Get a DemoDazos Login

December is one of the most important months of the year for behavioral health leaders. While the holidays often slow admissions down, it’s the perfect time to look closely at your data and prepare for the new fiscal year. 

A strong year-end audit helps behavioral health providers understand what is working, where systems need support, and how to plan for growth in the months ahead.

This type of review is not only helpful for operations. It also supports better mental health services, stronger health outcomes, and improved cash flow for your organization. 

Whether you run outpatient services, inpatient programs, residential treatment, or community-based health services, these metrics help you enter January fully prepared.

Below are six metrics every leader should review before the year ends and why they matter for behavioral health care.

7 Metrics to Watch in Behavioral Health Operations Ahead of the New Year

By reviewing the six key areas below before the New Year, providers can make smarter decisions, improve daily operations, and enter January with a clear plan for growth.

1. Inquiry and Referral Trends

Understanding how people reach your organization is one of the most important parts of your year-end audit. 

Referrals, outreach, website visits, and outpatient inquiries show how well your programs are connecting to the community. They also help predict what the spring surge in behavioral health may look like.

Review lead and referral trends by:

These patterns help your providers plan staffing, improve outreach, and adjust their treatment programs to meet client health needs more effectively.

2. Admissions and Conversion Rates

December is a good time to review how many inquiries turned into admissions across your health system or treatment center. Even a small improvement in conversion can make a major difference in the new year.

Behavioral health leaders should review:

This data matters across behavioral health services, mental health, and substance abuse treatment. A strong admissions process helps both clients and staff, and it prepares your team for high-volume months.

A clear audit also supports reporting needs for payors, managed care, Medicare, Medicaid services, and state department of health agencies.

3. Financial Statements, Cost Reports, and Cash Flow

Your financial statements and cost report are two of the most important parts of your year-end review. 

These documents help leaders understand expenditures, total expenses, and how your organization performed across the fiscal year.

In behavioral health care, this financial data supports:

Reviewing cash flow, billing delays, and payer trends helps make sure your team is ready for January changes from insurance plans and other requirements. 

This also supports non-profit organizations and community-based clinics that rely on grants and public funding.

Dazos’s IQ helps treatment centers track every claim, uncover missed revenue, and hold billing partners accountable, giving teams the financial clarity they need to plan for the year ahead.

4. Marketing Performance and ROI

The end-of-year period is one of the best times for behavioral health leaders to evaluate their marketing efforts. 

Understanding which channels drove the strongest inquiries, and which offered the best return on investment, helps marketing teams plan smarter strategies for the next fiscal year.

During your audit, take a closer look at:

These marketing insights help the entire organization. Leaders can make better decisions about budget allocation, adjust messaging for the new year, and build campaigns that support higher admissions during busy seasons.

Dazos’ marketing reports make these trends easier to track across behavioral health programs and locations.

5. Program Performance and Service Delivery

A strong audit also looks at the performance of your health services, including both mental health services and substance abuse treatment. Understanding program trends helps leaders improve care and plan resources for the future.

Behavioral health leaders should review:

These insights help you improve care delivery, plan new initiatives, or strengthen existing services. They also provide clear data for reporting to stakeholders, boards, and community funders.

6. Compliance, Reporting, and Audit Readiness

Before January, it’s critical to ensure your organization is prepared for audit requirements, including those related to:

A clean review now saves time and reduces stress in the spring, when audit deadlines are closer.

This work also supports better coordination with health care providers, partner organizations, and community mental health programs.

7. Alumni Engagement and Long-Term Program Visibility

Alumni engagement is becoming an important metric for many behavioral health leaders. It shows how well former clients stay connected to your organization. Alumni involvement also reflects how your programs continue to support individuals after discharge. 

This connection can strengthen community trust, improve program visibility, and increase future inquiries.

During your year-end audit, consider reviewing:

These insights help providers understand what builds long-term relationships and how alumni play a role in community awareness and program reputation. 

Even small improvements in communication or outreach can strengthen the sense of community your organization provides.

Why This Behavioral Health Audit Matters for the Year Ahead

A strong year-end audit helps behavioral health leaders enter January with a clear picture of what worked and what needs improvement. 

It supports better planning, smoother workflows, and stronger behavioral health care across all levels of service.

For many organizations, this review will guide decisions around staffing, new initiatives, billing systems, information technology, and reporting needs. 

It also helps service providers prepare for changes in health insurance, reimbursement, and managed care requirements.

Most importantly, your audit strengthens the foundation of your care. When your data is clear, your team can focus on delivering the best health care services, mental health, and substance use disorder treatment possible.

Enter the New Year With Focus & Understanding

Your year-end data audit is more than a checklist. It’s a chance to understand your organization in a deeper way and build a strong foundation for the future. 

