Scaling Growth Through Smarter Investment with Action Behavior Centers

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: Welcome back to Ignite: Healthcare Marketing Podcast. Hey, I’m Alex Membrillo. Today’s episode is going to be a blast, dude. It’s a little different. We usually don’t do this, we usually don’t regurgitate, but this is a good regurgitation. We’ve got a really special session from Scaling Up, and instead of our 20-minute format, we’re featuring one of the most talked about sessions we had with Action Behavior Centers. ABC is the largest provider of ABA therapy for children with autism, and they’ve got about 350 centers running really advanced digital media, measurement, analytics, all this kind of fun stuff.

You’re going to hear from Matt Stringer, ABC’s CMO, along with our Chief Strategy Officer, Rich Briddock. Over the next 45 minutes, guys, you’re going to hear real, unfiltered conversation about what it takes to scale marketing complex, multi-location healthcare organization, from building measurement foundations and fixing attribution and testing new channels, managing lead quality versus volume, earning trust with the C-Suite along the way. If going into this next year, you’re looking to expand your media mix and all that kind of fun stuff without wasting any money, grab your coffee, settle in. You’re about to have a blast and learn some new shiznit. Thanks for joining us.

Lauren: Today is a really cool topic and a really cool story. I’m excited to spend a full 45 minutes just talking with Matt about how Action Behavior has scaled growth through smarter investment strategy.

I think that’s a topic that we just left our CMO session. Everyone was talking about, “I have to do more with less next year. I’m focused on efficiency. I’m focused on outcomes.” That’s going to be a major theme of today. I think let’s get Matt and Rich up here on the screen. They’re going to pop in, unmute, turn their cameras on. Matt, I would love for you to just give a quick intro to everybody listening of yourself and your company.

Matt Stringer: Thank you for having me. Excited for the discussion today. I am Matt Stringer. I’m the CMO at Action Behavior Centers. ABC is the nation’s largest provider of evidence-based ABA therapy for children with autism. We specialize with early intervention in terms of the treatment we’re looking to deliver. We have over 350 centers across six states. My role as CMO really covers the full-growth engine, demand gen, data analytics, CRM, creative brand, marketing ops. As an organization, really, our primary focus is on creating immediate access to care, trying to help as many families with children diagnosed with autism spectrum disorder.

Lauren: Awesome, Matt. It’s so great to have you. I’m excited. Just your organization does so many great things. We at Cardinal absolutely love working in the ABA space in particular. We’ll dive in here in just a minute. Rich, do you want to say hello real quick? I know you’re going to join the conversation here in a few minutes after we set the stage with Matt on what the organization is up against this year. I’ll have you just say hello real quick to kick us off.

Rich Briddock: Yes. Great to be here at Scaling Up again. Rich Briddock, chief strategy officer at Cardinal. I’ve been working with ABC since they became a client of Cardinal’s. It’s been really exciting to see the journey in terms of the growth that we’ve been able to deliver together as a partnership over the last 12 months. There’s a lot more to come. This is just the very beginning of getting our foundations in place. I think there’s going to be a lot more work that we’re going to be doing to drive that growth and continue on this trajectory. Great to be here and looking forward to the conversation.

Lauren: Matt, I teed this up already. I had you give a quick intro. If we want to spend just another minute or two, I think as we talk about scale, which we’re going to spend a lot of time about how we scaled the marketing, but I think just the scale of Action Behavior, the number of lives you guys touch, and the complexity of the system and the microsystems within Action Behavior that you’re running, I would love for you to just share a little bit more about the size and scale of the org itself.

Matt: Yes, sure. The company was started about eight years ago and has had really exponential growth, headquartered in Austin. Really, the intention was one center, and then it was really easy to see quickly that there was a lot more need that needed to be served. Expansion through Texas, and then ultimately now into six states, soon to be several more as the growth trajectory continues to be pretty high.

We are very clinically focused in terms of most of our organization is comprised of in-center staff, from behavior therapists to board-certified behavior analysts, really, in support of both the children that we serve with ASD, as well as their families. The complexity of what we’re really trying to do is obviously create access to care, but a lot of that means helping families, in some cases, get a diagnosis where they may be seeing early signs and symptoms, talking to their pediatrician, talking to their physician, but not sure if, in fact, their child does have autism.

We will help support that diagnostics process as well as, obviously, hopefully, if they do need help, we can be of service to them, and if we can’t, provide them with recommendations on other therapists, if it might be a PT, OT, ST-type dynamic. We are insurance-based. One of our criteria in terms of helping to qualify leads is really understanding the insurance provider that the family may have or Medicaid in states where we offer it, as well as that diagnosis. Then, obviously, there’s a constraint on the age as well.

There’s some rigor that we have to put into the marketing model to help us understand. We’ll talk a lot more about lead quality and qualifications. As an organization, really, at the end of the day, it’s the mantra of doing well by doing good. As a CMO joining a company that is scaling quickly and helping so many families and touching thousands of kids and helping them reach those milestone moments that all those families want to see them achieve, and hopefully help them graduate into general education-type dynamics, is really rewarding.

Lauren: Yes. One of the things I learned very early on interacting with the ABC team was you’ve got this amazing call center, all these great consultants helping families work through this, and you get people calling in. Sometimes you’re their first touchpoint, just like you said, questioning whether the signs and symptoms are accurate and helping them navigate that, helping them navigate some of the self-testing that they can do at home.

I think I heard you guys say at one point, everyone leaves the phone call, whether they become a customer of ABC’s, a client, a patient of ABC’s or not, with what the next step is that they should take. That involves a lot of referring out to the right places as well. I think that doing good by families, those become the really great stories that make you feel good about marketing to families and getting them into the organization. Let’s dive into that. Let’s spend a bit more time. Really, just high level of the discussion ahead for everybody listening in.

