Timothy Zercher 0:00

Well, Carolyn, thank you so much for joining us. We really appreciate you taking time.

Carolyn Bradfield 0:03

Well, I appreciate being asked to join your podcast. I'm looking forward to the conversation.

Timothy Zercher 0:08

Absolutely. Absolutely. So let's jump right in. You've built both technology and behavioral health companies. What led you to focus on your work helping addiction treatment programs improve family engagement and retention specifically?

Carolyn Bradfield 0:21

Well, I have a lot of background personally and professionally in the addiction space. Professionally, I ran a licensed treatment program in North Carolina where we had a very robust virtual family support program that really helped on the parents with what we were doing for treatment. I mean, the number of years that we did business in North Carolina, we only had one AMA discharge. So it actually worked well. But most people are in this industry not for professional reasons, they're there for personal reasons. So for me personally, I had a daughter who struggled with addiction for 15 years, went in and out of treatment, and very little support, education, and information for me personally to know best how to support her. And so that told me that there was a huge gap in the industry that really needed to be addressed and needed to be filled as that was what led me into the industry. I have a technology background. So I was able to use that technology background strategically to do what I wanted to do to support family.

Timothy Zercher 1:35

I love that. I love that. So to dive a little deeper on that, where do you think the biggest gap is in how providers actually do support families? And what have you seen as the biggest mess so far?

Carolyn Bradfield 1:47

Well, providers have a lot of challenges anyway. First of all, they're understaffed. They're not compensated to support the family. So, you know, they have to really focus on patient care or family care. And they don't really have an understanding of what the family needs to have that support. So when you think about limited staff not being compensated to do it, and then really not kind of understanding perspective, I think it's generally a big miss with a program. So what we see them doing is they might do a family day where you come to the program. They might do a few support groups virtually, but again, that's not even close to being enough to what the family needs. So I think there's a miss all the way around.

Timothy Zercher 2:37

Do you see a trackable impact when groups start following your process of engaging the family? Like, do you see lower readmits, better long-term results? Do you have a way of tracking that yet?

Carolyn Bradfield 2:51

Well, I think the program has a need to improve their financials. So what the program ought to see is a reduction in the people that discharge early. So if the family is aligned with what the treatment program is designed to do, if they are resistant to that first phone call they're going to get that says, hey, this program is crazy, everybody here is nuts, the food is terrible, I hate my crewmate, I already know everything I need to know about treatment, come get me. Statistically, somewhere along the line of one in four patients will drop out early because that happens, right? And so if the program can just reduce that rate by a little bit, the massive improvement to their financials is unparalleled. They can recapture uh insurance reimbursements, they can lower the cost of patient acquisition because they're not having to fill an empty bed that stays empty on average eight to ten days. So I think if you want to know what the program cares about the most, it's financial stability.

Timothy Zercher 4:00

Absolutely. Absolutely. That makes complete sense. And obviously it also improves the actual impact on the individuals being served, right? If they can, if they can stay invested through the full process.

Carolyn Bradfield 4:09

Well, yeah, I mean, but you know, what's interesting about programs is most of them are not tracking post-discharge outcomes. So when the patient leaves, they kind of lose track of what's going on with them. And I think the reason is that payers are not very friendly in organic value-based care relationships with them. So why should they track outcomes they're not being compensated or rewarded for doing so? So, as much as I would love to say that they care about those lower relapse rates and less readmissions rates, a number of the programs kind of live and die on readmission. So that's really not as big an incentive as keeping the person in treatment longer.

Timothy Zercher 4:52

Absolutely. Absolutely. Which makes makes complete sense. Yeah. So as as we talked about, your mission is deeply personal. How has your experience as a parent shaped the way that you think about recovery support and specifically the role that families play in outcomes?