By reviewing these six metrics before January, leaders can enter the new year prepared, focused, and ready for growth.If you’re looking for tools that simplify reporting, strengthen workflows, or support clean data across your team, explore how Dazos helps behavioral health organizations prepare for the year ahead.

Sources

For many leaders in behavioral health, December is one of the slowest months of the year. Fewer admissions, fewer inquiries, and shifting client schedules can leave teams with more downtime than usual. 

While this can feel unsettling at first, the December slowdown actually offers a major advantage. That is, it gives behavioral health care teams the space to strengthen systems, improve workflows, and prepare for the busy season ahead.

That’s why December is the ideal month to focus on rebuilding operations. Your team has room to step back, evaluate what needs improvement, and launch new initiatives before the first Quarter 1 rush.

Take a look at the reasons December is one of the most strategic months to work on operations, and how behavioral health providers can make the most of it.

Behavioral Health Admissions Slow, but Operational Needs Continue

December brings predictable changes in client behavior. Families travel. Schedules shift. Deductibles reset. 

Many people experiencing mental health conditions, substance use disorder (SUD), or physical health concerns plan to wait until January before entering treatment. As a result, both inpatient and outpatient facilities see fewer inquiries and a drop in admissions.

But while client volume declines, operational work does not. Billing teams still communicate with insurance health plans, Medicare, and Medicaid services. 

Clinicians still update care plans and documentation. Leadership still monitors staffing, compliance, and quality measures required by HHS, state human services departments, and local public health agencies.

When there’s less pressure from day-to-day admissions, teams finally get room to address the systems that support future growth. And the near future in behavioral health often brings a boost in leads and admissions alike.

The spring surge often stretches resources across admissions, billing, clinical teams, and administration. When processes are not ready for the rise in volume, the entire care delivery system feels the impact. To that end, here’s how to prepare in December so your behavioral health care team is set up for success in Q1.

5 Ways to Strengthen Internal Systems This December

The slower pace of December makes it the ideal month to take a closer look at how your operations are running. This may include:

Many health systems and healthcare organizations use December to run internal audits. It’s easier to spot gaps when teams are not overwhelmed by daily volume.

Leaders can also use this time to connect with staff and better understand their needs. These conversations help strengthen company culture and improve health services outcomes across your programs.

1. Prepare for January and the Spring Surge

The first quarter often brings a sharp rise in admissions for mental health, SUD, and behavioral health services. People facing stress, grief, financial worries, or mental illness often reach out for help after the holidays. 

Many want to focus on their well-being and wellness goals at the start of the year. This increase in demand continues into February, March, and April.

If your operational systems are not ready, your team can quickly feel overloaded.

December allows leaders to:

Teams that clean up their processes now enter the new year with confidence, instead of scrambling to catch up.

2. Improve Your Revenue Cycle and Billing Systems

Billing departments often use December to prepare for updates from Medicare, Medicaid services, and health insurance carriers. 

These changes affect reimbursement rules, documentation, and the clinical information that care providers must supply.

The end of the year is a good time to:

Solid billing workflows support your company’s sustainability. Strong reimbursement sets the foundation for better staffing, improved resources, and expanded support services.

3. Refresh Your Marketing and Outreach Strategy

Many behavioral health leaders also use December to update their marketing and outreach plans. This includes reviewing:

This is also a great month to offer webinars, educational resources, or community updates. These efforts improve your brand’s visibility and prepare your organization for increased inquiries in January.

4. Support Staff and Plan for Their Well-Being

December is not only about operational work; it’s also an important time to support the people doing the work.

Leaders in behavioral health treatment can:

When mental health professionals, administrators, and clinicians feel supported, they provide better care and stay engaged through the busy months ahead.

5. Refresh Your Marketing and Alumni Outreach Strategy

December is also a great month to review how well your marketing and outreach efforts performed over the year. 

With demand often dipping this month, teams have more time to examine how different channels contributed to inquiries. These channels could include community partnerships, website traffic, paid campaigns, or outreach events.

It’s also the perfect time to look at alumni engagement. Many facilities rely on alumni for referrals, program awareness, and word-of-mouth visibility. 

Reviewing alumni communication, check-ins, or event participation helps behavioral health leaders strengthen this network before the new year begins.

A clearer marketing picture helps teams maximize return on their efforts and prepare for the higher-volume spring season.

December Is Your Strategic Reset Button

For behavioral health leaders, December is a powerful opportunity. It’s the month where you can slow down, look closely at your operations, and prepare your teams for success in the year ahead.

By improving workflows, updating systems, strengthening admissions, and planning for growth, your organization enters January ready to meet rising demand with clarity and confidence.

A smoother, more organized operation supports better experiences for clients, families, and staff. It also strengthens your commitment to person-centered care.

If you're looking for tools that simplify workflows, improve admissions, or streamline reporting, explore how Dazos supports behavioral health operations all year long.