All this content gets sent out afterwards, so it’s good to have a little agenda. The scaling challenge, that’s what we talked about the last 12 months, really growing that marketing engine. You mentioned, Matt, that you own measurement and data. In our CMO panel this morning, we heard a lot of groups talk about how integrating that into marketing has been a game-changer. The measurement is one of the most important things to really scaling the foundation. How do you then actually act on that, activate and act on it? Then would love to get a little bit of insight from both you and Rich on priorities for 2026.

That’s the agenda ahead. Let’s go ahead and dive into it. To really just set the stage on the scaling challenge, Matt, I want to get a little bit into your reality. You’ve got a private equity sponsor. You’ve got this desire to grow fast, and this need to prove that every dollar is well spent. Talk us through when you joined Action Behavior earlier in 2025. What were some of the goals you had as the new CMO, and then what were some of the expectations of the C-suite of you in that new role?

Matt: Sure. I mentioned ABC started about eight years ago. Just for context, in terms of what I was stepping into, when I joined earlier this year, I was actually the first CMO for ABC, for the company. The company, as I mentioned, has already really been scaling quickly. One of the larger players in the ABA space, just in terms of footprint and new centers. Again, great position for any CMO to be coming into where there’s already high growth. On the flip side, what we were lacking was really consistency in marketing measurement. As Rich will attest to, accurate or really the presence of attribution, be able to really understand our ad spend performance.

I think, simply put, the expectation was obviously come in fast lead growth to help keep pace with the new center expansion. There was also the notion of, we need growth with financial accountability, which obviously every CMO knows, working with their CFO, working with their CEO, and private equity sponsors for that tension of the accountability against every dollar spent being measured and delivering against the objective. For me, really, my main goal, I would say, was, yes, it was grow lead generation, but it was also to really professionalize the marketing function, and really bring more of a data-driven mindset to help understand our marketing performance, and obviously partnering with Cardinal to help do all of the above.

Lauren: I know we talk about efficient scale, and we’re going to talk about test and learn. Matt, you and I, we talk about test and learn. I think the “don’t waste budget learning,” but that doesn’t mean “don’t spend money learning.” Give us the short sentiment on that from your perspective, and then we’ll obviously spend more time because it’s an important part of how we scale.

Matt: Yes. I think in terms of trying to balance that growth against ROI and testing, for me, it really comes down to you want to build trust through transparency. Well, yes, every dollar should have an intention, and you need to have defined KPIs. Ultimately, at the end of the day, it’s trying to align on what success and failure looks like in terms of what we’re planning to do. When I joined, I didn’t come in and promise perfect performance. I really just promised visibility. I think, ultimately, once our leadership and our C-suite trusted that process, that really gave us the room to grow, to scale, and to test.

Lauren: Yes. I think, like you said, the transparency and the trust, and then you get over that hurdle, and then there’s really that inherent, like, “You do what you do best. I trust you to do it.” I think that’s great. Again, just a little bit more on earning that buy-in since we’re heading in that direction. When you think about risk versus opportunity, we’re going to talk about channel expansion here with Rich.

I think that’s really where test and learn comes, as well as things like asking for more budget or being given more budget and having to then spit back out a plan on what you plan to do with that and what you think it’s going to yield with so many unknown variables. When you talk about that transparency, the learning curve, setting realistic expectations, what’s your philosophy on that?

Matt: I think there’s a process that most CMOs would take. For me and for my team, it was really trying to understand where we were already maxed out on our existing digital marketing channels, which for us was really mostly paid search, and then partnering with Rich and team on trying to determine what incremental volume was even possible if we were to expand our investment into other channels.

Then to gain that support from our C-suite and from our CFO, our finance team, is we really had to define success upfront, align on what we were measuring, what was good and bad performance. In that, any good test or any good expansion effort includes criteria on, “Hey, if this isn’t working, this is when we would pull the plug and call it a failed test.” To that point, you have to set expectations.

These tests don’t happen overnight, nor does a channel expansion work maybe immediately. To really create a fair read and a level playing field, we would build in effectively like a 60 to 90-day learning curve. A lot of platforms, especially when you’re entering net new, you need to optimize the platform and let the platform learn against what conversion and what good looks like. Let that cost per lead stabilize.

Then finally, once you’ve gained alignment on what you’re measuring, what you’re testing, where the opportunity was against the investment being asked for, it really came down to communication and making sure that our internal stakeholders, whether it is the finance team or operators or even our centers, understood what we’re testing and why and the results and any insights.

We would report out pretty diligently on channels that were working. That was a thumbs-up. We were also open to telling them, “Hey, we’re seeing a slower start,” or “This didn’t work maybe as we planned to.” I think that approach in terms of being able to be really transparent and communicative, but also aligned to what good looks like and what failure looks like, too, really helps to create confidence that the risk against the investment being asked for is going to be appropriately managed.

Lauren: Do you think there’s this middle ground in which a test doesn’t always succeed or fail, but it’s iterative? What is your approach when it’s not so clear-cut?

Matt: Yes, I think that’s where you’re relying on data. Sometimes it is that gray area, that dreaded, like it’s not a clear win, it’s not a–

Lauren: You want to write it off completely, but I’m not going–

Matt: Yes, exactly. I think that’s really then understanding against the success criteria that you outlined to say, “Is there enough here to give it more time and to be patient?” If yes, let’s continue to test. Early indicators suggest maybe this isn’t going to work the way you’re expecting, then that gives you maybe more confidence to preempt it. For me, thinking about whether it’s success or failure, the key, I think, is really just gaining alignment, not necessarily approval to keep doing something or keep spending money. I think if people are aligned against what you’re trying to earn your way into, then there is more patience to take that test and learn approach that most marketers want to have the luxury to have.

Lauren: Matt, just a little bit on topic, but off-script, I get asked this all the time. Do you have any advice for people listening in on how much of your budget do you set aside for test and learn? Do you think there’s a guardrail there that they could start leaning into if, say, test and learn is 0% of their budget today?

