Summary: How can healthcare marketers use digital ads in a more cost-effective and efficient way? Let’s take a look at how campaign consolidation, smart bidding, and responsive search ads (RSAs) can help you reduce ad spend and increase your ROI.

Get lean and get mean might sound like advice you’d get from a fitness coach, but it’s pretty good advice for healthcare marketers, too, who have an imperative to reduce patient acquisition costs while still growing patient volume.

Yet, increasing acquisitions while reducing cost per acquisition (CPA) is a fine line to walk. While digital advertising can be a cost-effective method of acquiring new patients, you need to do it right. If media campaigns aren’t properly structured or fail to follow best practices, your costs can quickly balloon.

To help you avoid that outcome, here is a three-prong strategy to reduce advertising costs, improve conversion performance, and increase return on investment (ROI). It’s the same strategy we frequently recommend for our own healthcare client portfolio.


1. Campaign Consolidation

There was a time when every ad wonk on the planet was recommending hypersegmented campaigns. However, things have changed, and hypersegmentation is no longer the best approach. Hypersegmented account structures restrict algorithmic learning and place additional emphasis on technical account management, leaving less room for improvements in messaging, quality improvements, tracking, and the post-click experience.

Today, campaign segmentation should only be used to control budgets or other business objectives—it’s not very effective at driving improved performance.

Campaign consolidation is the first step in accumulating and organizing the data you need to benefit from algorithmic ad buys, such as smart bidding. While every business has different needs, we typically recommend only two campaigns per location: brand and nonbrand. Then, we push service granularity to the ad group level. Match type segmentation is no longer necessary as Google has updated its algorithm to ensure exact campaigns always win at auction.

By relying on machine learning, campaign-level consolidations can help drive more leads at a lower CPA. In fact, Think With Google conducted research that showed an 11 percent increase in reach efficiency after brands consolidated their campaigns.

All of this with a lot less manual effort.

How LifeStance Leaned on Paid Media to Generate 28,000 Conversions in 6 Months

To augment ongoing SEO efforts and capture incremental patient volume at a cost-effective CPA, Cardinal helped LifeStance launch various paid search campaigns. To date, account-level consolidations in particular have improved algorithm performance significantly, without sacrificing relevancy. For PPC, grouping by themes and intent has been pushed to the ad group level to allow the algorithm to find the most cost-effective conversions across geographic locations. The results after just six months have been tremendous.

2. Smart Bidding

As mentioned, consolidating your ad account allows you to make better use of Google’s smart bidding. Smart bidding is a portfolio bidding strategy that groups together multiple campaigns, ad groups, and keywords to reach performance goals. Smart bidding uses predictive machine learning to automatically set bids during an auction.

Target CPAs for PPC strategy

A portfolio strategy helps you optimize bids across multiple campaigns. They’re useful when you want to set a maximum cost per acquisition (CPA) across locations.


At their core, smart bidding algorithms need the rich data and budget that results from campaign consolidation to make more efficient ad buy decisions. And they need a structured campaign strategy, such as a consolidated portfolio, that doesn’t constrain the algorithm data-wise. From there, Google’s algorithms will find the most conversions or highest possible conversion value in the budget that is available.

Ad platforms, namely Google Ads and Facebook for Business, continue to enhance their ad bidding options with these smart bidding technologies—technologies that, in many ways, bid more accurately and efficiently than humans can.

Smart Bidding can factor in millions of signals to determine the optimal bid, and it continually refines models of your conversion performance at different bid levels to help you get more from your marketing budget

Google Ads & Commerce Blog

As we’ve discovered in our own client work, smart bidding is particularly useful for larger healthcare organizations with mature Google Ads and a big monthly ad budget. Indeed, smart bidding is only effective when used with large budgets; it needs the data that comes from a lot of ad spend. Also, it won’t work if there’s a large corporate budget that’s limited at each location. In fact, smart bidding works best when an organization is trying to reach a collective target like a specific CPA across all locations or for organizations focused on growing total patient volumes.

Types of Smart Bidding to Know

For healthcare search advertising programs suitable for smart bidding, search advertisers will have four strategies at their disposal:

  • Target Cost Per Acquisition (TCPA): What’s the cap on what you’re willing to pay for a conversion? With TCPA, you can set quite granular TCPA based on the quality of the lead that will result (by location, for example, or device).
  • Target Return on Ad Spend (TROAS): Across large medical organizations, revenue can be quite different for all the various products and services. This is where the ability to control TROAS comes in handy.
  • Maximize Conversions: It’s not uncommon for healthcare marketers to use max conversions to drive a high volume of web leads (appointments) for a particularly high-revenue service (plastic surgery comes to mind). With smart bidding, you can maximize conversions at a particular budget cap.
  • Enhanced cost per click (CPC): Enhanced CPC is a great way to drive a whole lot of qualified traffic to your website. This is useful if you know, for instance, that a certain percentage of clicks from a target demographic will lead to a high-value conversion.