Carolyn Bradfield 5:09

Well, as I said before, you know, one of the motivators for me to get into the industry was the 15 years I spent with my daughter navigating the world of treatment. She probably went in and out of maybe different programs. Everything from the Karen Foundation to Bridge for You in Atlanta. She said lots of different programs. And I feel like I made a significant number of unforced errors that if I had known better, I would have been a much better partner to help her recover, to help her pick the right treatment program, to stay in treatment through the step-down process to make sure that she had the right support and recovery. And then for me personally, to do things that a family needs to do, hold boundaries, manage their atemacy to codependency, not provide unrestricted financial support, not provide them a place to live when it's not appropriate. And unfortunately, my daughter, although she went in and out of all those treatment programs, she thought make it. She overdosed it eight years ago. So I do feel my family is really kind of left to the side. And they're the ones that tend to make the decision of where you go to treatment. 70% of treatment decisions are driven by the female in the family. They're the ones that will keep the person in treatment. They're the ones that are in the home environment when the patient is out in the world that has to understand and support recovery. And they're the ones that take a financial hit, you know, when the person is repetitive in treatment. So it informs everything I do. Not just from my own personal experience, but from very positive trajectory we had when we ran our own program at Asheville and what happens when you do really good family work and how that makes a huge difference in making these parents at the time that these were adolescents, making the parents good decision makers for treatment and making them empowered to know what the next right step was.

Timothy Zercher 7:18

Yeah, that makes complete sense. I love that you have you have such a passion for the field that I think is very genuine. I bet both your clients and their clients feel that in how your program impacts them.

Carolyn Bradfield 7:30

Yeah, I mean, I I do have a passion for it, and I think I'm in a very difficult industry because the amount of inertia is pretty profound. I mean, people tend to do what they've always done. And and so what I'm asking them to do is not what I consider very radical. Whatever you're doing in family support, we don't want to replace it. We just want to complement it. We just want to be that virtual environment that's there all the time in between other things that you're already doing. But that's just asking them to do something different is hard.

Timothy Zercher 8:02

Absolutely. Well, shifting into that, how you get them to change and to do things differently. Since we're a marketing agency that specializes in this field, we always have to ask some marketing type questions. The first one is what works best for you right now to pull in new partners? What works best for you to pull in new programs, especially outside of Board of Mouth?

Carolyn Bradfield 8:23

Well, I think when we originally started the company, we were really focused on soft benefit. Let's improve the recovery rate, let's make everybody feel better. And it really wasn't until we started talking about the hard financial realities of patient acquisition costs and early charges that programs started to pay attention. So in our case, we rely on three kinds of ways to market. We are very good at creating channel relationships. So we have channel partners that are working with programs for other reasons. They're either behavioral health revenue cycle management consultants. They might be alumni program consultants. We have a really strong relationship with a distribution partner that's creating a centers of excellence network for SUV providers and becomes their payer for self-insured employers. So that's attracting people in the door because we're helping programs not only see the value of family support, but we're also helping them with a new path like patience. So when you think about expanding their referral base, giving them ways to think about patience, that's a really strong argument for them. Then obviously, we do a lot of work on social media. We do a lot of webinars and live streams. So we're really educating the market to do something different than what they've done in the past. So that's a big thing, this market education.

Timothy Zercher 9:54

I love that. Yeah, yeah. Well, and and as you mentioned, penetrating the market and getting people to change how they've been operating is not easy. So it makes sense that you go in via relationships because those are already strong.

Carolyn Bradfield 10:07

Well, I was hoping you would ask me who my competitors are. Go ahead and ask them the question because I have a great little clip for you.

Timothy Zercher 10:14

Yeah, yeah. Go ahead. Go ahead. Who are your competitors in those places?

Carolyn Bradfield 10:17

My top two competitors are ignorance and apathy. They don't know and they don't care. You know, and look, and not to beat them up, I mean, that got more to do than to say braceover. They're running in a hard business. And so to stand back and say, wait a minute, let me just look at this thing that's not mission critical at this moment to patient care is hard to get them to do that. But ignorance and apathy are the two things. So it's my job to ignorance, make them aware. And it's my job to show them, but maybe you shouldn't be so apathetic because the family can either help or hurt you. And so you want them to help you and not hurt you.

Timothy Zercher 10:55

Absolutely. Well, and that family impact could be the difference between a life, right? Being educated and engaged might make all the difference.

Carolyn Bradfield 11:03

Well, for the program, it could be the difference in making a profit and losing money.

Timothy Zercher 11:08

Both. Yeah, absolutely. Absolutely. Yeah. The impact ripples, right? Perfect. Well, thank you so much. I really appreciate your time. I appreciate the work that you're doing. And uh hopefully, hopefully more groups are able to to get engaged with this kind of program.

Carolyn Bradfield 11:21

I appreciate it. Thank you for inviting me.