How to Pick the Perfect Healthcare Marketing Agency

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.

Alex Membrillo: You guys know how much fun I like to have. This is going to be a different one. I don’t say that all the time. This is going to be a different one, and this is going to be to help you. Let us help you, because we have one of my dear friends, Jane Crosby, on with us. Jane, she’ll tell you where she comes from. In general, guys, this is going to be an agency powwow to try to help you get the most out of your marketing relationship with the agency’s consultants and experts. Otherwise, Jane, what’s up? Welcome to Ignite.

Jane Crosby: Thanks for having me. I’m excited to be here. We’ve gone head-to-head. It’s fun to be friendly for a podcast episode, Alex, and hopefully help some of our healthcare marketers get the most out of a decent RFP process and agency partnership.

Alex: That’s right. What’s cool about being healthcare marketing agencies is both mission-driven, and I know that I feel– When we lose, we better have lost to another healthcare-specific agency, because I know they know how to connect patients with care. I am okay with– I don’t like losing, but I’m more okay with– Less not okay with it when it’s someone, another agency or group, that helps connecting patients with care because at the end of the day, that does fulfill the mission. It is good to be with you. I know you guys love it, and you guys just went through a rebrand. Tell us about it.

Jane: We did. It was fun. We’ve evolved a lot over the last 30 years. We needed to re-establish ourselves as a leader in performance marketing and full-service agency support. We’re excited about what we bring to healthcare marketers. There’s not a ton of small shops left that bring a full-service healthcare exclusive capability to this space. That’s what we’re trying to do, and I’m excited about some of the partnerships we’re bringing on.

The performance media space in particular is so fun because it’s changing so much, and we’re seeing so many small agencies outside of healthcare, just not able to keep up at all with all of the changes that are coming down the pike with Meta, and CDPs, and all of the tracking technologies we need to keep up with.

Alex: You just reminded me, we have a livestream tomorrow that I’m supposed to be prepping for on the Meta privacy changes. I’m just kidding, guys. It’s going to be good. Well, by the time you hear this, it was good. Yes, it’s a tricky space to be in, highly regulated, and a fun place to be as well. True North, reorienting towards becoming the best performance media agency in the country, I think you have a little competition there. I can’t wait to get into that. True North is based where, how many people generally, and what is the full– When you say full-service, what’s the full suite so everybody knows what to contact you for?

Jane: We are based in Chattanooga, Tennessee, but we’re fully remote. I’m in Minnesota. We have folks all over the place. That’s been great. That was a change with COVID that we made in talent acquisition. All the things have been fantastic with that. We’re about 60 people strong, mostly hospitals and health systems, some specialty providers. The insurance space is growing for us, but a lot of our work is the hospital and health system world right now.

Full-service to us is full-service. That can mean a lot, but brand strategy, creative strategy, developing a new brand campaign, and then executing on that from a performance media standpoint. We just built out a new measurement and analytics platform, so most of our growth and exciting stuff is happening in the performance media space at full-service and bringing out traditional media in-house. A lot of exciting new capabilities we’re adding too.

Alex: Yes, that’s fun. You all sound like the mirror image, except you’re mostly in health systems. We’re mostly in those PE bag, multi-site providers. That’s fun. I agree the media is super fun because now all the traditional stuff is now commended. Jane, I was sitting on my couch. We were watching Landman the other night. It’s on Peacock, or Amazon, or whatever. We’re served an ad, and it was for HIPAA-compliant software. I was like, “If you didn’t think OTT was targeted before, I was blown away.” I stopped and I talked to my wife. It’s super cool. Traditional now come in digital, and we can program any target.

Jane, the part I love is that now creative goes along with it, and all of us digital nerds get to pretend to be ad agencies and bulk up that capability. Very fun. Let’s get right into it though, the stuff that will actually help our provider group marketers. What advice– There’s a lot, so you’re going to have to pick a top few things. What advice would you give an in-house marketer to picking the right agency? How do you get the right one?