Sources

For many people completing mental health treatment or addiction treatment, leaving a program is only the beginning. 

Recovery continues long after discharge, whether someone completed residential treatment, moved into outpatient care, or joined an intensive outpatient program (IOP). 

Because recovery is a lifelong journey, behavioral health leaders need solid systems of ongoing support in place.

One of the best ways to provide this support is through a strong alumni program. 

Below, you’ll find clear steps and practical guidance on how treatment centers can build an alumni program that supports people, improves operations, and reinforces your mission.

Why Alumni Networks Matter in Behavioral Health

Executive leaders and providers recognize that an effective alumni strategy is not simply an afterthought. It’s a core part of long-term mental health treatment and addiction treatment success. 

An engaged alumni network helps former clients stay connected, gives them access to resources, and reminds them they are not alone. 

It also strengthens your organization by building trust, improving outcomes, and creating meaningful connections across your community.

A strong alumni program creates ripple effects across your facility:

1. Strengthened Long-Term Recovery

Recovery doesn’t end when a client finishes treatment. Many people need steady check-ins, support groups, and guidance as they return to everyday life. 

A strong support network reduces isolation and helps prevent setbacks. This is especially true for people managing substance use challenges or mental health conditions like anxiety, depression, or self-harm risk.

2. Increased Trust and Brand Authority

A visible and active alumni program shows that your team cares about people long after treatment ends. 

This builds trust with new clients and their loved ones, who want reassurance that your treatment programs truly support long-term success.

3. Organic Referrals and Reputation Growth

When alumni feel supported, they often share their experiences with others. This leads to more referrals, positive reviews, and stronger brand reputation across your local community and on social media. 

Alumni stories also show the real impact of your work, which is valuable for marketing, admissions, and outreach.

4. Continued Community Impact

Recovery is easier when people feel a sense of community. 

Alumni programs create spaces where people can share milestones, find peer support, and stay connected as they continue their personal growth and well-being journey.

The Foundations of a Strong Alumni Program

A successful alumni program doesn’t have to be complicated. It just needs clear structure, consistent communication, and meaningful interactions.

Here are the steps for building a strong alumni program for your behavioral health facility:

1. Start With a Thoughtful Post-Discharge Plan

Strong alumni engagement begins before discharge. Clients should know what to expect and how they can stay connected.

A strong post-discharge plan may include:

By making alumni engagement an extension of inpatient, outpatient, or IOP programming, your organization demonstrates continuity and care.

2. Use Tech Tools to Maintain Consistent Outreach

The biggest challenge for many organizations is staying consistent with outreach. Staff get busy, priorities shift, and alumni communication often gets pushed aside. Technology can solve this problem.

Automated communication tools, like the behavioral health-designed Dazos iCampaign, allow facilities to:

Consistent communication fosters belonging, reassurance, and connection — all essential components of a successful alumni network.

3. Create Opportunities for Meaningful Connection

Not every alum wants the same type of connection. Some prefer in-person events, while others feel more comfortable joining online groups or receiving occasional texts.

High-impact alumni offerings include:

These touchpoints give alumni chances to share milestones, return for inspiration, and stay rooted in a supportive community that upholds their growth.

4. Encourage Alumni to Share Their Recovery Stories

Alumni voices humanize your work. Their stories highlight transformation, recovery, and resilience. And they help your organization build trust.

Encourage alumni to share:

This not only strengthens your marketing and outreach but also empowers alumni to celebrate their personal growth and progress.

5. Assign Clear Ownership of Alumni Engagement

A successful alumni program needs consistent leadership. Identify a team member (even part-time) to manage communications, coordinate events, and oversee alumni participation.

Responsibilities may include:

Without ownership, alumni programs quickly lose momentum. With it, they become a powerful operational asset.

6. Measure Alumni Engagement

Data provides meaningful insight into alumni engagement and its impact on both recovery and facility growth.

Consider tracking:

These measures help refine your program, demonstrate ROI, and reveal opportunities for expansion.

7. Lead With Compassion and Authenticity

Above all, an alumni program should feel caring and supportive. Your goal is to maintain connection in a way that reflects the heart of your mission.

Every message, event, and connection should communicate: 

You still belong here. You’re not alone. We’re here for your continued recovery growth.

Effective behavioral health alumni programs:

Compassionate communication builds trust, belonging, and long-term connection.

Alumni Networks Strengthen Recovery and Organizations

A thriving alumni program supports everyone it touches. Alumni experience ongoing connection and well-being. Families and loved ones see a program that truly cares. And your organization gains trust, referrals, and a stronger presence in the behavioral health community. 

It’s a strategic investment that strengthens outcomes, deepens relationships, and reinforces your commitment to long-term recovery.

