Inside the Marketing Machine Powering 500+ Locations

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, Cardinals experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Ashley Petrochenko: Hey, everybody. Welcome to the Ignite Healthcare Marketing Podcast. My name is Ashley Petrochenko, and I’m the VP of Brand Marketing here at Cardinal. We have a special episode for you today. We are digging into the scaling of archives and bringing to you one of the best sessions from scaling up. AEG Vision is one of the fastest-growing eye care platforms in the US, operating more than 500 practices under a complex house-of-brands model.

In this session, AEG Vision’s CMO, Rachelle Kuebler, and Associate Vice President in Marketing, Allison Lancaster, are going to walk through how they’re building a data infrastructure and marketing tech stack that’s going to enable them to unlock more precise, efficient growth. They’re also going to share a little bit about their investment strategy, how they think about paid media, how they introduce upper funnel channels, the testing and incrementality approach that they use to understand what’s working, what’s not working, and where do you put the gas on. If you operate in a similar mindset and want to drive efficient growth, this is an episode that you don’t want to miss. Let’s jump right in.

Lauren: hanging on, coming back for this session. We’ve got an awesome session today, really focusing in on a single organization and all the work that Rachelle and Allie have done at AEG Vision to round out our morning before we get to lunch. I’ve got Rachelle and Allie here on the line. They’re going to pop in here in just a second, come off, turn their cameras on, and I’m going to let them introduce themselves.

We’re going to spend the next 45 minutes talking about the marketing machine that Rachelle and Allie have built, powering 500 locations. You guys have multiple brands, multiple markets, multiple states, quite a complex architecture. Really excited for you guys to share a little bit of the work you’ve done over the past year. Rachelle and Allie, you’re the brainchild behind all things. Oh, Alex wants to say, hey.

 Long time friends. Rachelle, is this your third year being with us at Scaling Up?

Rachelle Kueblel-Weber: I’ve done, this is my second, and we had someone from my former employer joining you last year in my stead.

Lauren: Yes. Excited to have you back. And Allie, welcome. Really excited to have you here. We’ve got a lot of really fun stuff to talk about. Why don’t you guys introduce yourselves, rather than me doing it for you? Allie, if you’ll tell everyone a little bit about yourself, your history with AEG because it’s so critical to what we’re going to talk about today.

Allison Lancaster: Yes, absolutely. I’m Allison Lancaster. I’m the Associate Vice President of Marketing for AEG. I’ve really been with the company since the very beginning. Started with one of the groups that we first acquired and formed AEG. My tenure with the organization has been going on for about 14 years now with the group. I’ve seen AEG grow from about 30 practices way back in the day to now 500-plus that we are here seven, eight years later. That’s me.

Lauren: Allie, 30 probably felt scary, and now you’re like, “Oh my God, that was so easy.”

Allison: I know, yes.

Lauren: Rachelle, you’re back. We’ve spoken with you here at Scaling Up at different organizations, and now you’re here bringing all your wisdom to AEG. Tell everybody about yourself.

Rachelle: Hey, everyone. I’m Rachelle Kuebler-Weber. I am the Chief Marketing Officer at AEG Vision. I joined the company in January of this year. I’m fortunate enough to join the team with Allie and learn a lot from her about optometry. Formerly came from VetMed where I was able to help Southern Veterinary Partners grow from 194 practices to 480, sell the company, merge with another company.

A lot of experience in the multi-location, independently branded space. AEG Vision was a very natural fit, fantastic company. Really excited about what we’re doing here.

Lauren: Yes, I’m excited, too, to tell the story of what you guys have done. It’s been a great partnership. I want to spend a lot of time on how you guys have built what you’ve built and also what the future looks like, too, because I know you guys have so many aspirations. I think this thought of everything just materializes overnight. It’s a process. It’s a journey. It’s taking iterative steps to get to where you want to be. I think you guys are really great at that.

Quick agenda for everybody listening in today. I think we’ll touch on that foundation, all the work that you guys have done. Allie, you’ve got so much context on some of the why behind performance, that really making growth operational that I think you lend a lot of experience on. Then would love to hear what you guys see as the next phase for an organization that’s made as much progress as you guys have this year. To kick us off, Rachelle, I think you mentioned joining AEG at the beginning of 2025.

