Healthcare Marketing Agency: Compare Proposals on Patients

Compare healthcare marketing agency proposals on one number: what each one costs per new patient who actually showed up. To get that number, you need to know what type of agency you are dealing with, how it is paid, and how the proposal defines a lead.

Quick answer

Sort each proposal into a type (see the table below) and strike the ones that do not serve practices your size. Write down the pay model and what it rewards. Find the sentence that defines a lead; if there is none, ask for one. Ask which patient data the agency will touch and get that question to whoever handles privacy for you. Then fill in the scorecard at the end of this post for each proposal, with the cost per showed new patient after three months as the last row.

Who is actually calling itself a healthcare marketing agency?

The search results for this phrase mix very different businesses. Hospital-system and pharma brand shops sell campaigns, branding and reach. Agencies for private practices sell new patients. A one-channel specialist does search ads or search rankings and little else; a freelancer is one person doing a slice of the same work.

Agencies also pay to reach you. Google Ads Keyword Planner estimates for the US, October 2026, put "healthcare marketing agency" at 5,400 searches a month with an average click price of $25.17, and "medical marketing agency" at 4,400 with $42.16. Those are national averages of what advertisers bid, not a price you will pay for anything. They do show that agencies spend real money for the visit that brought you to their page. Judge the proposal, not the page.

How is the agency paid, and what does that reward?

Each pay model rewards something different, and none is neutral. Read which behavior the fee encourages before you look at the amount.

I do not rank agencies and I quote no agency prices here. If a proposal gives a number, ask what it includes and what is extra: landing pages, call tracking, content, the website, ad spend itself. Ask for Google to bill the ad spend to your own card so the fee and the spend never blur.

What counts as a lead in the proposal?

This one line decides everything after it. "Lead" can mean a phone call of any length, a call over 60 seconds, a form fill, a booked appointment, or a patient who showed up. The first is the cheapest to produce and the last is the one that pays your rent.

Ask the agency to write the definition into the proposal and say who confirms it. A form fill counts as a lead even when the phone number on it is wrong. A booked appointment still hides cancellations and no-shows. A showed new patient is recorded in your own scheduling system, so the agency cannot count it without your front desk or a link to that system.

If an agency counts calls, ask how it separates a patient from a vendor, a job applicant or a current patient. Ask whether it reports leads by campaign. The same word hides different quality. If you want the mechanics of sending booked and showed visits back to the ad account, I explain them in how offline conversion tracking works from a CRM to Google Ads.

Which proposal is cheaper after three months?

Illustrative: every number below is made up for an imaginary three-doctor primary care practice, and none comes from a client.

Proposal A is a $3,000 monthly retainer and $5,000 a month in ad spend. Proposal B charges 15 percent of ad spend on an $8,000 monthly budget, so the fee is $1,200. Both run three months, and the practice counts what happened in its own scheduling system.

Cost per lead is total cost divided by leads: A is $24,000 ÷ 150 = $160, and B is $27,600 ÷ 90 = $306.67. By that measure A looks nearly twice as good. Cost per showed new patient is total cost divided by new patients who showed up: A is $24,000 ÷ 36 = $666.67 and B is $27,600 ÷ 46 = $600. The proposal with the pricier lead gives the cheaper patient, because B counted only calls over 60 seconds and A counted every form fill.

Repeat it with your own proposals. Keep the same three months for each, and use the same definition of a new patient (never seen before by your practice).

Will the agency touch patient information?

Possibly, even when the work is "just ads." Under 45 CFR 160.103, a business associate is a person who, on behalf of a covered entity, creates, receives, maintains or transmits protected health information for certain functions, and a subcontractor doing that for a business associate is one too (45 CFR 160.103, checked 2026-10-15). A covered entity may let a business associate handle that information if it gets satisfactory assurance, documented in a written contract or other written agreement (45 CFR 164.502(e), checked 2026-10-15). That contract is the business associate agreement (BAA).

So ask the agency to list what it will see: call recordings, form entries, chat transcripts, booking details, and any patient list used for ad targeting or to upload visits. For each one, ask whether a BAA is needed and whether its own tools sign one. If the answer is a promise instead of a document, take that to whoever handles HIPAA for you. I am not a lawyer, and nothing here is legal advice.

A patient list meant for targeting also runs into Google's own rules. When ads promote health content, such as a physical or mental health condition, treatment of a chronic condition or an invasive procedure including injections, Google does not allow advertiser-curated audiences, and Customer Match (an uploaded contact list) is one of them (Google, checked 2026-10-15).

Tags, the bits of code on your site that report visits to Google, Meta or another vendor, are the other route. HHS's online tracking bulletin gives the case of a patient booking on a clinic's website whose tags send the appointment details and the visitor's IP address to a tracking vendor: that vendor is a business associate, and a BAA is required. A federal court in Texas vacated another part of the bulletin on June 20, 2024 (American Hospital Association v. Becerra), the part saying HIPAA applies when a tool ties a visitor's IP address to a visit to a public page about a health condition or provider; the booking example is still on the page, and HHS says it is evaluating next steps (HHS, checked 2026-10-15 via the Internet Archive copy of 2026-10-11). I go through what that means for tags in HIPAA-conscious conversion tracking.

A BAA is a HIPAA term. Canada's federal privacy commissioner reads PIPEDA as leaving an organization answerable for information an outside processor handles for it, with a contract or other means needed to keep its protection comparable (Office of the Privacy Commissioner of Canada, checked 2026-10-15). Under Ontario's PHIPA, a vendor that handles patients' health information for a practice, with its permission and for its purposes, is the practice's agent, and the practice stays responsible for what the agent does with it (PHIPA, s. 17, checked 2026-10-15 via the Internet Archive copy of 2026-10-11).

What should the first 90 days produce that I can check myself?

Each item is something you can check yourself instead of taking the agency's word for it. If one is still missing at day 30, raise it then, not at the review.

• Admin access to every account it works in: Google Ads, your Business Profile, analytics, the domain and the call tracking numbers.
• A written tracking plan: what is counted as a lead, where each lead lands, and how a booked visit is matched to the ad or listing that brought the patient.
• A monthly table of leads, booked visits and showed new patients by source, built from your scheduling system and checked by someone on your team against it.
• A list of changes made to the accounts, with dates and the name of whoever made them.
• A review date at day 90 with the cost per showed new patient from your records, and the agency's plan if that number is above your limit.

If you want paid search read alongside this, medical PPC covers the ads side, and medical practice marketing covers what to do before you pay an agency at all.

How do I score each proposal?

A blank row is a question for the agency, and a row filled with a promise is a reason to ask for the document.