When you invest in alumni, you’re investing in the heart of your organization — and the communities you serve.

Take a closer look at how Dazos supports sustainable growth through stronger alumni engagement.

Sources

Behavioral health facilities today have an unprecedented opportunity. While demand for mental health and substance abuse treatment has never been higher, emerging approaches to admissions optimization are enabling leading facilities to connect 30-40% more individuals with care, without adding capacity or expanding staff.

The Breakthrough Moment in the Admissions Funnel 

The behavioral health industry is evolving. For years, access and financial challenges were attributed primarily to workforce shortages and capacity limitations. While these factors remain important, innovative facilities are discovering that improving the admissions process represents one of the highest-impact, most achievable pathways to expanding access and staying in business. 

Recent data from leading behavioral health organizations reveals an encouraging trend. Facilities implementing systematic admissions improvements are reducing time-from-inquiry-to-admission from an industry average of 5-14 days down to 24-48 hours in many cases. More importantly, these facilities are converting 60-75% of qualified inquiries into admissions, compared to industry averages of 35-50%.

The implications are huge. Every percentage point improvement in conversion rates means dozens or hundreds more individuals accessing treatment annually. That means revenue is recognized faster and financial stability is obtained, as well as more families supported. This isn't theoretical. It's happening right now at innovative facilities across the country.

Understanding the Admissions Landscape

The path to admissions excellence begins with understanding where traditional processes leave room for improvement. Rather than viewing these as failures, progressive leaders recognize them as opportunities to create competitive advantage while serving more patients.

The Speed-to-Response Advantage

Industry research consistently demonstrates that facilities responding to inquiries within five minutes are significantly more likely to convert them into admissions. 

Facilities implementing smart lead management systems and CRMs made for behavioral health report that rapid response doesn't require around-the-clock staffing or coordinator burnout. Instead, it stems from intelligent routing, automated acknowledgment, and strategic use of technology to ensure no inquiry goes unnoticed.

The results speak volumes. One multi-state treatment organization reduced average response time from 3 hours to 12 minutes through process and technology improvements and saw inquiry-to-assessment conversion rates jump from 42% to 68%. The investment paid for itself within eight weeks through increased admissions.

Data Visibility - The Game Changer 

Perhaps the most exciting opportunity lies in the emerging innovation of admissions analytics. Facilities that once operated on intuition and anecdotes now have access to granular data revealing exactly where opportunities for improvement exist.

Modern admissions systems and CRMs enable facilities to track conversion rates at each funnel stage, identify patterns by referral source and insurance type, measure coordinator performance, and test process improvements with precision. This visibility combines the art of admissions into a data-backed science. 

Purpose-built tools are making measurement accessible to facilities of all sizes, from large multi-location organizations to single location facilities. 

Those embracing data-driven admissions management are reporting consistent year-over-year improvements in conversion rates, reduced time-to-admission, and enhanced coordinator productivity. They're not working harder, they're working smarter, guided by insights that reveal their highest impact opportunities.

The Insurance Verification Checkpoint 

For years, insurance verification was viewed as an unavoidable bottleneck—a necessary evil that simply takes time. Now, there are several options to help instantly verify benefits and continue the process. 

The most progressive facilities are using one solution that can manage the whole process from end to end, including insurance verification. They can provide preliminary benefit information during the initial inquiry call, allowing patients to make informed decisions immediately rather than entering an uncertain waiting period.

The Communication Effect 

Behavioral health admissions inherently involves multiple stakeholders like patients, families, admissions teams, clinical staff, referral partners. Rather than viewing this as a challenge, see it as a chance to demonstrate the collaborative, patient-centered care that will define their treatment approach and optimize for more positive financial outcomes. 

Facilities implementing structured communication processes report remarkable improvements in both conversion rates and patient satisfaction. This ensures that everyone remains informed, no detail gets lost in handoffs, and patients never feel forgotten during the admissions process.

How do they do this? They invest in technology. There are platforms designed specifically for behavioral health that enable seamless coordination, automated updates to stakeholders, and comprehensive documentation. And the returns are big for patients:  

One residential facility implemented a unified communication system and saw family satisfaction scores during admissions increase from 6.2 to 8.9 out of 10. More significantly, patients arriving for treatment reported feeling more confident and connected to the facility before even arriving. 

The Measurable Impact of Admissions Improvements 

The facilities leading the admissions transformation aren't just meeting their admissions goals, they're generating meaningful outcomes across every dimension of the business. 

Financial Sustainability

Admissions optimization creates powerful economic effects. Facilities converting 20-30% more inquiries into admissions see proportional revenue increases without corresponding cost increases. This improved margin enables investment in enhanced programming, facility improvements, staff development, and competitive compensation.

Several treatment organizations have used admissions-generated revenue growth to fund innovative clinical programs that further differentiate their care—creating a virtuous cycle of improved outcomes, enhanced reputation, and increased inquiry volume.