Matt: [chuckles] Yes. I think in a lot of cases, especially health care, it’s a luxury to have a test-and-learn budget. I think it’s a discipline that most marketers need to instill in their organization and really be that champion of constantly testing and learning. Start small. If you’re at 0%, try to get 5% of your budget if possible. I understand budgets are very tight, and sometimes even that can feel like a lot. If you’re not testing, you’re not learning, and you’re expecting then the same result to continue to deliver the same results, which as marketers, we all know, is not necessarily going to be the case.

I think just wherever you are, start small and grow over time. Hopefully, you gain, again, that alignment, not necessarily the approval. If you’re C-suite and your partners, your private equity sponsors, whoever’s making the final call and discretionary test and learn, R&D budgets understand the value, then they’re going to be more keen on giving you the opportunity to build that and grow that investment over time.

Lauren: Yes, it’s helpful when you say this budget is separate from this budget, and it’s intended to do something different. It’s hard when you want to carve out some budget, but see if it can do the same thing as the rest of the budget. That’s where the “kill it early” often comes from. Unfortunately, you end up in a year-over-year situation where you’re just relying on the same channels that are performances degrading. We’ll get into that with Rich here in a minute. Let’s talk a little bit about the measurement framework. This was a huge part, and it’s still evolving. I know you guys are always working on this. I know you put a lot of work, you and Amy, into this throughout this year.

Rich, I’ll ask you, actually, just for a quick, fresh perspective, and then we’ll get Matt’s perspective. What do you think, as we entered this partnership with Matt and his team, were some of the most critical measurement gaps that needed to be filled in order to then say, “We have the confidence to get more budget, to know what to do with that budget, and for that budget to perform”?

Rich: I don’t want to instill a Pavlovian response in Matt when I say the word “attribution.”

Lauren: It was a healthy debate.

Rich: Yes. Well, no, I think it was a discussion that we talked about for many weeks. It’s interesting when you talk about testing and how long do you persevere with something. It’s the same thing on the measurement side. I think we banged our heads against the wall with attribution for a while, and then finally managed to leverage the tech that we had in place. ABC is CRM-enabled, which is fantastic.

That definitely gives us a leg up over other healthcare clients that are not CRM-enabled in terms of passing back information to platforms and getting really detailed reporting. There was definitely some ambiguity around attribution. The number one thing for us to do was just to figure out exactly what the existing channels were driving, and then, hopefully, whilst also figuring out the attribution issue, determine, could we pass back signals from the CRM or other places in a HIPAA-compliant way back into the ad platforms to make them more effective from a campaign management point of view?

Initially, it was attribution. I think the other big piece from our end is we had an anecdotal feeling and some back-of-the-spreadsheet math that we were over-leveraging certain channels at the outset of the relationship. Obviously, we’ve already been talking about it, and the whole topic of this presentation is about scale. If you’re starting with a core channel that is already hitting diminishing returns, the other big piece for us was understanding how much saturation were we hitting, how much diminishing return were we hitting, and then where would we need to go in order to offset some of that pressure on those existing channels and diversify to drive more leads whilst maintaining efficiency?

Another big piece for us once Matt came on board was to start the discussion around MMM, what could MMM teach us, how do we stand it up, and at least get a good sense from a channel standpoint or a channel viewpoint where the next dollar needed to go and how well we were funded across these different tactics in terms of driving the ultimate goal at the time, which was this qualified lead metric.

Lauren: Matt, you joined the organization. CRM’s in place, which is a great step. Probably a breath of fresh air. At least it exists. I don’t have to deploy it myself, but you had to do quite a bit of work in CRM to really look at the various lead stages, qualification stages, as well as attribution. How did you prioritize what to focus on first versus what could wait or what needed to come second?

Matt: Yes. To Rich’s point, I think we started talking about attribution on my second day at ABC, and quickly was made aware of some of the gaps that we needed to close. I guess what I would say is we knew, I knew that getting all the measurement pieces in place was absolutely going to take time, and that it had to be a staged approach to what Rich was talking to.

That said, where I felt like the most need was is we just didn’t even understand what I would consider foundational of understanding lead sources against the next ability to understand our pull through in the lead funnel, which would be a tease out to understanding lead quality. For me, that was the immediate priority, which, to your point, did come through using our CRM platform, cleaning up some of our landing pages, and some of the data that was feeding back into Salesforce for us, creating that accuracy against understanding just where are these leads coming from.

Over time, to Rich’s point, feeding the conversion signals back into the media platforms for optimization. Ultimately, the immediate priority was we were flying blind. We needed to understand what leads delivered the next stage, which, for us, would be getting to a tour. We knew some of the things we wanted to do, which we’ll get into around media mix modeling, and incrementality could wait because we just didn’t have the foundation built.

Lauren: Yes, and I think that’s a great transition. When you guys were net new partners working together, Matt, you had just started. Day two, we’re talking attribution. Then we’re also talking, what are the business KPIs that really matter? That has evolved over time as well. We jokingly, this morning on our opening panel with the CMOs of some of the big organizations that we had on there, said, “Throughout the vanity metrics, we really need to focus on the business KPIs.”

Everyone was joking when we said, “Throw them out.” This evolution of, “Hey, let’s get to a lead, a cost per lead,” that was stage one for many organizations. Now, it’s really, “Well, what happens to those leads? How do I know if they’re qualified? How do I ensure that they’re turning into the next thing that I need them to turn into?” Matt, talk us through a little bit of, I guess, the technical lift of getting that done, as well as the impact that has had on then scaling like we talked about.

Matt: Yes. The short version, it was a pretty heavy lift from a technical standpoint.