We know the organization that you came from and the growth that you had built there. When you came in, where did you want to take the org? What was your assessment of where they were and what your vision, even just for year one?

Rachelle: Yes. Thanks, Lauren. Honestly, the team here has built a fantastic foundation for us to launch from. Allie has done a phenomenal job establishing strong relationships and trust with our operations partners and really creating a true team, which isn’t always common in multi-location and healthcare and operations heavy groups, but this one definitely is. That was part of what attracted me here is we have the partnership, we have the teamwork, we have the relationship with operations, and we have the data.

What we didn’t have was the next evolution of martech and digital marketing capabilities. Coming in, it was really critical that we move from marketing our 50-plus brands separately to being able to market and budget at a location by location basis. So many of our practices within each individual brand are very, very different. They’re operating in very different markets.

Being able to customize and really offer a bespoke marketing approach to each practice but do it at scale meant bringing you guys in, one, bringing in call tracking, bringing in new analytics, new tag management, just new overall martech. We wouldn’t have been able to do it without the foundation that Allie built with the team before I got here. That, combined with what we’ve been able to accomplish in a very short period of time, both as a team and with you, has really been a catalyst for us.

Lauren: Allie, just for everybody listening, just how complex is it? How many domains do you guys manage? I think that is an astonishing feat. The contact at the field and at various groups, do you have to get together to make this happen? I think everyone should hear just how complex it is before we get into how you guys have gotten where you are.

Allison: Yes, absolutely. We try to group our practices with a parent brand or a parent network. We operate under about 60 different parent brands, though, and we operate under 500-plus individual practices. We’re operating under about 350 different names across our entire fleet of practices in that it rolls up to about 700 domains and 500-plus different campaigns. Yes, we are incredibly complex, but it also is our competitive advantage in many markets as well.

Lauren: I think you have one thing that isn’t overly complex about your business, which I really appreciate, which is you guys aim to do one thing for the customer. You’re not trying to be all things, offer multiple services. I think, Rachelle, when we first met with you, it was very clear the vision of optometry as the focus. Just talk a little bit about what you guys are offering as the end service.

Rachelle: Yes. That was also part of what attracted me. When I was talking with the company, a lot of multi-location healthcare companies decide to enter the market in one way. They might’ve entered the market in optometry, but then they start looking at, “Well, but you have ophthalmology, and can we build a hub, and could we expand our services?” I think the team here has been really smart. It’s optometry. That is what we do.

The way that we expand is through looking at what services, what new offerings can enhance and improve the eye health of our patients or give us better insight and them better insight into their eye health and how that impacts their overall health. We definitely do have an expansion strategy, but it’s more about how we can offer what we do better and provide more value to our patients through what we offer versus moving into being vertical within healthcare.

Lauren: Yes, absolutely. I think you’ve layered something quite complex with a very clear vision, and that at least gives you direction in how to move forward in the complexity. Speaking of that complexity, I think one of the things that you guys have done a really great job of over the past year is wrapping your arms around as much of the fragmentation as you can and putting some systems and processes. Like you said, we want to have bespoke programs, but at scale, right?

So you have to have process, and you’ve got to have things in the right place, data in the right place. I know one of the things we worked on together when we first got started was, what can we consolidate. I’d love to hear from you guys, Rachelle and Allie, what were some of the unlocks and consolidation? I know we did a lot of that in marketing campaigns. Where did you find that unifying certain things made your lives a lot easier?

Rachelle: Allie, do you want to talk a little bit about the brand overlap that we had in some markets and how we shifted budgets there?

Allison: Yes. I’ll start by saying we do have one common platform as an organization, which really gave us the right foundation I think we needed to then move forward with consolidation and leveling up how we shift strategy places. As far as our advertising strategy went, we were fragmented under many different parent brands and many different groups. We did look to how do we consolidate across a region and a territory, and even get down to that practice level.

That was one of the initial things that we focused on out of the gate is getting down to a place where we can manage across the portfolio in a way at scale, but also do so individually down to the practice. We had the right foundation there, just because as an organization, we have one common core system. There’s just a little bit of work that needed to be done on the advertising side.