The Benefits of Smart Bidding

For those with rapid acquisition plans, this approach allows learnings from existing locations to be applied to new markets or de novos quickly. It reduces setup times. This methodology can be applied across search, display, and social channels. What we’ve found is that smart bidding can lead to the following benefits, especially for larger healthcare accounts:

  • Reduce the cost to serve up display and search ads
  • Meet efficiency and volume goals
  • Optimize ads against appointment revenue (instead of just clicks or appointment requests)
  • Pull out certain locations for incremental budgeting on an as-needed basis
  • Adjust strategy for practices that chronically underperform on some channels
  • Minimize or eliminate loss of relevance or data granularity when set up properly

Again, smart bidding is not a set-it-and-forget-it kind of thing. Instead, it can be used to automate certain aspects of bid management that tend to drain time and resources. These resources can, in turn, be used for making seasonal adjustments or for revising advertising creative.

How a Leading Psychiatry Group Increased Their Patient Volume by 3x

Georgia Behavioral Health Professionals is a comprehensive mental health care facility with a private practice setting. With psychiatrists, addiction medicine doctors, psychologists, interventional psychiatrists, nurse practitioners, physician assistants, and master’s level therapists to treat a wide range of behavioral health disorders, Georgia Behavioral Health Professionals provides all of their patients’ behavioral health needs under one roof.

As a newly acquired entity of LifeStance Health, Georgia Behavioral Health teamed up with their parent company to grow the Georgia business larger than it had ever been before. They were specifically interested in getting much more out of paid advertising.

3. Responsive Search Ads (RSAs)

Of course, smart bidding isn’t the only way to leverage advanced technology to make ad campaigns more efficient. You can also create responsive search ads (RSAs). Essentially, you and your ad team can input up to 15 headlines and four descriptions, at which point Google algorithms take those assets and mix them into various combinations dynamically.

Responsive Search Ads (RSA) in Action

In an RSA, a Google or Facebook algorithm is helping you find the best combination of headline and description to meet a searcher’s query.


What’s nice about this approach is that a Google or Facebook algorithm is helping you find the best combination of headline and description to meet a searcher’s query. That’s quite powerful, considering the ubiquity of these algorithms. Some marketers have found that using RSAs in tandem with automated bid strategies can provide a significant performance boost, too.

The good news is that you already use RSAs by default if you use Google Ads (that or Call Ads). On the Facebook side of things, these RSAs are called Multiple Text Options, though they’re pretty much the same thing. Either way, RSAs will provide a couple of key benefits:

  • Simplify the workflow for ad copy testing
  • Save time while ensuring optimum conversions (thanks to machine learning)
  • Automatically adapt based on device type
  • Improve ad competition at auction
  • Test differentiated messaging, especially in ad headlines


Why Our 3-Prong Strategy Works

It’s hard to argue against minimizing manual effort, especially when it comes to ad bidding. This strategy will also help you reduce ad serving costs and improve campaign ROI. For one thing, you’ll be able to test messaging themes and advertising creative in volume and in real-time (a much more cost-effective and statistically significant way of testing compared to offline methods). Moreover, what you learn can be applied to improve other aspects of your marketing efforts.

From the perspective of campaign consolidation, remember that you should only consolidate on an as-needed basis. You can still address specific locations, for example, that need to be pulled out and given incremental budgets. You still accelerate practices to make up volumes, too.

In the end, the combination of campaign consolidation, smart bidding, and RSAs allow everybody to do what they do best. Marketers can set up algorithms for success with greater ease, improve user experience (UX), and create new messaging concepts. Machine learning can handle the bidding, segmentation, and audience expansions. It can test message combinations, too.

In other words, the three-prong approach outlined above leads to better performance at lower costs.

For healthcare marketers, that’s a win/win.

Alex Membrillo Cardinal CEO

Alex Membrillo

Founder and CEO

Alex Membrillo is the CEO of Cardinal, a digital marketing agency focused on growing multi location companies. His work as CEO of Cardinal has recently earned him the honor of being selected as a member of the 2018 Top 40 Under 40 list by Georgia State University as well as 2015 and 2016 Top 20 Entrepreneur of metro Atlanta by TiE Atlanta, Atlanta Business Chronicle’s 2016 Small Business Person of the Year,and the Digital Marketer of the Year by Technology Association of Georgia (TAG).