Lauren: Still ongoing? [chuckles]

Matt: Yes, and still ongoing, as you mentioned at the outset. Probably never to be finished, but absolutely worth it. I would say we had to spend a lot of time just really understanding the complexity of the multiple platforms. I think a lot of marketers are in the same situation where you’ve got data getting passed from a CRM platform to a lead management platform, and then into media platforms.

Really helping to architect what that looked like in terms of knowing what we wanted to get out of that first stage, which is that lead source identification, and really just understanding that we knew going in, and we aligned. Rich and I and the Cardinal team aligned pretty quickly that not all leads are equal. We knew some lead sources, or we had a hypothesis that some lead sources and channels would drive higher downstream conversion.

For us to be able to get to anything that we could action against in terms of spend or targets, echoing some of the earlier conversation from this morning, it became moving off of just lead volume, which was really the initial mandate to understanding, “Hey, how can we understand lead volume as it chases through to disqualification rate, to cost per qualified lead, to cost of acquisition, to conversion?”

For us, the biggest hurdles in that from a technical standpoint, or really even an internal standpoint, was really change management and then internal bandwidth. I think with change management, everyone talked about marketing and ops this morning. For us, it’s the same dynamic. We partner really closely, but everyone defines things a little differently, and making sure that as we were working through the technical changes with our IT team, we knew we had to train our teams managing the leads.

That probably took a little longer than I might have expected, just because of the fact that it was pretty intensive in terms of what we were trying to change. At the same time, it was definitely an important step to ensure that we had the alignment and that those changes were going to be successful. Otherwise, you create the attribution, but no one’s following the guidelines against how we’re going to actuate against that, or even what we’re going to do with that. Then, like any small business that’s growing really fast like ours, there’s always project demands on IT, and making sure that we get queued up.

For me, my advice to anyone listening is bring your IT department along in the plugging process. Communicate early and often. They knew our full scope of what we wanted to get accomplished in ’25, even if we knew based on their bandwidth and the appetite for the internal change management had to happen in stages. By communicating and signaling to them where we wanted to go, we were able to actually break it up into smaller projects that ultimately could get us faster results in terms of what we wanted to get to.

Lauren: Yes, bring them along for the ride. Make it their project as much as it is your project. I think that’s the MOps alignment. That’s the alignment that our clients have had to have with their compliance teams over the years, and I think in this enablement project with the IT team as well. Matt, you guys did all this really great work to put this in place within Salesforce.

Rich, we started this partnership with Action Behavior, just trying to get qualified leads as the metric and platform. Then now, we’re really working to evolve that to continue to align with what the business outcomes need to be. Just talk to us a little bit about the importance of the algorithms working with the same metrics that the business is working with.

Rich: Yes, these algorithms, you see it now with the recent update with Andromeda on Meta. Essentially, targeting is becoming diminished. AI Max for Search is another obvious shift as well in terms of these platforms. It’s just they want to be given an objective. They want to be given a conversion to go and get, and then they’re essentially saying, “We’ll go and get that.” You give us some inputs like the landing page and the creative.

By and large, our algorithm is going to go and figure out how to get you as many of those things as you need, or as much of those things as you can get for the acquisition costs that you’re willing to pay. What you feed that algorithm is incredibly important and has never been more important. If we’re not able to send back signals that actually correlate with the KPIs that grow the business, there’s oftentimes a mismatch in terms of what we’re reporting out as up into the right marketing performance, and what the business is seeing as true growth to the bottom line.

Yes, it’s been nice that at least in this relationship, we’ve at least always been talking about activities that happen in the CRM. We’ve always had some kind of feedback, even if it’s not being pushed in and feeding the algorithm in terms of, we’ll understand if we run a Meta campaign. If the disqualification rate jumps up, if maybe people don’t have the right insurance, or if people are the wrong age, for instance, there’s then things that we can go and fix in the creative or go fix in the targeting.

That’s nice, but Meta does not know that, or Google does not know that. That final step is making sure that we’re pushing those deeper signals in, so that Google also knows that, so that algorithmically in every auction, or when we’re looking at a user that we’re trying to essentially get our ad in front of, is that the right user? Unfortunately, again, we’re losing control there. The algorithm has much more control.

Giving it the same information to use that we’re using is becoming crucial. For all the healthcare marketers out there, you’re probably scratching your head and thinking, “Well, what about HIPAA?” That’s the other piece of this puzzle is, again, trying to give as much information as we can to be as effective as we can, but to be mindful of HIPAA and some of the challenges there.

That’s a large part of what we do with healthcare clients is to work with them on sharing information with platforms, but doing so in a way that they deem to be compliant or that matches the risk that they’re willing to take in terms of driving the marketing machine. Yes, I can’t underline this point enough, and that’s why we have a slide on it. It’s one of the most crucial optimizations that we do these days is making sure that we’re sending these qualified signals back to the platform.

Lauren: We got a question that popped up that I think is really relevant, so we’ll stay here for just a minute. Matt, we’ve got qualified leads that then have to book tours. They’ve got to show up for those tours. They’ve got to complete an assessment and ultimately choose Action Behavior and start their journey with you. The time between the qualified lead coming in and the patient start, how long is that if you’re willing to share, even just anecdotally, and does that affect the ability to optimize towards some of these downstream outcomes?

Matt: Yes, the short answer is it’s going to be different for each family. That said, on average, it is a longer journey just due to the steps that you outlined, Lauren, in terms of sometimes diagnosis even before a tour, and then the assessment, insurance verification, et cetera. For us, it does create some challenges in terms of understanding the quality signals.

Some of what we’ve put in place more recently is starting to look at qualified leads over a longer period of time to make sure that not just coming in, they stay qualified over three, five, seven days and longer. We also look at what I’d call more leading indicators. This gets into some of the pivots we made against lead volume versus lead quality and understanding the conversion rate to tours. That’s the most immediate journey step for us in terms of looking at a conversion.