Rachelle: I think one of the things that we saw when I came in was we had spun up so organically. We would acquire a group or we would acquire a set of practices, we’d move into a new state, we’d build a new brand that went under its own account with its own budgets. We have 24 regions or areas where our brands overlap. They were operating out of separate accounts, completely separately managed, separate logins with separate budgets. You can imagine the cannibalization that happened there as a result.

One of the things we did with you guys was, the first thing was just get everybody under the same management, get it under one parent account, one set of billing, and then from there, then go into how we consolidate budget management. It’s not 100% managed all under one budget, but I think the team has found a really great balance of grouping our practices in ways where we can drive growth in one group where there’s opportunity, and in other groups, we can make sure we’re optimizing performance where there’s not as much opportunity or the competition are a little higher.

Lauren: Yes, I think that’s a key unlock, Rachelle, the moving away from, “Well, these clinics are in the same zip code, so they should get the same playbook,” and really starting to look at the data, the operational data, the financial data. That’s a perfect segue into the why behind performance. You can’t diagnose what you can’t measure. That’s been a major theme of scaling up 2025.

You did a lot of work this year on tracking, server-side tracking, your UTM structures, like, “Hey, guys, I need this data flowing in a way that I can then democratize it, look at it together, but slice and dice it.” What were some of, you think, the key unlocks that you put in place, martech, or build from the ground up that have made your lives easier?

Rachelle: When I joined, the team had rightfully erred on the side of extreme caution around HIPAA, which meant that we had very limited analytics, very limited marketing signaling. We handled all of our practices in every state with the most extreme privacy requirements, and bringing in a more modern analytics approach, bringing in a more modern tag management approach, and then overlaying that with– Shoot, completely lost it. Overlaying that with the right tag tracking and the right privacy management. Every state is not the same.

Lauren: Your compliance banners and the programs in place, yes.

Rachelle: Yes. We were blocking ourselves from being able to market and track across probably three-quarters of our practices, largely because we were treating them like California. In Alabama, you can market to me all you want, and you don’t have to tell me anything. Now, we try to do what’s right by our patients and make sure they’re aware of what we’re doing, so we’re not trying to take advantage of them.

At the same time, what you can do as a marketer within the bounds and confines of law, if you have the right analytics, if you have the right setup, if you have the right privacy differentiation is a game-changer. We gain visibility into more than 30% of our portfolio just by changing our privacy management approach.

Lauren: Then I think that becomes maybe a third of the equation of the data you need to still make the right decisions by the right clinics. It’s obviously up here on the screen, but what do you guys think, the operational data and the market macro environment data that is being pulled in to say, these clinics behave this way, these clinics behave this way, and start to really build playbooks, customized at scale, but still as micro as we can get them?

Rachelle: Our practices operate at margins that span the gamut. That’s one piece. As you’re looking at marketing, often marketers will measure ROI based on revenue, but what we’re doing comes off of the bottom line, not the top line, so looking at margins is critical. We have practices that are running at 70% margin, and we have practices that are running at 20% margin. What we can spend there to get a patient in the door is very different. We have practices where we have a 95% show rate for patients.

If we get them, a patient, through ads, they’re going to walk in the door more than 9 times out of 10. Then we have some where the show rate in their area is 50%. Combining that with what the practice’s margins are. Then Allie did a great job with utilization, and us being able to track utilization and tie that to marketing. Allie, do you want to talk about how we leverage utilization?

Allison: Utilization, and we’re driving our business through exams, and so utilization being a key factor of that. We measure utilization by the number of total slots available and how many are currently filled. Partnering with operations and looking at areas where we can increase the number of slots available, we can ensure that slots are available online is crucial in the success of our advertising. If we have no slots available, we can’t drive patients back to the practice.

Lauren: Yes, that’s been a big theme as well, that alignment with the operations teams to use the data that you guys now have available. Call center pull-through has been another thing that we’ve looked at to work with the operations team to say, “Can we get more? Can we make more available?” Not just demanding this thing and saying it’s going to fix my problem, but really showing them how you’re holding up your end of the bargain as well.

