There’s a reason boards and CMOs like ROAS: it’s one of the most measurable ways to evaluate marketing performance. You can see what you spent, what revenue or conversions were attributed to that spend, and calculate a return.
What’s easiest to measure isn’t necessarily everything driving performance.
Healthcare brands are investing more in paid media, yet many are finding that patient acquisition isn’t keeping pace. When that happens, the natural response is to look at the media mix and ask: Are we on the right platforms? Are we spending enough? Are we targeting the right audience?
Before changing the media plan, it’s worth looking at the measurement framework itself.
Put Yourself in Your Patient’s Shoes
A patient might discover a provider through an ad, search for the practice later, read reviews, visit the website, compare options, and eventually schedule an appointment. Each interaction can play a role in the decision, even if only one of them receives credit in an attribution report.
And the data reflects how much digital research is already part of the healthcare journey: 59% of healthcare consumers use online search to find a new primary care provider, while 80% say online scheduling influences their choice.
That means the patient journey is rarely as straightforward as a click-to-conversion report makes it look.
The Patient Journey Isn’t Linear
ROAS primarily tells you what happened at the bottom of the funnel and, more specifically, what your attribution system can connect back to a marketing channel.
That makes ROAS incredibly useful. It also makes it inherently limited.
Search is a good example. It can show a very strong ROAS because it captures patients who are already actively looking for a provider or service. If you optimize exclusively around that number, the logical conclusion is to keep putting more budget into search. It’s measurable, it converts, and the return is easy to see.
But there’s a problem: the channel getting the credit isn’t necessarily the channel creating the demand.
If all you optimize for is ROAS, you can end up concentrating your investment in the channels that are best at capturing existing demand while underinvesting in the channels that create it.
That can mean competing harder for the same bottom-of-funnel patients while overlooking the marketing that builds awareness and makes a practice the provider patients ultimately choose.
Measuring What You Can’t See
This is why healthcare marketing needs a measurement framework that goes beyond platform-level attribution. At ARSNL Health, we use Marketing Mix Modeling (MMM) and incrementality analysis to help isolate the impact of media that can’t be cleanly tied to an individual patient in a database. MMM helps evaluate the contribution of different channels across a broader set of business outcomes. Incrementality helps isolate the impact of an investment—what actually changed as a result of putting money into a particular channel or campaign. Healthcare is one of the categories where you can’t (and shouldn’t try to) measure everything at the individual level. Not every billboard impression, programmatic exposure, brand interaction, or offline touchpoint will show up neatly in a CRM. That doesn’t make those investments unmeasurable. It means they require a different approach.
The goal isn’t to abandon ROAS. It’s to understand its place in the measurement framework. ROAS tells you what you can attribute. A broader measurement approach helps you understand what is actually driving patient acquisition and growth. And when those two perspectives come together, you can make better decisions about where to invest, not where the reporting is easiest.
The best-performing channel isn’t always the one that gets the most credit. It’s the one that helps create sustainable growth.
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