Waiting all the way to that new patient start would create some challenges from a signal standpoint to be able to feed that back. A tour is a more immediate type activity that can happen sometimes as early as within the same month. A lot of it is just understanding your own lead flow and understanding what are the conversion signals that make the most sense. Obviously, the farther you can go down the funnel, the better. We’ll talk, I think, a little later about ultimately trying to get to ROI against revenue and thinking about TROIs and revenue-based bidding.

You have to have some signals that give you that canary in the coal mine of, “Is this working or not?” For us, that’s really tours and understanding if we can get a lead to a tour, if they stay qualified, and then schedule a tour. That’s a pretty good indicator that the lead is qualified and that they have a decent chance of progressing from there. Waiting longer would create some more challenges that we’re still working through in terms of how we chase it all the way down to a new patient start.

Lauren: Yes, you might create a bit too much of a delay to actually impact the front-end. I think the question popped up, and you just answered it, Matt. Just to explicitly answer it, what exactly are you passing back from CRM? These are the stages, as many of the stages as you can. I think you just said it, that tour’s booked. The qualified lead to tour booked conversion rate is really where we’re living right now in terms of what we’re optimizing against. It’s strong enough correlation to the outcome we need, but early enough in the stage that we can capture it in a timely manner and take action against it in real time.

Let’s go ahead and dive into it. I could talk about data with you guys all day. It’s my favorite thing to talk about. As Rich mentioned, the most important thing before we get to this, scaling. Matt, you walked into an organization that had some serious scale plans. I know growing leads, forex, from start of and end of ’24 to end of ’25, and that is no small feat. The roadmap, I think, and the planning of doing that, and how we get there. Can you just talk to us a little bit about the channel mix, how you decide where you double down, how you decided what to add, how we work together to do that?

Matt: Rich alluded to this a little bit at the outset. When I joined, and only shortly after Cardinal had been brought on, the marketing parts was pretty one-note. It was a lot of page search. Page search is still a very productive channel for us, but we had reached demand constraints, against another dollar couldn’t be spent efficiently within the one channel. For us, as we think about the framework for testing, it was really a matter of both when and where.

We really looked at it through two lenses. One is we had markets that we had capacity, meaning there was availability to get families and kids started, but we were struggling to create demand. A lot of that was because we had tapped out on page search. The second piece was we also looked at those same markets and understood, where do we have good operational support in terms of the appetite and ability to test? That’s super important. Everyone knows that the balance of power between marketing and ops can be tenuous.

When it works well, and it does work really well at ABC, it’s super valuable because you’ve got an alliance against what good could look like. You’ve got the same motivation against trying things differently to create additional demand. For us, in terms of thinking about how we were prioritizing our testing, obviously, first things first, I think any good marketer wants to maximize proven chance. Again, page search. Where did we have more opportunity to create demand? Some of that was creatively driven.

We were losing some impression share. We had to reinvent all of our landing pages, change our messaging, give better signals back to Google to get higher placement in some of those options. Once we had tapped that out and felt like, “Hey, we’re getting the most value out of that one channel,” then we started looking at new channels and saying, “Hey, we need to understand what other channels can add value,” whether that’s a top-of-funnel channel like an expansion into Meta, or to demand gen that’s going to create a halo effect for page search, as well as incremental expense in Bing and understanding search and Pmax, as well as what we could do in connected TV or even programmatic display.

For us, success was really built around understanding what we could measure. Again, back to attribution, the catchphrase for 2025 for ABC, not just pure volume. As we look to expand those channels, we also wanted to look at where we could get higher conversion rate. We had some missteps, for sure, and I think we’ll talk more about that in terms of some of the challenges when you grow fast.

You have channels that maybe look good at first blush, low cost per lead, high lead volume, but don’t ultimately have good conversion rates. For us, we had to pivot away from some of those channels that didn’t work, and then understanding where we could expand into those markets that had the need and had a willing operator who was going to be a good partner against the test-and-learn agenda.

Lauren: I think you said it best. There were missteps, areas that we learned. This looks really good in platform, but doesn’t translate is something that I think a trap that you can easily fall into when you’re measuring things like some of the signals, but not necessarily the downstream. This working really well in tandem with what we just talked about.

I think, Rich, with everything Matt just said, one of the things that has been an effective way to consider those channel expansions and identify what really is and isn’t working is incrementality testing, really understanding what is driving incremental business downstream and not just what is looking good on the front-end of delivery, which we saw happen quite a bit and moving fast this year. Can you share a little bit about the incrementality testing that we’ve put in place, and I think some of the aspirations to do a lot more of this going into next year?

Rich: Yes. I think this is where we’re at today with ABC. We’ve got MMM stood up. That’s providing insights for us, such as some of the things that you’d expect, whereby maybe the platform reporting for brand search looks incredible, but the actual effect share according to the model is less. The MMM is telling us that we’re actually getting pretty significantly less out of brand search. Then the platform is telling us similar with non-brand. Again, it supports the insight that perhaps we’re at this point of diminishing return on search. We’ve got to find other places to invest the dollars.

We’ve been through this testing approach even without the framework of incrementality testing stood up because we were moving fast to scale. Some tactics that we have ran in the last 12 months have driven a ton of front-end activity, things around webinars, things around e-books. Potentially, they’ve not had that same impact in terms of these downstream activities. Again, while they’re driving a lot of incrementality upfront, they’re not necessarily driving incrementality at the KPIs that we truly care about.

To the point of the spirit of this conversation, the only way that you’re going to scale is by testing. It’s crucial for us to go outside of the tried and true, understand where we are tapped out, and then look for other opportunities to say, “Okay, if we are going to run performance max webinar lead campaigns, is that actually going to drive incrementality to the bottom line, or is that just going to drive a ton of activity at the top of the funnel that, therefore, doesn’t actually then run through the pipe and create more of those KPIs that we really care about?” I think the other thing that we’ve found ourselves and why we need incrementality testing is we’ve expanded out pretty wide on a ton of channels.