Jane: Healthcare expertise. I think you have to find healthcare expertise and structure a review process so it’s collaborative. You’re not going to get a good proposal or a good understanding of how an agency is going to partner with your team if they don’t have the information about how you operate, what your goals are, or how your business is structured. That’s the biggest red flag that we see when we get an RFP, and don’t have any access to discovery, and it’s totally procurement-driven. Those are so challenging because you’re guessing.

That hurts the client too. It’s like you’re going to get a tailored recommendation, and you’re going to learn about the pitfalls and cultural misalignment, all of that stuff, if you give people access and have conversations before the RFP goes out and throughout the process. That’s the biggest one for me.

Alex: Yes, I love it. Okay, so a collaborative RFP. I want to talk more about the RFP in a second. Why is it healthcare expertise? It seems obvious, but then when I started thinking about it, there are tactical reasons that you want people to have healthcare experience other than not getting sued, because they uploaded your PII in a minute. What else matters within our expertise here in healthcare?

Jane: We know how the business works. Everyone says their business is unique, and it’s different here, and yada yada, but it actually is different. Having a partner who understands what an IDN is in the health system space, that does matter because you get strategies that are actually appropriate for an IDN. Don’t strike any Stark law nerves. Those kinds of nuances are pretty critical. It’s a lot different than selling shoes or cereal.

Alex: Yes. Ooh, we did sell shoes and pizza at one time. It is different. [laughs] We got them fat, and now we’re getting them skinny again. Yes, it is different to the technologies that you use, what makes sense, how to talk– One of the biggest differences I’ve seen is that when we were selling pizza and shoes, there wasn’t call centers. That can be one of the biggest downfalls of the lead flow. CPL looks good. Why is there no revenue? It’s oftentimes call center and stuff like that.

All of these little things Jane mentioned matter for healthcare expertise. If they never worked in dental, okay, they’ve worked in term PT [unintelligible 00:06:02] They get it, I assume, right? Is health system portable to provider groups, Jane?

Jane: Yes, for sure. I think vice versa because, fundamentally, the businesses are structured really similarly. It’s just a level of complication. I think slightly different challenges. In the health system side, the access to data is so limited. Most of our specialty groups, it’s a little bit easier to get some acquisition data coming through or ROI insight. There’s stuff like that. That’s just simpler, I think, with the multi-specialty space.

They’re also more performance-driven, and so the pressure for ROI, and agility, and optimizations, that’s a little bit different in that world too. I think the expertise and the healthcare nuance, I think it’s pretty portable across specialties and domains.

Alex: The passion will be there from the agency that they actually will care about the patient and figuring out a way no matter what and staying up at night, if it means like serving an ad to get someone in for a cardio. Okay.

Let’s go back to the RFP thing because I know a lot of people, RFP or agencies. RFP is the big groups do that. Provider groups often just reach out. How should they look at that in the process? What have you seen been the most rewarding and kicked off a great client engagement, collaborative? Why? How? How do you do that?

Jane: I think pre-qualify who you invite in. Let them do some discovery, listen to their spiel, get an initial sense for how they think about your business, and then either issue that RFP or go through the selection process and the scoping process for a partnership. I think that’s the biggest thing. If you don’t do that, or it’s a RFP that procurement issues to everyone who’s in your database as a marketing vendor, you’re just not going to get the personalized attention that you could if you were collaborative and started to pre-qualify agencies.

You can do that even if legal requires them to stick to a procurement-driven RFP. We’re in one of those right now, but you do the discovery ahead of time before the RFP goes out and you can at least get to some of that and set the agency up for success, and yourself.

Alex: Is there any way? Do you like being tested here? Do you like being– Y’all are trying to get more-

Jane: Yes.

Alex: -as long as you– Do you like, “Hey, show me creative, or mock something up.”? Are you asking for free work? What’s your thought?

