Residential / Inpatient · Paid Media · Colorado
How NRT Behavioral Health Got Full Visibility Into Their Ad Spend and Cut Cost Per Admit by 60% in 60 Days
A small-budget Colorado launch built on full-funnel tracking and payer-mix strategy delivered results NRT had never seen from a paid media partner before.
TL;DR
The Short Version
The Problem
- Previous agency gave zero visibility into what the budget was actually driving
- Seven campaigns running with no conversion tracking and no admit attribution
- Payer mix skewing heavily toward Medicaid as residential reimbursement rates were cut 50%
The Strategy
- Built full-funnel conversion tracking from scratch with every lead, VOB, and admit tied to the campaign
- Launched Colorado PMax and branded search, weighted toward commercial residential
- Optimized week over week based on real payer data, not just lead volume
The Result
- Cost per admit dropped 60.5% in 60 days
- VOB to viable rate hit 93%, more than double the industry benchmark
- NRT had more visibility into their paid media than they had ever had before
The Challenge
Flying Blind While the Business Model Was Changing Underneath Them
When NRT Behavioral Health came to Webserv, they were running seven paid media campaigns through a previous agency, spending money every day with no real understanding of what it was producing. There was no conversion tracking tied to outcomes. No line from ad spend to VOBs. No admit attribution. Just traffic numbers and a monthly bill.
At the same time, a major shift in Colorado Medicaid reimbursement had cut their residential rates by 50%. Two of their strongest payer regions, previously their bread and butter, were now significantly less profitable. Continuing to fill residential beds with Medicaid patients was no longer a viable model. They needed commercial admits for residential specifically, or the revenue math stopped working.
The problem was not just that their marketing lacked transparency. It was that without real data, they had no way to steer toward the payer mix their business now depended on.
In Their Own Words
"It was just kind of like, this week was good, this week was bad. There was nothing with respect to conversion or the viability of the calls. There was no transparency."
NRT Behavioral Health
- Starting Point
- 7 campaigns spending $55 to $75 per day with no outcome tracking
- No conversion tracking no VOB, viable, or admit attribution in place
- No dedicated landing pages for paid traffic
- 50% Medicaid rate cut on residential making commercial admits critical
Core Problems
Zero TransparencyNo reporting beyond traffic volume. Budget was spent with no insight into what was converting or why.
Budget Bleeding on BrandedAd spend was leaking heavily into branded search terms, paying for clicks from people already looking for NRT by name.
Payer Mix CrisisColorado Medicaid cut residential reimbursement 50%. Without a shift to commercial residential, the revenue model was broken.
No Landing Page InfrastructureNo dedicated pages for paid traffic. Visitors landed on generic site pages with no conversion-focused experience.
Our Strategy
Build the Foundation First. Then Let the Data Drive.
Before we could optimize for outcomes, we needed to be able to see them. The strategy started with infrastructure, then used real conversion data to steer toward the exact patient profile NRT's business model needed.
01
Full-Funnel Conversion Tracking Built From Scratch
The first task was visibility. We built conversion tracking from the ground up, tying every lead, VOB, viable VOB, and admit back to the exact campaign and keyword that drove it. For the first time, NRT could see exactly what their ad spend was producing at every stage of the funnel. This was not just a reporting improvement. It was the data foundation the entire optimization strategy depended on.
02
Colorado PMax and Branded Search Built for Commercial Residential
We launched a Colorado-targeted Performance Max campaign alongside a lean branded search campaign with brand exclusions on PMax, ensuring prospecting spend went toward new high-intent audiences rather than existing brand searchers. We weighted campaign targeting toward inpatient and residential services, the level of care where commercial payer mix had the most revenue impact. As NRT opened their Denver IOP location mid-campaign, we adjusted targeting in real time to support the new facility without disrupting existing momentum.
03
Performance-Based Scaling Tied to Real Outcomes
Every budget decision was grounded in actual conversion data, not assumptions. As cost per admit improved month over month, confidence in scaling grew with it. We excluded low-value zip codes showing higher Medicaid concentration, refined the negative keyword list weekly to prevent irrelevant traffic, excluded problematic display placements, and continuously pushed positive commercial policy data back into the campaign to reinforce what was working.