As Matt alluded to, it was very page search-focused at the beginning of the relationship. We have significantly scaled up Meta, and I know we’re going to talk about Meta here in a second. There’s also performance max, demand generation. There’s now programmatic in the mix. It’s really crucial that you have the ability to understand, Lauren, to your point when you phrased the question, is that actually driving net new activity, or when I run programmatic, am I actually just engaging with the same people who are then going to come to the bottom of the funnel, search me, and convert anyway, right?

I think having a framework, and we’re standing up a platform in our relationship with ABC that really helps us to isolate and measure incrementality, but also thinking about how we deploy media through geo-lift experiments, holdout tests, market-match experiments. This is the part of the relationship now where we’re really going to try and isolate specific elements of the media mix to truly understand if we are reaching net new perspective patients and families that we were not able to reach before through our existing channel mix, so that we’re able to continue to drive scale beyond those core tactics.

Lauren: Rich, just to get super tactical here for one minute, because I’m seeing some questions pop up. When you think about incrementality testing, what tactics are you using? Geo-holdouts, ghost bidding? What is really the, I test if it adds incrementality in this area by comparing it to this other area?

Rich: Yes, it’s a spectrum. A shameless plug, we do have a session on this at Scaling Up. The easiest way to do it is essentially to do something like a holdout test, where you’re like, “Okay, I’m running–” and especially if you’re running in multiple markets, it makes it easier, right? I’m running Meta in these markets. I’m going to turn Meta off in these four markets out of my eight markets and see if I actually lose any true volume in my bottom line, or do I just lose activity at the top of the funnel?

Now, you’ve got to be careful when you’re doing that because there may be a lag. [chuckles] You may shut it off and be like, “Oh, great, my business KPIs aren’t impacted,” but then two months later, they are, right? Again, I would factor that in. That’s a very easy way to do some kind of incrementality testing. The other one is [unintelligible 00:39:59] a geolift experiment where essentially you isolate a couple of geos, you have a control group, and you have a testing group, and you’re testing tactics in that testing group and looking at control to measure the difference between the two. Those are the ways that you can do it in a very simple way.

Then obviously, it can get very sophisticated in terms of market matching, in terms of incremental, like actual platforms. There are some sophisticated geolift platforms out there, things called HALs, which has a lot of Marsai, digital science behind it in terms of how they do market matching and stuff. It’s easy to start incrementality testing just by doing holdout tests or simple geolift experiments. It will open up your eyes in terms of what you’re actually getting from your different channels.

Lauren: Getting really into the weeds of one of the key learnings from this year, I think you guys alluded to, and we’ve discussed Meta as a channel and really figuring out its role in ABC’s marketing mix, and also that not necessarily being linear, that it’s all or nothing. We have all these different markets that each themselves act as different kind of micro-environments that have to be thought of and treated differently.

Meta was a journey to discover that the front-end metrics weren’t necessarily translating and really ensuring that it was driving incrementality. Rich, will you quickly walk through the journey? I do want to make sure we get through the rest of the content we have, and probably could have allotted 90 minutes to chat with you guys today, but we didn’t. Hit us with the quick story here on Meta.

Rich: I think we had an audience partner that was being leveraged at the beginning of the relationship. We moved away from that audience partner and started testing more broad audiences. Those were very effective at driving top-of-the-funnel engagement, but we weren’t actually seeing a ton of qualified leads come through, and then tours and tours booked and tours scheduled. The primary focus was around creative because when you’re using those broad audiences in Meta, it’s super important to give Meta a ton of creative options to optimize against.

The focus was we heavily leverage lead forms as part of our strategy, and so more and more, the focus became around the form itself. How can we put some safeguards in place around the lead form to try and prevent as much spam as coming through as possible? Meta has understood that this is not just a challenge for ABC or in the healthcare space. It’s a challenge across Meta’s advertising clients in general. Things like conditional logic, 2+3=5, higher intent forms. Meta actually has a setting inside of lead formats, which is more volume or more quality. Making sure that we were optimizing towards quality instead of volume, using conditional logic. We implemented things like a capture to make it even more difficult and reduce spam.

Then another thing that we’ve really focused on is placement as well. Meta, like a lot of platforms, they want all the settings to be turned wide open. That is, if you go into a Meta account, advertising account, by default, it’s going to be all placements. They want you to use Advantage Plus Creative, which is going to allow them to tweak things inside of the creative so that they can essentially feed the algorithm with as much signal as possible, but also give it as much opportunity as possible. What we found is there are just certain placements inside of the Meta ecosystem, i.e., reels overlay, which again, I don’t want to cause Matt to have a Pavlovian response, that just drive a ton of spam.

They’re great for engagement, but it is that the quality of traffic is really poor. I’ll also say Meta is where we’ve been testing webinars and e-books and things that are further up the funnel, which again, might not necessarily be spam, but just it’s a prospect. It’s further away from conversion than some of our traditional tactics. A large part of it has been trying to isolate and remove spam. The other piece of it is just understanding how far up the funnel do we go or do we need to go to start engaging with folks? Should we have a different expectation of those leads versus the leads that we’ve traditionally been driving that are much closer to the bottom of the funnel and conversion?

Lauren: Matt, we get in, you start driving spam. We realize the mid-funnel engagement is great, but it’s not translating to what we need it to for the business. We’re giving it a significant part of the budget. Is there ever a temptation to say Meta doesn’t work? I think that’s what we said. This is one of those perpetual tests that never has an end to it. What keeps you from doing that and keeps you invested in testing the channel?

Matt: As Rich knows, we certainly debated what to do with Meta given the frustration we had. At the end of the day, we know our audience is there. Our moms and dads are there on the platform. If used correctly, we absolutely believe Meta can definitely be a strong, probably more upper to middle funnel type channel. Simply walking away wasn’t an option. I think the knee-jerk reaction is to blame the platform. I think we can obviously all certainly be critical of Meta and whether they’re doing enough to please some of the spam that’s happening on the platform.

