeting the patients’ needs is the most important factor when it comes to new patient acquisition. Patients aren’t interested in ads or landing pages that promote “comprehensive,” “holistic,” or “integrated” care. All they want at first is their prescription as fast and as cheap as possible.
“Fast” and “covered by Medicaid/insurance” are your two most important marketing messages to connect with new patients. They don’t care about the rest when initially seeking services.
The Patient Chose You, Now What?
However, there is another group of patients that are seeking or at least come to value more comprehensive services. We estimate this group to be about 50% of patients in a given area. We need to stipulate here that ALL patients need medication fast once they seek treatment. As we’ve discussed, this need will trump any other consideration at first.
But, as patients stabilize, a certain percentage will value other aspects of care. Perhaps they’re looking for a better life or perhaps your program opened up their eyes to the possibility of something different. For these patients, additional services are seen as value adds rather than hoops to jump through.
More than anything, patients are seeking compassionate, non judgemental care. The reality is that there really aren’t any switching costs for a patient to go from one provider to the other except for the small hassle of doing a new intake process. We find that many patients try multiple providers. The most common reason patients stay longer with a chosen provider is that they feel like they are treated well.
Remember that, before Medicaid started covering MAT prescriptions, patients paid cash out of pocket. The majority of patients on Medicaid live paycheck to paycheck. They don’t have extra cash lying around. Instead, they often have to find creative ways to come up with money for extras, whether that’s a drug of choice or a medical treatment.
The point here is that, for patients that didn’t have a dime to their name, they’d be able to come up with $400 a month to pay for a prescription. That’s how bad they wanted the treatment. From a patient acquisition standpoint, if you can meet their primary need to get treatment as soon as possible, that’s the most important factor.
Patients seeking MAT services need to get in within 24 hours from when they call or walk in. If your clinic can’t accommodate that, they may possibly be willing to wait 48 hours if there isn’t another clinic in the area that can get them in sooner. But they won’t wait longer than that. The fact of the matter is that, if no one can get them a prescription within 24-48 hours, they’re going to turn to the streets and buy whatever they can find there instead, perhaps closing the window on treatment for the foreseeable future.