Jane: I love it. If an agency doesn’t want to do free work, like why? They’re probably not totally in it. Some of that stuff doesn’t take that much time. As long as you give them the right information and access, and are clear on expectations, you’re not going to do brand training and you’re asking for concepts on creative, that’s fine. Just make sure you’re lined up on the fact that they might use your logo, or your color strong, or throw in a new color palette. That stuff’s important, but we’re not afraid of free work. I think it’s important.

I like audits. If you can get people access to your ad accounts and let them get in to poke around at the structure, and actually give you some feedback on how they would change ad account structure, PPC bid strategies, I like that too.

Alex: Yes. Some people get nervous because my agency is going to find out when I add that Gmail read only or whatever. You can send over data and screenshots just to see how the agency thinks. I think that is an important part of it. Well, while we’re on this topic, Jane, how important to you is it? How important should it be to an in-house marketer to get to know the team that they’re going to be working on? Is that important? Is it possible when they sign the partnership six months later? What is the right mix there where they get to know the people that aren’t just selling like the Jane, and Lauren, and stuff like that?

Jane: I think just vet what the structure is like. Jane and Lauren are– You’re probably not going to get Jane and Lauren every single day. There’s a reason certain people are in certain roles selling, pitching, and doing those presentations, but make sure there is a team. I had somebody a few weeks ago say, “Is there a team behind you, or is it just you?” I’m like, “No, there’s an actual team. Here’s the structure.”

Ask for the structure, ask who’s on the account. Ideally, meet them at some point. If it’s a massive opportunity, our agencies aren’t Merkle. We’re not huge. We don’t have available capacity sitting there for 10% growth in a single account. You have to understand that there’s going to be some staffing and deck chairs that are moving around.

Alex: Yes, buddy. I battle with this all of the time. What is the right size? If you’re a huge health system, huge provider group, what is the right size agency? Have you seen any trip ups, red flags that need to go to Merkle as June or Cardinal? Is this okay? Does it matter?

Jane: I think our agencies can support anybody, and it depends on their scope. Full-service AOR for everything? Maybe we’re still a little bit small to serve the biggest enterprises, but from a performance media standpoint, there’s no reason our agencies can’t take on enterprise business at the largest scale, because those groups are still going to get personalized attention. They’re going to go to Merkle and be a small fish compared to Target and Nike and some of the bigger advertisers out there spending millions a month or a day.

I don’t think we’re too small by any means, but dig into stuff like QA processes, transition plans, what happens if a key person leaves an account. We’re happy to share how we handle that stuff. I think it’s pretty critical because that’s where you’ll figure out if there’s a got-you.

Alex: One day, I’m going to get that out of you. This year, more [inaudible 00:10:43]

Jane: Good enough. Okay.

Alex: It’s tough. We’re saying to 60, 80 people, whatever, but it’s still small, and everybody is a key piece. I think the thing that big agencies have is there’s like five more of them. There’s not five more of those people here. We think that people here are more in tune, and they’re more into it in the more senior level generally. I agree, performance media, both of us can handle the largest stuff.

Talking AOR, what we’ve seen, Jane, is like when we get canned because our group thinks they get too big and they go to the big holding co-agency. It’s like when you break up with someone, you go to the exact opposite. You’re like, “I’m going to get the one that’s fully tattooed,” and you’re like, “Whoa, that was too crazy.” They go to the big thing and they realize it’s actually something in the middle, or the thing that they had was–

Jane: Well, I think too. When you’re talking to those groups, dive into transparency and data, because the way that they move is a lot different than how our groups probably buy media. There’s a lot of principle buying going on, and there is no transparency there in terms of how much money is actually going to ad spend and not, and how much credits they’re just putting back into their own pockets instead of passing back to you. That stuff is pretty meaningful for a mid-level advertiser who’s not spending millions.

Alex: True North does not own any of the– The money does not flow through you guys. You let the clients own everything, website, app, platforms. Money, they pay direct.