For us, it was really about partnering with Cardinal, really understanding what was happening. Then trying to index just towards being overly restrictive to get the right conversion gates in, whether that’s what the forum, as Rich was saying, whether it’s with the verification and getting the quality right first. Then obviously making sure the quality is balanced against your message, against your expectation of what these leads should be. It’s okay if they’re earlier in the funnel. Therefore, we need more nurture. That wasn’t the issue. The issue was just we had flat-out spam that was just noise that we needed to get out of the system.

Lauren: I put some outcomes up here, the payoff. Matt, if you want to quickly walk, or Rich, walk us through this. I think finding the role of the channel, it might not be the highest volume, but it certainly has a place in the mix.

Rich: Yes. Matt, I’m sure you’ve got thoughts on this. Typically, again, when we’re thinking about the channel mix and certainly where we were with search, the incremental CPA on search for some markets could be significantly higher than even the qualified lead CPA on Meta that we’re driving when you deal with some of these disqualification rates. I know there were certain months where we had really high disqual rates that we were dealing with.

As a strategy, when you start to move away from a blended channel cost and you start to think about a marginal or an incremental channel cost, even when we were dealing with some of these tough disqual rates, it still made sense to have a presence there and to have some spend on those channels than to try and force all of that spend and that scale back into a channel that was already at the upper reaches of what it could deliver from a qualified lead point of view. Unfortunately, we would love the search universe, and I’m sure Google would, to be infinite with people seeking out ABA therapy and ABA services. In reality, it’s just not the case, and the elasticity of that channel has to give up at some point.

Lauren: I think we’ve talked a lot about this, so we don’t have to belabor the point, but this kind of quality, quantity dance, which we just flashed up some of the metrics and the outcomes of putting in the work on the spam and the SMS verification, and also just identifying the role of Meta in the funnel stages. Anything you guys would add to– and Matt, I’ll start with you, the dance between quality and quantity overall for ABC, thinking about your broader channel mix this past year?

Matt: We’ve hit a lot of this. I think at the end of the day, as you’re scaling, you’re always going to get to some point of diminishing returns. You’re going to get higher intent or lower intent leads higher in the funnel that are going to take more time to nurture. We saw really good volume growth. We were hitting targets, green across the board. The conversion rate to tours were dropping. As Rich has already mentioned, we weren’t seeing necessarily the outcomes we wanted. We were growing tours year over year, but it just wasn’t scaling commensurate. It certainly wasn’t a sky-is-falling moment, but at the same time, what we were expecting to see was a disconnect.

I think for us, this moment in time really coincided nicely with getting some of those foundational attribution pieces in place, which were really key for helping us to realize some of what we were scaling was just noise. I’m not just talking about the spam from Meta, which was– but some of it was just not real opportunities. It wasn’t equating to outcomes. I think once we could see that really clearly with the data, we knew we had to effectively reset our definition of what good looked like and move beyond just that initial lead volume tracking.

Some of the vanity stats that were being talked about this morning, important. You need to have volume, but at the end of the day, we wanted to make sure that those leads were converting to the next step in the funnel. By virtue of having that data, having good conversations, good transparency, it was an easy pivot to ultimately make.

with leadership to get them aligned on, “Hey, we might actually need fewer leads, they just may need to be more expensive because the quality is going to be higher.” I think everyone with the data and able to visualize what was happening with the funnel.

The upside was clear that it’s going to be higher conversion, it’s going to be more tours, and then ultimately lower cost of acquisition, which I think again, that made the recommendation to pivot from continue to grow to say, “Hey, actually, I think less could be more here in terms of what we’re trying to get to ultimately for new patient starts.”

Lauren: Matt, since we have touched on this topic a bit, I saw a question pop up. I’ll throw it out there to you. Eforex, the lead volume coming into an organization like yours, how does that affect ops, call centers, everybody actually making that happen?

Matt: The short answer is it was a challenge. I would say we overwhelmed some of our teams that were managing leads. I think that because we had a good open relationship and dialogue with operations, they were quick to communicate, that they were feeling overwhelmed, and quick to voice concerns against some of the lead quality against certain lead sources. I think once we could validate with the data that what we were getting qualitatively from our centers against the lead quality, married to the data from a quant standpoint, it was easy to have the confidence to say, “Hey, we should pull back.” We’re getting diminishing returns, not just in the lead quality, but even the ability of our teams to scale and to be able to manage that.

My advice to everyone in this dynamic is you want to grow. Obviously, I’ve seen in the chat, yes, it’s hard to say no to leads, but data is your friend here. You have to be brave to know when to pull back. Just do it quickly. If you continue to scale bad leads, it’s going to burn trust, time, and ultimately money. Nobody’s happy about any of that. At the end of the day, we’re all marketers. We’re not magicians. No one has that magic wand that’s going to get the perfect lead every time. It also means you have to be humble and own when a test or channel isn’t working and make a change. That’s effectively what we did. We communicated what we wanted to do from a change management. It was well received.

Last several months, lead volume has gone down, but the quality has gone up. Tours have gone up. Conversion has gone up. Ultimately, at the end of the day, everyone’s happier because we’re able to manage higher quality leads and get the better outcome for the business, which is ultimately what we all want.

Lauren: Yes, and not break the call centers and all your ops partners with the leads that aren’t converting, too. I think it helps everybody win.

Rich: Yes, I think it’s important to align on where marketing plays its role and where ops plays their role and where on that continuum of the funnel does one of those parties influence more than the other. I think we’ve aligned on tours scheduled is probably the metric that is deep enough down the funnel. Where marketing plays enough of a role where it’s fair to be held to that metric.