Enhanced Team Performance 

Counter to concerns that admissions optimization might increase pressure on coordinators, facilities implementing best practices report the opposite effect. Coordinators equipped with efficient systems, clear processes, and performance visibility report higher job satisfaction and lower turnover. 

Expanded Access to Care

The benefit to the community is straightforward but profound: more people receiving treatment. Facilities improving admissions efficiency by 25-30% are serving hundreds of additional patients annually with existing capacity.

This expanded access ripples through communities. Each additional admission represents an individual gaining tools for recovery, a family system beginning to heal, and potential reduction in downstream costs to healthcare, criminal justice, and social service systems.

Here’s What the Innovators Are Doing

Across the behavioral health landscape, innovative facilities are implementing strategies that are generating breakthrough results. While approaches vary based on organization size and number of locations, patient population, and treatment modality, several common themes emerge.

Designing for Speed and Humanity

Leading facilities recognize that rapid response and compassionate care aren't competing values—they're complementary. They implement systems enabling immediate acknowledgment of inquiries while ensuring every interaction reflects warmth and understanding.

This might involve automated text confirmation within seconds of web form submission, followed by personalized outreach from a coordinator within minutes. Or intelligent call routing that ensures every inquiry reaches a live person quickly, with no one stuck in phone tree purgatory.

The key insight: technology should enable financial outcomes AND human connection, not sacrifice one to have the other. 

Investing Strategically in Technology - and Consolidating the Tech Stack 

Leading facilities recognize that admissions technology built specifically for behavioral health organizations generates extraordinary return on investment. Rather than viewing software as a cost center, they see it as infrastructure enabling their mission.

The facilities making these investments report that technologies meant to streamline marketing, insurance verification, admissions and revenue recognition typically pay for themselves within months through increased conversion rates, reduced coordinator overtime, and decreased dropped leads. The ongoing return—measured in both revenue and lives changed—continues indefinitely.

Building a Culture of Measurement 

High-performing facilities treat admissions as a continuously improving system. They establish clear metrics, review performance regularly, celebrate improvements, and systematically address bottlenecks. This isn't about creating pressure—it's about creating visibility that enables smart decisions.

Importantly, these facilities measure efficiency metrics (response time, conversion rates, time-to-admission), experience metrics (patient satisfaction, coordinator wellbeing, referral partner feedback), and revenue generation and recognition metrics. The balanced approach ensures that optimization never compromises care quality.

Questions That Unlock Opportunity

For facilities exploring their admissions optimization potential, several key questions can reveal where the greatest opportunities lie:

How many more people could we serve with our current capacity if we converted inquiries more effectively? This question reframes admissions improvement from just operational efficiency to include mission fulfillment.

Where do most inquiries drop off in our funnel? Different bottlenecks require different solutions. Identifying your specific constraint focuses improvement efforts where they'll generate maximum impact - and financial benefit. 

How does our time-to-admission compare to competitors? In behavioral health, responding faster often determines whether someone accesses care at the facility at all. Understanding your relative position reveals competitive opportunity or vulnerability.

What percentage of coordinator time is spent on administrative tasks? If administration dominates, technology investment could dramatically amplify your team's impact on both the bottom line and patient experience. 

Can we measure what's working and what isn't? Data visibility transforms improvement from guesswork into systematic progress.

The Technology Catalyst

The encouraging news: sophisticated admissions technology is more accessible than ever. Purpose-built platforms designed specifically for behavioral health provide capabilities that were unimaginable just five years ago.

These systems offer centralized inquiry management capturing every lead regardless of source, automated workflows guiding coordinators through complex processes, accelerated insurance verification through integration and automation, real-time analytics providing visibility into performance and opportunities, and communication tools facilitating seamless coordination across teams.

Facilities implementing these platforms consistently report conversion rate improvements of 20-40%, time-to-admission reductions of 40-60%, and coordinator productivity gains of 25-35%. 

The Path Forward

The future of behavioral health admissions is bright. The tools, knowledge, and best practices needed to dramatically improve financial outcomes and patient experience already exist. The facilities achieving breakthrough results aren't lucky—they're strategic. They recognized that admissions excellence represents a high-leverage opportunity and made systematic investments to capture it.

For facilities beginning this journey, the path is clear: assess current performance honestly, identify the highest-impact opportunities, invest in appropriate technology and training, implement measurement systems that enable continuous improvement.

This isn't just about facility success, although improved admissions directly impacts profitability. It's also about maximizing every organization's capacity to fulfill its mission. Every inquiry represents someone courageous enough to seek help. Admissions excellence ensures that courage is rewarded with access to treatment.

The opportunity is clear. The tools are available. The results are proven. The question isn't whether admissions optimization is worth pursuing. It's how quickly your facility can capture the opportunity and begin serving more individuals, families, and communities.