What We Did
Execution Across Every Layer
Tracking and Attribution Infrastructure
- Built conversion tracking from zero with every lead, VOB, viable VOB, and admit tied to campaign and keyword
- Integrated CTM call tracking for full call-to-conversion visibility
- Aligned conversion scoring with admissions team workflow to ensure clean data into campaigns
- Set up ad schedule aligned to admissions team hours so no spend ran outside intake capacity
Campaign Architecture
- Launched Colorado PMax with brand exclusion for pure prospecting with no branded waste
- Built separate branded search campaign to protect against competitors at controlled spend
- Weighted asset groups toward inpatient and residential to align with commercial payer priority
- Adjusted targeting in real time when Denver IOP launched mid-campaign
Audience and Budget Optimization
- Excluded high-Medicaid zip codes to improve commercial payer concentration
- Excluded problematic display placements to prevent low-quality traffic from entering the funnel
- Shifted budget distribution toward inpatient asset groups as payer data confirmed value
- Continuously expanded high-intent keyword coverage while growing the negative keyword list
Weekly Performance Management
- Reviewed CTM lead scoring weekly to catch unscored commercial policies
- Monitored search term reports daily and added negatives in real time
- Tracked cost per VOB and cost per viable week over week against benchmarks
- Provided full reporting transparency on every dollar across leads, VOBs, viables, and admits
The Results
Feb to May 2026: A Foundation That Gets More Efficient Every Month
Cost Per Admit
60.5%
Drop in cost per admit from $5,131 in March down to $2,025 in April, well below the $5,000 benchmark
VOB Quality
93%
VOB to viable conversion rate in Q1, more than double the 45% industry average
vs. Projections
+62%
More viable VOBs than originally projected for Q1, with 13 delivered vs. 8 projected
Funnel Performance
- 23 OON viable VOBs delivered since February launch
- 8 confirmed admits across Mar to May as attribution data came in
- 103 leads, 14 VOBs, and 13 viable VOBs in Q1, exceeding projections on all three metrics
- Lead to VOB rate improved from 13.6% in Q1 to 23.5% in April, right in the target range
Cost Efficiency
- $2,025 cost per admit in April, the best month on record and well below the $5,000 benchmark
- $1,089 cost per viable in May, the lowest since launch
- $30K total spend Feb to May with every dollar tracked to outcomes
- NRT now has a full line of sight from ad spend to admit for the first time
On Seeing Results
"Each week I feel like I noticed the difference. There is just more coming in."
NRT Behavioral Health, Admissions Team
On Commercial Leads
"Every time I see a commercial come in, I am like, yay, love it."
NRT Behavioral Health, Admissions Team
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What Made the Difference
01
Transparency Before Optimization
Most agencies start optimizing before they can see what they are optimizing toward. We built the tracking infrastructure first so every decision that followed was grounded in real admit data, not proxy metrics. NRT could finally see exactly what their budget was producing at every step of the funnel.
02
Payer-Aware Campaign Strategy
Understanding that commercial residential admits were the priority, not just any admit, shaped every targeting decision. We did not just drive volume. We steered the campaign toward the specific patient profile that made the revenue model work, excluding low-value areas and weighting budget toward inpatient services from day one.
03
Real-Time Responsiveness
When NRT opened their Denver IOP location mid-campaign, targeting shifted the same week. When the admissions team flagged workflow changes, we adjusted conversion scoring immediately. When performance dipped after the branded and prospecting split, we explained it, monitored it, and rebuilt momentum rather than going quiet.
04
Small Budget, Zero Waste
With a $10K per month budget, every dollar had to work. We excluded problematic placements, zip codes, and search terms proactively rather than reactively. Branded spend was isolated and controlled. The result was a campaign that got more efficient every month, not because we spent more, but because we were deliberate about where every dollar went.
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