Being held to start, there’s so many other things that then go on operationally that are out of our control that it becomes a very difficult metric to be held accountable for. Having that alignment inside of the organization of, this is mainly marketing’s patch, this is mainly operations’ patch, once those leads are in the door and at a certain level of the funnel, I also think is crucial for success.

Lauren: Then the constant holding each other accountable to each person’s role in that step, too. Let’s go ahead and just quickly look to 2026. I think this is the fun stuff that everybody’s wondering. Matt, when you think about– We talked a little bit about getting to tROAS and some of the objectives for next year. Why are you thinking about 2026 being about revenue impact and not just lead volume? I know we’ve touched on it a lot, but organizationally, from your C-suite, from your seat specifically, redefining success for next year?

Matt: 2025, as we’ve talked about, it was an aggressive test and learn agenda. We had to build some foundational attribution, really shift that mindset as we’ve talked about from just more leads in favor of higher-quality leads. I think for us, the next logical chapter of where we evolve is that ROI, revenue-driven growth. Some of it is against where we want to be from a budget standpoint and some of the constraints against the business but still sustaining heavy, heavy growth.

Whether that’s using revenue-based bidding or introducing call tracking, or to Rich’s point, figuring out where marketing can continue to support maybe a little bit farther down the funnel beyond just lead gen, 100% alignment that tROAS is the right metric, but also knowing that there’s more we can do to help with lead management, which obviously would optimize new patient starts even further. There is that point in that journey that is hard or harder for marketing to impact, but at the end of the day, for us, a lot of the hard work we’ve done this year, I think, really just sets us up for making this pivot to more of a business outcome, revenue-driven approach going into ’26.

Lauren: Rich, when it comes to putting that to practice, in platform, especially, can you talk a little bit about the shift to a tROAS or a revenue value-based bidding model?

Rich: Yes. I think it’s, first and foremost, it’s working your way back up the funnel and understanding the ratios in terms of how many tROAS become a start, how many assessments become a start, so that you can give the relative values to each of those actions that you’re pushing back into the platform. The worst thing that you can do is assign arbitrary values to actions that are in platform because what it’s going to cause the algorithm to do is just to over-index on the wrong thing and under-index on the right thing.

There’s an analysis that needs to be done when you’re starting with value-based bidding. Once you’ve got those values in place, those values have to sit and mature with the platform for a few weeks. You can’t just jump from a volume-based bid strategy to a value-based bid strategy the first day you put values in. Meta needs to sit on those values. Then, just like anything, I think we would highly encourage that you test into it. We know that target ROAS or max conversion value for Google is their gold standard. That doesn’t mean that in every situation, every single time, it’s going to outperform a volume-based bid conversion strategy.

Just like with anything, test it, test it in a couple markets, use campaign experiments, see how well it works. Then, once you’ve seen those results, and it might require you to do a bit of finagling with the values to get it just right in terms of what the algorithm is able to deliver, then you can roll it out across the whole of your campaigns or into your different markets, et cetera. It should be a really considered approach to move from a volume-based bid strategy to a revenue-based bid strategy.

Lauren: Then, Matt, the layer on top of that, you’ve got the right activities happening, the right weighting of those activities. Then you’ve got this lifetime value component, too, which can play a significant role in the ROAS of any given dollar spent. What are you guys thinking about patient, the lifetime values now, and how do you see its role in something like a value-based bidding model next year?

Matt: It hasn’t really been leveraged yet. That’s an exciting prospect as we get smarter with the revenue-based bidding that Rich was alluding to. For us, LTV is really simple in the sense that we’ve just got to identify the channels and the leads that are going to bring in families that ultimately stay longer and benefit the most from our ABA therapy, the services we provide.

In many ways, the beauty of this approach is that it’s really just the win-win sweet spot for us in terms of marketing, doing more than just driving those leads, as we’ve all talked about, but ultimately helping to change lives for the better. The ability to have that measurement, and we do have that in place, to be able to look at LTV against the cost of acquisition and find that sweet spot for return on ad spend is an exciting prospect in terms of as we get smarter going into 26.

Lauren: Absolutely. Then I’m going to end on a takeaway. We did some Q&A throughout, so we don’t have to do a whole section on that. Matt, if you could give maybe one lesson learned and one bit of advice, looking to next year for everybody listening, and we’ll end it there.

Matt: Yes. I think, from an advice, I’d just say transparency. I mentioned it a few times. You don’t need perfect performance. Nobody can deliver that. No CMO can be right all the time. That’s why test and learn is in place. You just need to move fast. You need to be agile. You need to get started. You do need to be confident in the data you do have. Figure out what’s important to you, whether it’s one signal, multiple signals, get the right insights, improve performance, and then just be open about sharing what’s working and what’s not and why. I think if you do that, you’re going to build bridges and partnerships with finance and ops that’s going to give you credibility.

Like I said, you’re not just going to get approval for budgets. You’re going to get alignment, and then you’re going to be able to scale faster. In terms of lesson learned, and I’ll use the example of stepping in as a new CMO in New York, everyone wants to deliver the wins and fast growth. That was definitely the mandate in joining. Again, I would just say, don’t chase approval. Long-term success is about building trust. Growth is never, despite what private equity wants, is never straight up into the right line.

Exercise, it’s always going to fluctuate. It’s two steps forward, one step back. Once the C-suite or your private equity sponsors trust your approach, growth gets a lot easier. Don’t underestimate the power of transparency and the importance of building trust to be able to do what you want to do, both from

a test and learn from a financial investment, and then ultimately to be able to build the growth that the organization wants from marketing.

Lauren: Speaking of transparency, Matt, it’s been great having you here, getting to spend a whole hour really just diving into one organization and their journey over the past year. Thank you for sharing the wins and also the learnings, the failures, the things that we would do maybe differently next time, or how we’re evolving off of maybe something that didn’t work the way we thought it would. Richard, Matt, thank you guys so much for joining us.