For the majority of outreach professionals in the behavioral health industry, targets and quotas loom large. The journey of a new outreach representative often begins with excitement and anticipation, fueled by a fresh role, a box of business cards, marketing materials, and organizational expectations. However, beneath the surface of this dynamic profession lies a crucial yet often overlooked factor that can significantly impact a business development rep's success: ramp-up time. In this article, we will delve into the intricacies of ramp-up times, the behaviors associated with different expectations, and the resulting return on investment (ROI) for businesses.

Defining Business Development Ramp Up For Behavioral Health

Ramp-up time refers to the period between the date of hire and the achievement of expected production levels. While production can vary, it typically involves generating sufficient revenue to meet the organization's targeted return on investment (ROI). Understanding ramp-up times is essential for both businesses and representatives. It provides businesses with a projection of when their investment in a new employee will yield results, while reps gain insights into the behaviors necessary to meet their targets.

Why does this matter? 

Well, for the rep’s planning this is wildly important.  A typical rep in the behavioral health space has anywhere between 500-1500 viable referral sources within their territory.  This could include any vertical market and any potential referral volume.  Understanding the ramp-up expectations determines how that rep manages that territory. 

Case Study: Treatment Rep A vs. Treatment Rep B

To illustrate the impact of ramp-up time, consider two reps hired on the same day by treatment programs in the same market. Treatment Rep A has a 120-day ramp-up to reach two admissions per month, while Treatment Rep B has only 30 days.

Treatment Rep A will be inclined to do two behaviors specifically to achieve those goals.  Behavior 1 is diversifying account mix.  Rep A is able to work slower referring accounts, such as unions and hospitals, because they know they have the time to have at least 3 meetings prior to hitting their target.  Accounts like this typically take that amount of contact as a minimum prior to referring.  The second behavior Rep A can do is focus on A & B level accounts – the higher referring accounts.  Similarly, these accounts all have options for where they send patients and generally don’t switch easily.  These type of accounts take several meetings, site visits, etc. to gain a significant chunk of their business.  With the time to do so, Rep A is able to mix in a healthy amount of these accounts into their account plan. 

On the other hand, Rep B has to produce quickly.  They aren’t afforded the time to put lots of energy into A accounts or vertical markets that take more time to materialize.  Rep B has to immediately become a transactional rep which in behavioral health generally means focusing on one vertical market in particular – other treatment centers.  Rep B will have to spend their time meeting solely with other BD reps and admissions teams to get referrals, and generally are only able to do so with an expectation of reciprocation. 

Which Approach Yields Better Results?

While it's challenging to definitively quantify the performance of each approach, several key factors come into play: turnover, admissions fluctuations, and ramp-up production.

Rep A could begin exceeding those targets within 30 days, nullifying the need for the ramp up.  Rep B could be an exceptional outreach rep who is able to generate admissions quickly and sustain that level of production.  Before deciding upon which rep is the better decision, let’s take a look at symptoms of these decisions, not just at the singular rep level, but as a team of outreach representatives. 

Turnover

Hubspot reports average rep turnover for sales personnel is around 35%.  Personal experience shows that turnover for the team with a longer ramp-up is dramatically lower with recent experience showing turnover below 10%.  For a team of 20 outreach reps, 35% turnover at an average salary of $85,000 can cost a company $300,000+ per year in both soft and hard costs.  Soft costs being associated costs such as recruiter fees, labor to interview for new roles, labor for onboarding, etc while hard costs can be things such as a direct hit to revenue due to lack of production from an open territory.  Reducing that turnover number to 10% saves the company around $260,000 annually.  $260k even moderately invested back into patient acquisition is at least $1mil worth of new top line revenue.  All that, just by reducing outreach rep turnover. 

And That’s just year one.  Moving forward, the positive effect of keeping employees multiplies.  Not only does the company save on all the costs like lost productivity, recruiting, contractors, etc., but they also get the compounded effect of more tenured reps generating more revenue.  Now the added benefit to the $260k savings is more production at the top line from the same staffing level as before.

Admissions Fluctuations

The challenges with acquiring business from longer sales cycle accounts/vertical markets can be negated over time by consistency.  Behavioral health, in particular, has cycles that much of the industry assumes is natural, when it is in fact a symptom of a behavior.  For example, is all addiction and alcoholism cured in December?  Of course not. As an industry it’s generally accepted that December will be a slower month, but it doesn’t have to be slow.  That’s the benefit of having an account mix comprised of A accounts and vertical markets that do not rely on internet search for leads (unions, hospitals, etc).  To add to that, not only having that account mix but also having deep and respected relationships with those accounts.  That way, the reps in this system are the first choice for referrals when those accounts need to send a patient to treatment.  Being the first choice is wildly important for consistency as the aforementioned target accounts are inclined to reduce referrals to others during “slow times,” but will remain a consistent referral pattern to their top choice.  What’s not to like about that?