Rachelle: We’re very fortunate to have a call center team here. I haven’t had that luxury at most other companies I’ve worked with. I think as we’re looking at the call center, the practice teams, they’re focused on the patient in front of them, as they should be. The person who is seeing our doctors, the person who is considering contacts or glasses, choosing their frames, deciding what lenses they’re going to get, all of those pieces, the last thing they need to be doing is answering the phone in the middle of talking to a patient.

What we found with call tracking was we had a 60% higher answer rate in our call center, which sounds like a no-brainer, but you’ve got to be able to measure that to then be able to talk to your operators about, “Hey, guys, we’ve got to switch our advertising calls to go to the call center. These are patients with high intent. If they don’t go to the call center and the practice can’t answer it, those are folks that are going to go to our competitors.”

So in June, we were able to switch all of our advertising calls over to our call center. Now, all of our website calls, regardless of advertising, are also going to our call center. We’re seeing some good results as part of that decision.

Lauren: Rachelle, the relationship with the call center team, just a little bit, I think that’s, like you said, a dream scenario, a luxury that not every organization has. Who owns that at your organization, and how do you guys work together?

Rachelle: On one level, we all own it. Operations works very closely with our call center team. Call center rolls up into marketing. We look at it as patient experience. Marketing owns the patient experience and making sure that how we’re communicating to them and how we’re communicating with them is aligned. It’s really hard to do that when they roll up to a completely separate arm of the company that may have not the same insights into how we’re driving patient experience.

By bringing it all together, that was, again, a real privilege to be able to come in and do this, bringing it all together allows us– Yesterday, we had a leadership meeting where we planned 2026. We were talking about how we affect cancellation rates and no-show rates. It was our call center leader talking with Allie, talking with our head of analytics, talking with our head of field marketing about what our plan is, talking with our head of patient experience and growth what our plan is all under marketing to affect it across every touchpoint.

That creates a synergy that amplifies any growth that we can create as just the functional marketing team alone.

Lauren: Yes, absolutely. I think those relationships are so key. We’ve talked about finance, ops. I think that call center piece really being as critical. You guys did all this work. You did the server-side tracking. You got the calls converted to call center. We got call tracking in place. Really, the impetus behind all of that was because we had signals in platform that were not representative of what we wanted the campaigns to do for the business.

Not that they weren’t potentially driving those things, but we just had no way to tie them together. Allie, I know you’ve been managing the digital media for a long time. Can you talk a little bit about the transition that was made in platform to really make better buying decisions in real-time?

Allison: Yes, absolutely. As part of some of the additional work that we did around tracking and the server-side tracking. We also implemented call tracking, which then gave us the ability to look at what actual signals do we have in a booked appointment. Where previously we were looking at really basic tracking from a call perspective, just looking at time to convert and things like that.

Adding in the layer of call tracking and the call tracking platform earlier this year gave us a whole different perspective on what was happening and what was ending up truly coming through as booked appointments from our call conversions. Then the other thing we did is we focused a lot on UTMs. Updating all of our platforms across the broader organization to track UTMs.

Not only from some of our work with Cardinal, but in addition to all the other places that we’re sending touchpoints out to potential patients and current patients, implementing UTM tracking to see what was really happening behind the scenes. Really, all of that was to ultimately determine whether we’re getting new patients or existing patients into our system from all of our different activities that we’re working on. Then we can start to then take that data and revise our campaigns accordingly.

Made some significant adjustments in how we look at some of our Google performance, just based on the campaigns that we’re currently running, keywords that we’re using, and traffic that we’re driving back to our sites. Knowing and having visibility to whether they were existing patients already that were just clicking on the first thing that they saw, or that they were truly new patients coming in and finding us.

Lauren: Allie, everybody always loves to hear. Any shout-outs for tech partners that have enabled you guys through this? I know you mentioned call tracking. If you want to shout out who those partners are you’ve chosen to do that.

Allison: Invoke is our current call tracking partner that we’re using. They’ve been a great partner to us this year. Stood up pretty quickly. Again, we’re a little complex. A lot of websites and a lot of different places, a lot of different campaigns, but they’ve been a good partner to us.

Lauren: Fantastic. Yes, I think picking the right partners can really accelerate that. You guys have done a great job of doing that. Where we are today is a part of a process to get where we want to go. I think, Rachelle, we talk a lot about the next iteration, and we’ll talk about 2026, but enhanced conversions, value-based bidding. Can you talk a little bit about what the dream state would be as we work our way towards it?

Rachelle: Yes, I think, as I mentioned, there’s variability in margins across our practices. There’s variability in show rate. There’s even variability in what proportion of people who are clicking on ads are established patients versus new patients. We’re targeting new patients, but in some of our practices, 60% of the people who click on our ads are established patients, regardless of whether or not we’re running branded. We run just unbranded search. They’re still sometimes clicking on those ads.

Now, you can argue on one level that that’s a recaptured patient, and that’s part of what we want to get to going forward with you guys. That’s one of the things we’ve talked about with y’all. As far as value-based bidding, our average ticket across our practices runs between $200 and $600. What I can afford to bid on a practice that has a $600 average ticket is very different from what I can afford to bid on a $200 average ticket. Then you add margin and show rate on top of that, and it just further differentiates it.

We need to be able to do it scalably. We need to be able to bucket our practices into groups where they are able to pay similar rates to get patients in the door from advertising without giving up margin, without negatively impacting EBITDA. I think that’s the next turn. The first turn was just getting everything in and getting all of us working together and all the infrastructure. The second has been, how do we overall optimize budgets, and where can we lean in and increase our investment and have it provide good returns.

Then now we’re moving into, “Okay, now that we’ve got everything and we’ve got it solid and we’ve got it performing pretty well. Now how do we differentiate it to drive maximum value through that value-based bidding?”

Lauren: Rachelle, I think a lot of people maybe think that this target end state, are you guys CDP-enabled, CRM-enabled? Is this like your homegrown? Everybody wants to know, do I have to have those things to get to this end state, or are there ways? I think you guys have taken a really creative approach.

Rachelle: Yes. Our CRM is homegrown. Again, I keep saying fantastic because the folks here are really great. Our IT partners are second to none. They’re the best technology and analytics team I’ve worked with. When I say we have a homegrown CRM, very different level than most CRMs you have. We do not have a CDP yet. That’s on the 2026 roadmap. If you are a vendor partner out there, I’ll be reaching out to you. Please don’t feel the need to call me right after this session. [giggles]

Lauren: Hey, hey, don’t interrupt.

Rachelle: We’re moving on it. [laughs] So we’ll bring in a CDP. We have a homegrown email platform, an SMS platform. We’ve got to change that. It served us very well up to this point. Now, we’ve got the marketers, and we’ve got the data, and we’ve got the knowledge and frameworks where we need to be able to move faster. Homegrown platforms make it a little bit difficult to do that. New email and SMS platform, new CDP coming in this year will be critical. You don’t have to have everything in place to be able to supercharge your growth.

Lauren: That’s such an important message. We just talked about measurement and not feeling paralyzed by the fact that you don’t have the perfect stack, but just making progress and doing something. You guys have really made the most of a lot of the homegrown systems. Rachelle, you mentioned you just left a leadership meeting yesterday where you guys were talking about budgeting for next year. All of this data you’ve been collecting, I’m sure, enabled some really great conversations.

Can you talk a little bit about how that data is helping you go and make the case? Whether it’s more money, money you want to spend in different places than you did in years past, and just how you’re bubbling that information up.

Rachelle: Yes. The first piece of this is, for bottom-of-the-funnel and mid-funnel marketing that we’re doing, we have to be able to tie that spend back to revenue in our practices. We have direct matchback. That’s something that we’ve built this year. With that, what that empowers us to do as a marketing team is actually have a conversation with my colleagues. If I’m talking to the CFO, we are talking about incremental spend. It’s not, “Well, marketing just wants more money.” We’ve all heard that, and that dynamic exists for us.

It’s a conversation about, I can tell you, if we put another $100,000 a month towards something, this is the ROI that we will get. This is the number of patients in the door we will get. We’ve partnered really closely with you guys, and then leveraged our operational data and our marketing performance data to be able to tie that all together. I’m pretty proud to say we’ve either hit it within 10% or far exceeded it when we’ve done those investments. Especially with the macroeconomic factors that we’re all working through this year, it’s been really great timing.

Lauren: Yes. You guys have a pretty interesting story of, I think, you did a really great job of looking at incrementality. There was some cannibalization going on and really just getting the dollars in the new. Again, you couldn’t do that if you didn’t have data on whether the patients you were driving were new or existing. It all comes full circle.

Where you guys were earlier this year to where you are now, just a little bit of that journey, the incremental growth. You mentioned 10% or exceeding it. Allie, maybe you could talk through just a couple of the activities. Some of them are up on the slide. For everybody listening, what are some tactical shifts you could do to ensure way towards really making sure you’re driving incremental growth and not just the patients that were going to come anyways?

Allison: Yes. Previously, we took the approach of as many exams as we can get. Then when we built in some of this additional tracking and with call tracking and UTM and really getting it down to a newer, established patient, what we uncovered is that a lot of our patients coming through the doors were existing patients. Where some of our campaigns were those branded campaigns, were driving all established, and even like Rachelle mentioned, was some of the new patient campaigns that we thought were driving new patients.

Those new keywords, eye doctor near me, eye exam near me, we were finding we were still driving established patients. The lights came on a little bit, which gave us the visibility that we needed to make a strategic shift from branded campaigns to more non-branded campaigns. Looking at it again, down to the practice level, we have a little bit more control. Previously, everything rolled up to these big parent buckets where we didn’t have as much visibility as to what was happening.

Now that we have the visibility down to the practice level, we’re starting to make those shifts. We’re getting smarter every day as the more data comes in and the longer that we have. Looking at many different factors. How does utilization impact the booking conversions? Where do we have high cancellation rates that we need to drive above and beyond in order to meet budget deficits and things like that? Really looking at the bigger picture, but making that strategic shift when we have more data available and could make more informed decisions.

Lauren: Yes, and I think that’s a perfect segue. Allie, I think there’s a lot of people that aspire to have the alignment with ops that you have. Can you just, day in the life of Allie, working with your operational counterparts, what type of comms are you having? What are the cadences that you find work really well? If it’s sometimes lower touch, just data flowing your way consistently, what are some of the key unlocks?

Allison: Yes. We’re fortunate to have many leaders across our organization that either have marketing backgrounds or have a really strong passion for marketing as well. From an operations side, they get marketing, they love marketing, and know that marketing works. That certainly helps. From an operations perspective, partnering with the team itself to, again, ensure we have slots.

I talked about looking for opportunities where we see a high demand in a market and we maybe don’t have enough slots available. Or we may see that some doctors are booking better than others in particular locations. Having those conversations with operations and then helping to inform the slots that are available that we can then drive appointments to has been really helpful. But it all comes back to looking at the data that we’re looking at.

Being able to give visibility to our ops partners and all of the new information that we have coming in is giving us credibility so that we know this is the data that we have, this is what’s informing the decisions, allowing that two-way conversation to hear is there something else going on that we’re missing, is there something else at the practice that we’re maybe unaware of. Having that kind of two-way communication and partnership with them, and then making sure that all goes back to just informing our strategy and where we place dollars in the market.

Lauren: Yes. Allie, I think sometimes people in your seat especially, maybe you’ve experienced this at some point in AEG’s growth history, the tendency of marketing dollars to be reactionary to ops and not the proactive working with them. How do you avoid firefighting all day long when you guys have so many practices and so much need?

Allison: Well, I’d like to say we don’t do any, but of course, that’s not true. There are situations that we, of course, have to react in specific markets when there’s things that happen that are beyond our control. We partner with other cross-functional teams across the organization, too, where we’re looking at, from a corp-dev perspective, we grow through acquisition.

There’s always new acquisitions that are coming down the pipeline, so looking ahead to what’s to come in specific markets. We’re partnering with our real estate teams to looking at where are we adding exam lanes, where are we doing remodels, where are we doing relocations, where do we need to get ahead on what we can forecast and what we anticipate to see in these markets with dips in performance and dips in patient volume. Again, looking at partnering with operations from our doctors.

Where are our doctors? Do we have retirements? Do we have shifts? Do we have changes? Do we have new ODs coming in? Trying to get ahead of where we’ve got that anticipated capacity and an anticipated need and then use advertising to help fulfill that.

Lauren: Yes. We spoke just this morning after our opening session with Sherri-Ann from Heartland Dental about her aspiration for next year really being an AI-enabled capacity budget adjustment in real time. I think you guys have a report that’s been really critical to you, built by your IT team, so super important for that integration. Your exams available online versus in practice and some of the data that bubbles up to you.

How often are you making micro and macro shifts in your strategy based on that information? Because I think that’s something we get asked a lot. How much is too much? Am I making changes enough and adapting to what’s happening on the ground?

Rachelle: Yes, so–

Allison: Go ahead, Rachelle.

Rachelle: No, no, you go ahead.

Lauren: [unintelligible 00:35:32]

Allison: Go ahead.

Rachelle: We calibrate with our leadership team at a macro level on a monthly basis. We evaluate how things are going, how our investment is doing, whether or not we need to dial it up or dial it down. We made decisions the last couple of months to continue to invest because we were seeing great return. The third month, we decided to hold steady because there was so much opportunity for optimization, we wanted to do that first. That’s the kind of conversation we’re having on a monthly basis.

On a weekly basis, we’re looking at what’s going on with the practices. There may be an operator that calls an RVP, regional vice president, or one of our district managers who says, “Hey, I really need help with this.” In a lot of those cases where we send them, frankly, it’s a call center because the call center can make, if I look at what can move the needle immediately, what has a two to four-week pull, and then what has a longer pull, the call center can get exams in the door within the next five days.

If they need help, the short-term is not a conversation about, do we adjust the budget. We meet with you guys once a week, and we go over the data. Usually, it’s macro discussions. It’s not, “I want you to change the budget at practice 1532.” I don’t think we’ve had that kind of discussion in months and months and months. Instead, it’s, “How is it going? What are the next steps? What do we need to change? Look at shift. What’s the new test we’re running? How’s the outcome with that?”

We have, and I’ll tell you, I had in my previous slides with you guys, a much more hands-on approach with my team and our relationship. We’ve really shifted to making sure that we’re equipping you with the data, making sure we’re equipping you with the right operational information, and then that we’re evaluating the impact on the practices and getting that back to you. Then you guys are basically telling us, “Hey, this is what we think we should do.”

Those conversations, again, happen on about a monthly basis because we’ve got such a tight team between your team and ours. We are one team driving growth together. With our operators, unless it’s the firefighting stuff, and again, that goes more to our call center, it’s more on a monthly basis. We have a bi-monthly update that we do to them.

We have, obviously, our quarterly board meetings and all of that, but it’s not as much on the micro level. That has shifted over time and diminished a little bit over time. I think it’ll continue to shift as we get sharper and better at communicating out what’s going on and what we’re doing.

Lauren: Yes. We had someone chat in. They were just curious. I’ll ask it while it’s relevant. This exam’s available online. The ability to get that data, do you guys have a universal online booking solution or is that fragmented as well?

Allison: It is. That’s that common platform that gave us the right foundation to take it to the next level. That’s been really crucial. Yes, we do operate under one core operating system and have one scheduling.

Lauren: I think that’s a dream for so many house of brands groups. That’s definitely foundational. Rachelle, you mentioned testing. Let’s spend our last seven minutes together talking about the really fun stuff, forecasting, the testing, what’s coming next. We’ve asked a lot of people this throughout the course of scaling up ’25. Philosophy on what’s your core, what do you test, do you have a framework for the right amount to invest in testing, and a framework to know if tests are working?

Rachelle: For us, part of the testing is typically our approach is 5 to 20 practices, give or take. 20 practices, it’s enough of a sample set to be able to give us some good results. It’s not so much that it’s going to negatively impact the entire portfolio. We will typically, depending on the test, we may test across multiple markets, or if it’s something that’s complex that requires a lot of operational discussion, we may go all in one district with one district manager.

We take all of their practices and we move them forward on a test. I think we’ve run paid media ads in Louisiana with you guys, for instance. That allows us to really evaluate for that subset of practices in that area, how did they perform against the others that are in their cohort, their cities, their state. There’s that. I think we all know that we can’t permanently depend on Google. That creates some level of risk as a result, even though Google’s been really good to our business, and I’m sure everybody on here’s businesses.

Testing other channels, other media, having that as an ongoing initiative is critical. Then how we measure, frankly, is we’re looking at, if it’s bottom of funnel, we are looking at dollars pull through in profit. That’s the gold standard. If it’s mid-funnel, we don’t have everything figured out. We’re dependent a lot on you guys. We work a lot with Brandon to give us a view of when it’s good that we’re getting traffic versus what we’re seeing in conversions. Right now, we’re running PMax and we’re seeing great conversions online.

We’re not seeing any of them pull through. Here’s the thing, we’re still on last touch attribution as well. We’re not seeing any of them pull through on last touch attribution. Yesterday, I had a conversation with my head of analytics where we were talking about, yes, but the way we’re defining things may need to change so that we can better understand how PMax or how upper funnel is impacting the overall business.

Now we’re looking at, “Okay, well, then let’s put in an incremental lift framework and allow us to compare our practices on the same strategy, same level of spend, same type of DMA, and then look at apples to apples performance and see if there was an incremental lift.” There’s a lot of nuance that goes into it. We don’t have it all figured out yet. That’s why we’re testing.

Lauren: I think it’s great. I think what’s most important in this narrative is, and actually this is perfect segue into what’s coming next, you had to do all the work that you had to do this year to get to this point where you can then say, “Let’s do geo holdout tests, let’s do ghost bidding tests, let’s do incrementality measurement, let’s start thinking about some other more advanced measurement frameworks.” I think what you can’t do is leap from nothing to those things without the steps in between.

Rachelle: No, and everybody wants to. If your CEO is reading anything, they’re going to ask you two things. When are we going to get an MMM? And what are we doing about AI? The problem is I see a lot of people asking in the chat, “How do you get operations to give you that information? Did you say you can tie profit straight back?” Those are table stakes. For you to really understand what’s going on with your business, MMM’s not going to do anything for you if you don’t know how the ads are actually impacting your revenue.

You’re not going to be able to talk to your CFO in terms that he’s going to be able to understand and relate to and release money for that new critical initiative that you need to run. Being able to redirect your folks back to the table stakes. Even on a small testing level, take a handful of practices, a handful of folks in your operations, and try to work with them to get what you need so that you can prove the value before you look at pole vaulting forward.

Lauren: Yes. You guys have put in the hard work to now get in line for the pole vault and start doing some of those things. I would love to hear what’s on the roadmap. Rachelle, what are your priorities? Allie, I want to ask you the same thing for 2026.

Rachelle: We have the framework. Now we actually need to pay attention to AI more. We’re seeing some erosion on some of our organic properties. We’re going to address that this year. We definitely want to make sure that we’re preparing for advertising moving into AI because that’s coming.

Lauren: They’re losing [crosstalk].

Rachelle: It’s already here. Yes. We’re probably going to be expanding in PMax. We’re going to go into LSAs. We will move back up the funnel as we test and know what actually works for which practices. Then we are bringing AI full bore into our call center. AI-based QA, AI agent assist, we’re bringing a digital agent in to answer calls and lessen some of the pain of our IVR systems.

Then from that, we’ll expand our model from last-touch to multi-touch. We’re putting in the steps to do tracking now for that as well. Just across the board, shifting us into the next one or two years.

Lauren: Allie, anything you would add on that, focuses for next year?

Allison: I think Rachelle hit CDP. We’ve got the data now. It really hasn’t been long that we’ve had the data. I think continuing to watch trends and pivot accordingly when needed and be flexible on the plan. Yes, looking forward to next year. We did a lot of work on Foundation this year, and next year is the pole vault, so I’m excited.

Lauren: Yes, absolutely. For everybody watching, just summing up our conversation here, I think Rachelle and Allie said it best. I think taking the right steps to get here, not expecting to get there overnight. We spent a whole year doing this. We have so many aspirations. Rachelle, you mentioned going back into upper funnel. I think it’s okay to take a half step back and reset. It’s okay to say, “Those things weren’t failures, but I need to recalibrate my baseline, and then I’ll do it in a measured, intentional manner.”

Yes, we know we should be there. It doesn’t mean we have to be spending money there for the sake of saying we’re doing it. It’s okay to take a step back. I love how you guys are really putting data at the center of everything. Allie, Rachelle, it’s been great having you guys. Thank you so much, like hanging out with friends. We could do this for hours, I’m sure. Thank you so much for your time today.

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