Jane: It depends on the client. We’re happy for clients to pay direct, but usually we’re billing them for media spending as a pass through. If we get credits back from the ad-serving platforms, we’ll give those back to the clients. It’s not right to transition that into another client, right?

Alex: Y’all, it is hard to find a transparent agency, and True North is one of those. It rubs me so wrong. The agencies I’ve seen through the days that take the media in and then you get a magical dashboard that tells you to return, but you have no clue what actually got bought, ooh, that rubs me so wrong when people do that. The other thing that rubs me wrong, we didn’t touch on it yet. Be very careful when the agency owns your ad accounts, your website, they build a website and something only they can do, Scorpion. That all very dangerous and not very fun. Own your own ad accounts and your tech.

Ooh, real quick, tech. What is the best healthcare marketing tech? Let’s talk attribution. Let’s talk tracking, RNCDP. What are your favorites? Then let’s talk immature provider group, health system, getting started. What are the basics? Let’s not get fancy yet.

Jane: Yes. I think for enterprise, for the big guys, server-side tagging has seemed to be really effective, because you’re able to keep Google Tag Manager, Google Analytics, all the things you know to be true. You’re implementing a CDP-like solution that allows you to control data flow. CDP, we like Freshpaint, a household name. It seems to have a good reputation, performs well, consistent. We’re typically using those guys. There’s new ones out there like ours and some alternative analytics platforms.

Alternative analytics is tough. You still have to tag things. If you want to send data back to Meta, then you still need a CDP anyway. There’s a lot out there. It’s challenging to see clients completely switch gears and go to Adobe if they don’t have the infrastructure to support it. It’s great and so powerful for the enterprise, but for a mid-level marketer or a small market system, it’s going to be really challenging to manage it if you don’t have the in-house expertise to build it and set up integrations and stuff.

Alex: Then in expertise to build it and all that stuff, guys, the CDPs and all these things, they really are great. You really need to be advanced and be able to buy that thing and a support team of dads or engineers temporarily or onboard to implement it. Guys, we’ve seen even things like Salesforce that you would think would be simple.

We went to Dreamforce one or two times and just become shelfware. I sat in rooms where tons of provider group marketers are like, “It’s shelfware. It sounded cool.” I’m like, “If you’re not willing to onboard and have a team, don’t do those fancy things.” Basic, basic, basic though, Jane. If you’re 25 locations and you’re not even tracking anything, where do you start?

Jane: I feel like in that scenario, you need a CDP, or at least a light CDP so you can start tracking conversions again, and at least get data flowing on your ad performance, because some of those groups are still spending a decent amount of money on media. Either work with an agency that can provide some level of CDP access, at least for conversion landing pages, or invest in a light option yourself to get the compliance benefit.

Alex: I love it. Freshpaint owes you a commission just for all of the shout-outs you just gave them. Ours is very nice to Adam, very nice. He sat on a panel with us in Nashville. That was very fun. Sweet guy. They have some significant clients. Giving you a run for the money. The thing I like is Freshpaint, very enterprise. Things like ours are popping up, they can serve a wider group. That’s good.

Hey, Trump is firing all the inspector generals, including the HHS. What do you think about compliance? Are we going to be rolling back pixels back on, or is this just going to keep going more? How do you guys think about what’s going on over the next year? What’s the best way to play it safe, run advertising effectively?

Jane: Yes. In our view, we have a point of view and a solution for the most conservative health systems because of all of the state level laws. We have clients in states like Virginia, and Iowa, California, that have really strict consumer privacy laws at the state level that are similar to what we’re thinking about with HHS OCR guidance anyway. Plus, there’s civil lawsuits around Meta Pixels and use of Google Analytics in some cases. We’re still pretty conservative but wanting our clients to work with legal, if they’re wanting to push the boundaries on any of that stuff. Yes, we have-

Alex: Do you?

Jane: -a few running GA4 unprotected and stuff like that. It’s out there.

Alex: Yes. Yes. Yes. Those are the gutsy ones. They’ll tell you. I’ll get on with them, and they’re legal. They say, “We see this as a competitive advantage to still have these things going. We’re willing to pay out instead of all of the prevention of advertising.” I’m saying you’re crazy. All right. Jane, what is the best mix? Let’s talk patient acquisition. What have you seen as the best mix of media? What’s working? Where are people going to need to evolve later in ’25? What still works? Where are they going to need to go?

Jane: PPC always works. It’s not going away. Adopt an LLMO strategy too so you’re visible in AI-generated overviews, ChatGPT, all of that. We’re not seeing a decline in volume or performance when it comes to PPC. Keep going, especially if you’re a lead gen-focused organization. You can’t pull back there. Upper funnel channels, definitely diversified. I don’t love Google Display right now. We’re testing Demand Gen, PMAX, and then programmatic placements for stuff like CTV.

Like you said, you can use propensity modeled audiences and target TV spots. That stuff, I think, is going to be a big deal, and it requires a healthy budget. Don’t spread yourself too thin and try to do a little bit of everything. That’s a big theme for us, is that media diversification.

Alex: Yes, the basics matter, SEO, PPC, and then they go media. Okay, PMAX got it. That’s within the Google Suite. Then what do you think? Meta and YouTube’s in the PMAX stuff, I guess. Meta and Programmatic, is that too fancy for most groups?

Jane: Meta and Programmatic, we’re cautious about TikTok, especially right now. If you’re not on TikTok now, I don’t think you can even download the app yet, so I wouldn’t put too much money around a TikTok strategy at the moment, but get ready for it. Employ a video strategy for YouTube and for Meta anyway, and then you’re ready for TikTok , if it comes back or whatever’s next.

Alex: That’s what I was trying to get to. We’re seeing a lot of clients now coming to us fully bought in on like, “Yes, run PPC till the end, till diminishing returns.” They’re also realizing we need to start building their performance creative muscle, because we started experimenting with short form video and get out of just static stuff pushing. They’re coming to us to help with both, so I like that. Guys, we’re also seeing like, if you have your brand agency, cool. They don’t do performance creatives. Still pay Jane for performance creative.

Jane: Yes, you can have both.

Alex: Yes.

Jane: A good agency is going to work with others.

Alex: This is my last question, I think, because you’ve got to go. You’re more busy than I am, more important.

Jane: I don’t think so.

Alex: Your favorite, your team’s favorite type of client does what differently than the other clients to get the best results out of them?

Jane: I think competitive, willing to make optimization decisions, willing to innovate, try new things, and engaged with the data. They ask good questions. They challenge us. They’re actually looking at the dashboards, looking at our insights, notes, that stuff. Our favorite client from like a macro level. My favorite is our children’s health organizations. The stories that we see and the impact that we’re able to make on families is so cool. Those are my favorite. I think globally at True North, it’s anything that makes a really meaningful impact on patient lives.

Alex: It’s cool you hear it from Jane. You’ll hear it from other people in healthcare more. In the end, the cool thing with being in healthcare, Jane, is that the marketers you talk to are really mission-driven too 99% of the time, and they love it too. I agree, the children’s stuff is the best. ABA, Children’s Hospital is the best. Listen to what Jane said, and I’m going to let her go, “It’s the ones that are competitive and collaborative.” They like to get in there. They don’t expect the agency to make magic happen without their own collaboration.

If you are onboarding an agency, just expect half of your time for the first few months should be going to that and a decent amount thereafter. We cannot– What do they say? Can’t make shine or something like that? We can just make stars brighter. I think I heard that today.

Jane: Yes. Yes.

Alex: [laughs] To hell, I’m going to use that with my kids. Jane-

Jane: You’re welcome.

Alex: -thank you for joining me on Ignite.

Jane: Thank you.

Alex: I think our three listeners love this one.

Jane: [laughs] Awesome. Thanks, Alex. This is fun.

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