The other factor that comes into play for organizations suffering from peaks and valleys of census is staffing.  How do you consistently staff an 80 bed program if some month’s census is at 40 and other months it’s at 75?  Staff for 40 and you don’t care for patients during times of targeted census.  Staff for the middle, say 65, and you’re overstaffed for 40 (wasting money), but understaffed for full census.  Staff for 75 and labor costs will dramatically outweigh the revenue from times of low census.  This is an obvious issue. 

Furthermore, if understaffing is the choice a program will inevitably run higher AMA risks (patients leaving early Against Medical Advice), lower average length of stay (ALOS), and thus dramatic decreases in revenue.  For just one example using this 80 bed program, a typical 30 day program running at a target of $1000 per day could lose up to $2 million annually by an average drop of ALOS of just two days per patient.  Does that outweigh the increased admissions that shorter ramp-up typically brings the program?  That’s up to the individual program to run the math.

Ramp-Up Production

It’s not all roses for the longer ramp-up option.  Even with a projected higher turnover, Company B (and thus rep B), will typically have a higher number of admissions year 1.  Running several models utilizing a team of 10 reps showed this again and again.  If the singular goal is to get to high census quickly, then this method will do that given the organization does hire several reps to hedge against turnover.  For organizations that just opened their doors or have experienced an event that dramatically dropped census and now need a quick rebuild, this method could be the better short term plan.

However, when taking into account the aforementioned soft cost issues, as well as the inevitable peaks and valleys of census (and impact on staffing, ALOS, etc), it’s difficult to recommend a shorter ramp-up as the best overall plan for a treatment center’s productivity. 

Conclusion

In the realm of behavioral health business development, understanding and optimizing ramp-up time is crucial for achieving sustainable success. Often BD admissions and productivity is looked at in a vacuum, and unfortunately the benefits and consequences of BD goals, structure and expectations are looked at outside of the whole ecosystem of a treatment center.  Taking this holistic approach to revenue generation over time should not only remove some of the consistent headaches of facility management, but it should also provide a level of stability and predictability that can stabilize an organization, thus improving the opportunity for better patient care.  Therefore, it’s safe to conclude that providing a larger investment on the proper development, and thus ramp-up, of a business development representative is going to provide a larger ROI across all aspects of the company, even though top line admission totals might lag early on.

About Steve Donai

Steve Donai, founder of Growth Sherpa Consulting, is a business development executive with more than two decades of successful sales and leadership experience. His career working in behavioral healthcare fulfilled a passion for using his sales knowledge to make a positive impact on the patients and families trusting the company he served.

With more than a decade of behavioral healthcare-focused experience, generation of over $250 million of revenue, oversight to 14,000+ admissions, and the development of dozens of leaders within the behavioral health space Steve decide to create Growth Sherpa to offer his unique coaching and professional development methods to assist business development leaders.

Growth Sherpa is different because of the understanding and purpose-driven approach to the challenges programs face. We will partner alongside your leaders to find solutions so programs can focus on what is most important — providing excellent patient care.

With this purpose, Steve has put together a team of behavioral healthcare professionals at each level of your patient acquisition operations. So whether you need a staff level employee to put together a prospect list in a new market, a sales director to oversee your outreach team, or an executive leader to work directly with leadership to ensure all parts of the revenue generation ecosystem are working in harmony Growth Sherpa will have the bespoke plan created for your organization

Treatment centers have a difficult decision to make as they build out their Outreach team.  Do they hire somebody with little to no experience but have the skills, attributes, and character that matches what their program exudes and allow them a ramp up time within the role, or do they go looking for an experienced Outreach Rep that brings with them a book of business (a BOB rep)?  This is a challenge because both options have their pros and cons, and the reality is both options can be effective when used as part of a greater strategy.  However, empirically a pattern tends to arise when treatment centers choose the second option – a rep with a BOB rep.  This pattern, and stop me if you’ve heard it before, is that a treatment center hires a rep that promises them loads of admissions because of their relationships, months go by with much less production than promised, that rep turns over, and then the process is started up again.

That cycle creates a lot of challenges.  On the surface, it’s easy to see how referral partners in the community can become weary of said treatment center as their Outreach team continually turns over.  It creates a known but difficult to define barrier to success in the referral market.  Second, it creates an environment where talented reps don’t want to work there.  If you’re a rep that has had a respected seasoned career then you’re not going to be too excited to work at a program with a reputation for turnover.  Recruiting talent in this competitive market is hard enough, and repeatedly turning over reps makes the task that much more challenging.  Finally, the soft costs of this loss are a killer.  On top of the lost revenue from lost business, an increase in Outreach team turnover from 10% to 30% can cost a treatment center upwards of $200,000 just in soft costs.  That money even moderately reinvested in patient acquisition should easily yield $1,000,000 in top line revenue.  

