Podcast #56

Is SEO Worth It? How to Measure SEO’s Impact on Revenue

It's vital for healthcare groups to build an organic presence on the search engine results page (SERP) if they want to reach potential patients. To get on the first page, they need to invest in SEO. However, many organizations struggle with SEO because they don't see an immediate return on their investment. SEO takes time to gain top ranking positions. Because of this, SEO campaigns are often cut during times of economic uncertainty.

Episode Highlights:

Jacquelyn Green: “SEO is a really complicated channel, and the strategies that we create are typically going to be really robust and account for a lot of different pieces of the user funnel. It’s not going to be as clear cut as you land on an organic page, and then you click through to the conversion stage, and then you become a patient. It’s not going to be that clear. I would love it if it were, but it simply isn’t.”

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Announcer: Welcome to the Ignite Podcast, the only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Lauren Leone: Hey, everyone. Welcome back to Ignite Healthcare Marketing Podcast. My name is Lauren Leone. I’m the SVP of healthcare marketing here at Cardinal. I’ve got Jacquelyn Green joining us again this week. Thank you, Jacquelyn, for joining us for two weeks in a row. Jacquelyn is our director of SEO operations, and she is going to be joining us to talk about measuring SEO. This is the topic that we hear all of the time, which is how long is SEO going to take and how am I going to know if it’s working?

Let’s have a conversation around what we can track, what kind of promises we can make to clients about timing, and where tolerance needs to exist for SEO to become a part of your evergreen strategy. It’s never going to go away.

Let’s start by asking Jacquelyn, why is it that SEO is harder to track than some of our other channels like perhaps paid search or Facebook ads?

Jacquelyn Green: SEO is a really complicated channel, and the strategies that we create are typically going to be really robust and account for a lot of different pieces of the user funnel. It’s not going to be as clear cut as you land on an organic page, and then you click through to the conversion stage, and then you become a patient. It’s not going to be that clear. I would love it if it were, but it simply isn’t.

We are thinking about patients who are just beginning their journey toward finding a provider all the way toward looking for a location to actually go in to see a provider near them. It’s really important to consider all of the different metrics along the way. I think sometimes that considering the length of the funnel that’s associated with SEO can trip planes up because they want to see the revenue fast, and they want to see it very clear, but it doesn’t always happen that way.

Lauren: This concept of the ROI of our SEO is going to be X is really in theory not a thing, because in something like paid search, and this isn’t always fair to say to that channel, but in theory, paid search is typically a bottom funnel. It is service near me now, service near me provider that therapist that does X, Y, or Z. In theory, the goal is to capture that existing demand and simply guide them towards your website to take conversion.

Like you said, SEO is so much more than that, and that is because the way we think about SEO is full funnels. Talk to us about the KPIs at different stages. Let’s just talk in top, middle, and bottom funnel for SEO specifically. What would that look like?

Jacquelyn: Yes, so the way that I typically present it to clients is you almost want to see the top, middle, bottom-funnel user journey corresponding to the timeline of your success. It always will start with visibility. It starts with making sure that you are in the search results, which sometimes can be even more challenging if you don’t have any visibility to start with or if you have technical issues on your website that might inhibit you from appearing. All of that’s going to come first. When we talk about top funnel and we talk about visibility, really we’re looking at rankings. We’re looking at are you appearing in search for the right queries. Are you able to track impressions in Google search console?

Those types of metrics are going to be really important at the beginning because you are trying to get a sense of are users even able to find you in search. That’s always where it starts. After that, then you can start measuring things like traffic. This is really where we get hung up with clients a lot of times is getting stuck in this middle section of being able to drive traffic to your site but not necessarily immediately seeing the conversion. One thing that’s really important to consider is where you’re appearing in search results and for what queries, which goes back to the top of the funnel. You want to make sure that you’re actually appearing for really conversional searches.

If you’re not, if you’re just appearing for maybe the top funnel blog posts, you’ve still got a ways to go before you can expect to see conversions come in. When you are ranking for those important queries that you’re tracking and you’re seeing those rankings on page one, especially when you’re in the top three positions, then you can expect to start seeing traffic. You’ll want to measure organic traffic coming through your site. You’ll want to measure clicks through Google search console.

Then, beyond that, you can start measuring maybe the more interesting metrics, so things like user engagement. Are users actually staying on your webpages for a decent amount of time or are they bouncing? We can measure things like pages per session or we can examine the user behavior flow to see how they’re interacting with your site and then make tweaks to the content to better accommodate.

Then, at the end of the day, what really is going to be the money maker for the practice is going to be conversion. We definitely still want to measure form fills. We want to measure click to calls or calls through a call tracking system. That is going to be the most bottom-funnel metric that’s going to correspond directly to patients in the door. It takes a long time to get there, and there’s a lot of different metrics along the way that you can’t ignore.

Lauren: I think sitting on the sales side when we’re in taking new clients, what’s interesting, you just described a timeline. What we aim to understand in that process is where are you on that SEO journey. We work with groups who are, they just purchased their domain yesterday and they’re building a new brand. That timeline looks very different than someone that perhaps had their domain for 20 years.

Maybe they haven’t really done a ton of SEO, maybe they explored with a contractor, so there’s some equity there. Maybe we’re coming in the middle. Then we work with groups that have been working with agencies for many, many years, and perhaps the equity is built, but that relationship has taken a turn, or perhaps a current vendor isn’t keeping up with helpful content and current modern-day strategies so they want to make a move.

It is not this one-size-fits-all answer to the question of how long is SEO going to take. We don’t even think about at that point the competitors set yet, and how much do we have to overcome to even get you where you want to be on the conversional terms. There are so many consideration points when answering that question, and that’s why you’ll oftentimes get a non-answer which is it depends.

Jacquelyn: I know that SEO can get a bad rap for using “it depends” as an answer, especially when it comes to actually measuring or forecasting, but it really does depend on where you’re at. I think that you summarize that really well. That’s why our roadmaps and our strategies are so customized because we really want to make sure that we are developing a strategy that’s going to be tracking the right metrics. We will see a lot, especially with clients who come in from other agencies.

They’ll say, “Well, we were really successful. The agency did a great job, but it just didn’t transfer into leads, it didn’t transfer into patients.” We’ll say, “Well, in looking at your success so far, we are seeing a lot of ranking keywords. We are seeing a ton of impressions, a ton of visibility, maybe even a lot of traffic.” The reason you’re not seeing it convert is because it’s not on terms that would convert. It’s on really top-funnel keywords.

There’s nothing wrong with those keywords. If your goal is going to be patients in the door and not visibility, then we don’t want to focus fully on visibility. It’s about making sure that from day one, we really understand what your goals are as our client, and that we can really partner with you to track those goals and create strategies that are going to deliver on those goals.

Lauren: It’s interesting, I mean we’ve had clients come in before where if, let’s say, for example, traffic was the KPI for SEO, and obviously we know it’s one of many KPIs. If traffic is all you’ve historically looked at, and what we find is that the traffic that you’re getting to your site, let’s say, 95% is coming through blogs that are maybe adjacent to but not hyper-relevant to your services, maybe our objective is to reduce that traffic. Let’s cut out the traffic that isn’t relevant and focus on rebuilding traffic that is relevant. This idea of just constant up, up, up, and a trend line that just never falters is really a problem in SEO because the data can appear one way and really mean something very different.

Jacquelyn: Yes, absolutely. Like I said, it can be easy to get sort of stuck in that middle phase. I think that is where clients tend to become impatient, and I understand it. They want to see the revenue quickly, but it can be tricky when you’re in that traffic-driving stage because at that point that’s when you need to really reassess your strategies. That’s when our team is in the data every single day, in your website every day, making sure that if we need to make tweaks to the user experience of a page to help guide toward conversions or help guide toward the next step in the user journey on a different page, that we’re able to do that.

Then we can track those metrics. Maybe the goal in the meantime, while we’re unable to fully drive a ton of qualified leads right now, maybe the goal is, “Okay, let’s just get people to your location page. Let’s make sure we can do that and have that as a clear goal in the first six months. Then from there we can start focusing on maybe the next step is actually getting patients in the door.” That patience and tolerance along the way is really important if you want to see long-term sustainable success.

Lauren: You mentioned roadmaps. I think that is the best answer to the non-answer that we give around it takes time and it depends. Talk about what a roadmap looks like and how it essentially acts as that checkpoint, that gut check. It’s not to say there’s a promise at the end of this roadmap. It’s to say let’s sit down and constantly be reassessing where we are in that journey and what the next step looks like.

Jacquelyn: I honestly think roadmaps are one of the best things that Cardinal does that is unique from other places I’ve worked at least. The roadmaps we create are extremely tactical, really well thought out, very strategic and we lay them out in a way that is going to correlate with the monthly reports that we show our clients. Every quarter we’re going to put together roadmaps that always contain an objective, all of the tasks that are going to fit into that objective, what KPIs are we going to track, what keywords might we measure, or what metrics might we keep track of. Then we’re going to give timelines around how long is this going to take and when do we expect to start seeing this payoff basically.

To use an example, if one of our objectives is to improve visibility, then tasks that fit alongside that might be creating blog posts or creating mid-funnel service and condition pages. If our objective is drive patients in the door by a certain percentage, then our tactics are going to look different. If it’s going to be location page optimizations or Google business profile optimizations, all of those things are going to have more of an impact. When we show our clients those roadmaps we want to make sure to educate them on exactly what the point is of what we’re doing so that they can be along for that ride with us, and so that the reports we deliver on the metrics actually have a clear story that they’re telling.

Lauren: I’m going to ask you a question I get asked which is, can I invest in 12 months of SEO and be done with it?

Jacquelyn: No. I don’t say that just because I want to keep my job but because I really do think that long-term success is not set it and forget it. There are certain things that will pay off for a long time, like a great Google business profile. If you’re not changing your hours, if you’re not changing your services a lot, we’re not going to be in there tweaking it every day. That is very much something that you can sustain as long as your business is roughly the same and Google’s policies are roughly the same.

With your website, the landscape is ever evolving. If you don’t continue to optimize to meet Google as it changes and as your competitors change, you’re just going to find that the success you’ve seen previously is going to fall off. We see that with clients time and again. Often, they’ll come to us and say, “Well, this strategy worked for us two years ago. Why isn’t it working anymore?” The answer sometimes is we don’t know. That’s how it works. Google changes its algorithm every day to make sure that it is serving users in the way that it sees best. We just have to fit into that process and make sure that we are constantly strategizing against the competitive set and against what Google is forcing us to do.

Lauren: It’s really interesting. I’ll take an example out of the addiction rehab category. Let’s say for the past two years you’ve been owning your category because you’ve been producing 20 blogs a month and that’s been your approach. According to Google’s algorithm that’s been what’s put you on top. You quit your SEO program and you thought I’m on top and I’m here to stay.

Helpful content algorithm update hits. All of that content equity is gone because it’s no longer helpful. Google sees that you were just doing it for the sake of doing it and not really thinking about what the user needs to hear. Without someone who sees that update coming down the pipeline quickly understands what needs to happen to react to it and can do so alongside of or ahead of your competitor set.

If you didn’t have SEO as an investment in your day-to-day marketing strategy, you would take that hit and you would lose years and years of investment in SEO overnight.

Jacquelyn: We actually saw this quite a bit especially with newer clients that had come to us. If we had clients who came to us a couple of months before the helpful content update, we did see several clients who really took a beating with the helpful content update because they’d come to us with a lot of traffic driving content that was really making up the bulk of their traffic metrics, their visibility metrics.

With that being our baseline, once Google realized that content was not helpful, it was just keyword stuffed, or it was just thin or useless to a user, they really saw a sharp decline in those metrics. Again, that doesn’t really paint the full picture because those pages may have never been driving leads. It’s important to like I said keep a really clear goal in mind and make sure that you’re working toward that alongside all of these updates. Otherwise it’s going to be way too easy to get lost in all of the madness of SEO.

Lauren: When we think about a media and marketing mix where SEO is part of it but so are paid channels, paid search, social advertising display, any number of things, and maybe offline too, direct mailers, whatever it is that an organization is doing, certain channels have this, you’re always paying for the placement. Every direct mailer you want in an inbox costs X amount of dollars. That rate can go up, and every pay-per-click ad that you want to place as the landscape gets more competitive, the cost per click to get that is going up.

SEO is a little bit different in theory. When you really think about it as an evergreen investment, your cost is fixed. It is the cost of your agency’s retainer and what they’re doing within that. Now retainers may go up slightly over time or there may be additional tactics that you want to add in, but in theory, each click or visit to your website for SEO does not cost incrementally more.

Talk about for the clients that we see at Cardinal that have invested, let’s say, five years with us, and alongside other channels, what happens to that SEO cost per lead metric over time and how does it compare to the rest of the channels?

Jacquelyn: Absolutely. I think that the big word to consider here which you used earlier is equity. As you are investing in your SEO strategy you’re continuing to build that equity or that authority of your website, not just in terms of true backlink authority, which is a more measurable metric. Over time, all of the work that you’ve put into your SEO strategy is going to continue to manifest itself in that pay-out over time.

You’re not going to have to create another service page. You’re not going to have to spend another dollar on a new backlink campaign. All of that work that you’re putting in is going to snowball and continue to build that equity over time. You’ll really just continue to see the results of that. Now like you said we can always be fluid with our strategies and reallocate that funding toward different strategies that might have more impact. We might need to reoptimize every now and then, but we don’t have to continue doing the exact same thing.

With pay per click, you have to continue to run those ads. You have to continue to deploy those strategies. With SEO, you really don’t. We can take that funding that you might put toward your retainer, and we can instead pivot that toward a backlink campaign where we can really prioritize your authority.

That’s going to just improve the value of the time we spent creating those blog posts or creating those service pages. It’s really cool over time because we get to see our clients really thrive once we’ve put all of the foundations in place. We don’t have to go back and redo that. We can really just evolve our strategy and do more fun things for them and really get to see them grow into new areas which is really cool for us.

Lauren: I think that’s probably where people see or maybe perceive that SEO as finite. You built my service pages, my website looks the way it does, and that is SEO, but like you said, there is more to it. There is building up of authority externally into the domain. There is creative new content ideas. There is SEO UX. Starting to dive into the layout of pages and how the content is structured visually, working on optimizing video. There’s just so much you can do beyond what I think the perceived fundamentals of SEO are.

For anyone listening, as you think about considering SEO and however you choose to execute it, choosing someone that thinks about and understands that SEO is dynamic and it is not a static list of deliverables, be warned or be weary of scopes that are X number of this, Y number of this, Z number of this, because that person, their success is in delivering that quantity of materials.

It is not on thinking about all of the tools in the SEO toolbox and being fluid over time as to which ones are going to have the greatest impact. I think this has been a great conversation about valuing SEO, about thinking about SEOs, KPIs. ROI specifically is something that you can get to over time alongside your other channels if you are thinking about closed-loop attribution and deploying a tech stack to support it.

In the meantime, what Jacquelyn has discussed with us about the KPIs that matter at various stages is really what we encourage you all to be focusing on. Thank you, Jacquelyn, for joining us. Thank you guys for listening to Ignite. This has been another great episode. Please share, like, subscribe, comment wherever you’re listening, and we hope to see you all back again soon.


Announcer: Thanks for listening to this episode of Ignite. Interested in keeping up with the latest trends in healthcare marketing? Subscribe to our podcast and leave a rating and review. For more healthcare marketing tips, visit our blog at cardinaldigitalmarketing.com.

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