So if these are the negatives, why do programs continue to do it?  Simply, many programs have to.  Running a treatment center is expensive.  Rent, utilities, labor, etc all really add up, and with reimbursements declining in many markets by many payers the need to jump start revenue generation is paramount.  Still, if your program is in this situation there are ways of hiring the BOB rep but also doing that in a way that increases the probability of success.

Interview for the behaviors and not the outcomes. 

If you’re hiring a book of business rep then you’ve already seen their resume.  It should show some level of repeated production throughout their last stint(s) at other treatment centers.  So put that aside and find out how that BOB rep got that success.  Did they inherit a productive territory that they had to manage or did they have to build up their business from scratch.  Have they only produced for INN only local detoxes while your program is OON out of state residential – if so, how do they plan on translating that experience?  How do they plan their week and what do they consider a successful week of activities?  All these things, and so many others to look for, should expose if it was the reps’ behaviors that resulted in growing business (which they can replicate with you) or if it was external influences that mattered more (which they can’t take with them).  Most reps have a little of both, and it’s up to the treatment center to decide what they’re willing to accept moving forward.

Have a process to ensure this new person is a culture fit.

Remember, Outreach representatives are a local face to your treatment center.  Who they are, how they conduct themselves, and of course their ethics are all a representation of your program.  If you look around the country at the reps who’ve had the longest tenure at their program you’ll notice one thing every time – they’re a perfect culture fit for their program.  Just like addiction treatment, when all things are equal the longer you stay engaged the better outcomes you get.  Reps at a program are no different, and if it’s not a good culture fit you’re going to see turnover that actively stunts your growth.

Do the math before hiring. 

A book of business rep can often come in asking for a high salary.  Paying a lot of money for a rep isn’t bad by itself, but understand how that spend affects your budget and what amount of revenue you truly need from them to break even.  For healthcare it's not uncommon for 9-14% of the gross revenue of a company to be spent on revenue generation.  So before spending $100,000 on that experienced rep (plus taxes, insurance, T&E, etc) be sure you feel comfortable that there is a path to them generating $700,000-$900,000 their first year.  If that path doesn’t comfortably exist and you hire them anyway it’s a recipe for turnover.  So instead consider variable comp plans.  Obviously don’t pay for admissions because that’s illegal, but figure out how to create an enticing plan that has lower salary (lower risk for you) and can compensate the rep for when they exceed targets.  If you’re unfamiliar with how to do that there are good resources available that can help you navigate.

So is a Book of Business Rep Right for Your Treatment Center?

While the allure of immediate patient flow through a BOB rep can be tempting, it's essential to approach this decision with a strategic mindset.  Patient acquisition should be set up as a harmonious ecosystem, and the type of Outreach rep that you bring in needs to fit into that ecosystem properly.  Lions and sharks are both great hunters, but they wouldn’t do well in each other’s ecosystem. The same truly goes for an Outreach team.  The good news is that there is no one size fits all approach to patient acquisition, and the right approach to one center could look completely different than another.  Hopefully focusing on the above suggestions will assist in deciding that direction for your program whether you bring in somebody who has potential and train them up to greatness or hire greatness and bring them into your culture.

About Steve Donai

Steve Donai, founder of Growth Sherpa Consulting, is a business development executive with more than two decades of successful sales and leadership experience. His career working in behavioral healthcare fulfilled a passion for using his sales knowledge to make a positive impact on the patients and families trusting the company he served.

With more than a decade of behavioral healthcare-focused experience, generation of over $250 million of revenue, oversight to 14,000+ admissions, and the development of dozens of leaders within the behavioral health space Steve decide to create Growth Sherpa to offer his unique coaching and professional development methods to assist business development leaders.

Growth Sherpa is different because of the understanding and purpose-driven approach to the challenges programs face. We will partner alongside your leaders to find solutions so programs can focus on what is most important — providing excellent patient care.

With this purpose, Steve has put together a team of behavioral healthcare professionals at each level of your patient acquisition operations. So whether you need a staff level employee to put together a prospect list in a new market, a sales director to oversee your outreach team, or an executive leader to work directly with leadership to ensure all parts of the revenue generation ecosystem are working in harmony Growth Sherpa will have the bespoke plan created for your organization.

We are a software and technology company focused on providing solutions for the addiction treatment and behavioral health space, founded in 2018 by a group of entrepreneurs with a wide range of experience in the medical, behavioral health, and software development fields.
951 Yamato Road, Suite 100
Boca Raton, FL 33431
Copyright ©2018-2025 Dazos, Inc. All Rights Reserved.
cross linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram