From Ad Impressions to Lifetime Care: Measuring What Really Matters with Jeremy Rogers

Most healthcare marketers are optimizing for the wrong outcome.

You track cost per click, conversion rates, booked appointments. You report these metrics to leadership as proof marketing is working. Your campaigns look efficient in the dashboard.

But booked appointments aren't the real conversion. Neither are form fills, or phone calls, or even attended visits.

The real conversion is lifetime value. Share of wallet. Health outcomes. Whether a patient stays with your system for ongoing care or churns to competitors after that first visit.

And if all you're feeding your marketing strategy is last-click signals from Google—optimizing for whoever is actively searching right now—you're missing the actual game.

Jeremy Rogers has spent 10 years as VP of Digital Marketing and Experience at IU Health, one of Indiana's largest health systems. What makes his approach different isn't sophisticated ad tech or massive budgets. It's that he's figured out how to connect marketing activities to what actually matters: Are we driving the right growth? Are we acquiring and retaining patients who need our full spectrum of services? Are we improving health outcomes over time?

His conversation with Freshpaint CMO and Marketing Rounds host Ray Mina reveals what changes when you stop optimizing for last-click conversions and start building for lifetime patient relationships—and why that requires fundamentally different infrastructure, metrics, and strategic thinking than traditional healthcare marketing.

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1. Post-Pandemic Healthcare Broke the Simple Acquisition Playbook

Here's what most healthcare marketers haven't fully processed: the supply-demand equation changed fundamentally after the pandemic.

Many clinics are already at capacity. Primary care providers are booked out weeks or months. Specialty care has waitlists. There's a national shortage of physicians, nurses, and technicians that won't resolve anytime soon.

In this environment, acquiring a net new patient may not be your highest priority—especially if you can't service that patient downstream.

"The supply demand curve is much different than it used to be. Many clinics around the country are already full," Jeremy explained. "So in that environment, acquiring a net new patient may not be the highest priority if you can't service that patient downstream." This creates a fundamental tension most marketers haven't solved: Google Ads still works for capturing intent. Someone searches "primary care near me" and you can show up and convert them.

But what's the point if they book an appointment, show up once, then churn because the experience was poor or they couldn't get follow-up care when they needed it? 

That first appointment—the one most healthcare marketers celebrate as the conversion—is often a loss leader. Primary care appointments typically lose money. Health systems make margin on procedures, specialty care, chronic care management.

So optimizing purely for acquisition volume means you're potentially filling your system with patients who generate low lifetime value while capacity-constrained services that actually drive profitability sit underutilized.

What this means for you

Stop celebrating acquisition volume without understanding downstream outcomes. Start asking questions about…

Churn analysis:

• What percentage of new patients return for additional care within 12 months?
• Are patients seeking deeper care with your delivery network or going elsewhere?
• Which acquisition channels drive patients with highest retention rates?

Lifetime value by channel:

• What's the LTV of patients acquired through Google vs. other channels?
• Are certain channels bringing in patients who only use low-margin services?
• Can you track from initial acquisition to downstream revenue over 12+ months?

Capacity mapping:

• Which services have excess capacity that could absorb more volume?
• Which are capacity-constrained and shouldn't be marketed aggressively?
• Are you driving demand you can't service, leading to poor patient experience?

If you can't track beyond the initial appointment to downstream value, you're flying blind on whether marketing is actually driving profitable growth.

2. Healthcare Isn't One Funnel—It's Multiple Funnels Throughout a Life

Most marketers think about a single conversion funnel: awareness → consideration → booking → visit. Done.

That's not how healthcare works.

"It's really not one funnel," Jeremy said. "If you look at a patient's healthcare lifecycle, it's a series of funnels. You're winning that relationship every time." Patients aren't continuously in-market for healthcare. They might need care a handful of times per year. But each time represents a moment where they're choosing: Do I go back to the system I used before? Or try somewhere else?

This completely reframes what marketing should optimize for. It's not just about the initial acquisition. It's about being top-of-mind at each moment that matters throughout a patient's life:

• A young family expecting their first baby
• Someone receiving a life-changing diagnosis who needs specialty care
• A patient due for preventive screenings they might not realize they need
• Someone with chronic conditions requiring ongoing management

These are all separate funnels. Separate conversion moments. And they happen across years, not weeks.

"Most patients are not in market for healthcare services very often throughout a year," Jeremy explained. "Every time they're seeking care, you're putting them through a new conversion funnel. You've got the benefit of having that relationship with them."

The advantage health systems have is simple: they hold more customer data than almost any other industry. The challenge is using it to stay top-of-mind and relevant between care episodes.

What this means for you

Stop thinking about a single patient acquisition funnel. Start mapping the multiple funnels across a patient lifecycle.

Map the moments that matter:

• Which life events trigger healthcare needs? (pregnancy, chronic diagnosis, aging parents, sports injuries, preventive care milestones)
• When are patients "in market" for different services throughout their lifecycle?
• What's your strategy for staying relevant between active care periods?

Build lifecycle marketing infrastructure:

• Can you identify when patients are due or overdue for services?
• Do you have permission-based communication to reach them proactively?
• Are you using care gaps as marketing opportunities to drive engagement?

Measure relationship health, not just acquisition:

• Net Promoter Score by service line, provider, location
• Share of wallet/share of care across your delivery network
• Patient retention and return visit rates over 12+ months

In healthcare, you're not acquiring a customer once. You're building a relationship that plays out across decades through multiple care episodes.

3. First-Party Data Isn't Optional—It's The Foundation For Everything

Here's the uncomfortable truth: your EHR only tells you half the story. The EHR captures what happens when someone is actively receiving care. It's the "patient" data.

But what about before they become a patient? When they're researching options, considering competitors, showing intent signals digitally but haven't booked yet?

And what about after care delivery? When they're evaluating their experience, deciding whether to return, potentially in-market for other services but you don't know it?

You need both sides of the equation. Consumer data and patient data. Digital behavior and clinical outcomes.

"You've got to be able to have those intent signals going back and forth," Jeremy said. "When have I come out of a care delivery experience and I may be looking for other support? When may I be open to nudging for further engagement? If you do that solely based upon EHR data, you basically have one hand tied behind your back."

This is where most healthcare marketing organizations fall short. They have rich clinical data but limited understanding of pre-care consumer behavior. Or they have digital analytics but can't connect it to actual health outcomes.

Without a robust first-party data strategy that bridges both worlds, you can't:

• Attribute marketing activities to health outcomes
• Optimize campaigns for lifetime value vs. one-time visits
• Personalize outreach based on care gaps and health status
• Measure true ROI beyond initial appointment bookings

IU Health has spent years building this infrastructure. Data lake. Data warehouse. Integrations between EHR, billing systems, CRM, and digital analytics. It's not easy. It requires sustained investment and cross-functional partnership.

But it's become table stakes.

What this means for you

If you don't have a first-party data strategy, you're behind. Start building in phases now.

Phase 1: Inventory your data assets

• What patient/consumer data do you currently have?
• Where does it live? (EHR, billing, CRM, digital analytics, marketing automation)
• What are the gaps preventing you from seeing the full journey?

Phase 2: Define your integration strategy

• What are the technical requirements to connect these systems?
• Do you need a CDP (Customer Data Platform) or data warehouse?
• What partners can help with the heavy lifting?

Phase 3: Build incrementally

• Start with one use case (e.g., connecting digital clicks to booked appointments)
• Prove ROI on that use case to justify continued investment
• Layer in additional data sources over time (show rates, outcomes, LTV)

Phase 4: Activate the data

• Use it for audience segmentation and targeting
• Feed it back to campaigns to optimize for better outcomes
• Build reporting that shows marketing impact on health and financial outcomes

Reality check: This takes years, not months. But health systems that crack this will have enormous competitive advantage over those still optimizing for last-click conversions.

4. Not All Growth Is Created Equal—Balance Capacity, Quality, and Profitability

Here's what separates strategic marketers from tactical ones: understanding that not all patient acquisition is equally valuable.

Some services have excess capacity and need volume. Others are capacity-constrained and shouldn't be marketed aggressively. Some are financially profitable. Others are loss leaders. Some have high NPS and great patient experience. Others are struggling with quality and satisfaction.

Strategic growth means balancing all of these factors simultaneously. Jeremy describes it as "3D checkers"—looking at multiple dimensions to figure out the right channel mix and investment strategy:

Dimension 1: Capacity

• If you don't have adequate capacity for a service, there's no point driving more demand
• Marketing to services you can't deliver creates bad patient experiences and hurts brand
• Requires close partnership with operations to understand supply constraints

Dimension 2: Quality/NPS

• If NPS for a given service isn't good enough, why drive new patients to have a bad experience?
• Fix the experience problem before investing in acquisition
• Use NPS as a leading indicator of which services are ready to scale

Dimension 3: Financial health

• Some services are more strategically important even if less profitable
• Others have "long tail value"—downstream revenue from follow-on care
• Primary care may lose money per visit but creates entry point to full care continuum

Dimension 4: Strategic priorities

• Which services align with organizational mission and community health goals?
• Where are you trying to grow market share vs. defend existing position?
• What's the balance between margin and mission?

At IU Health, these factors inform every campaign decision. They don't just ask "can we fill the appointment slots?" They ask: Do we have capacity? Is the patient experience good enough? Does this drive strategic value? Can we service this patient's needs long-term?

What this means for you

Stop treating all acquisition as equally valuable. Build a growth prioritization framework.

Service line assessment:

• Map each service line across capacity, NPS, profitability, strategic importance
• Identify which should receive aggressive acquisition investment
• Which need operational improvements before marketing investment
• Which are capacity-constrained and need retention-focused strategies instead

Multi-stakeholder alignment:

• Marketing can't make these decisions alone
• Partner with finance (profitability), operations (capacity), quality/patient experience (NPS)
• Build consensus around which services are growth priorities

Dynamic budget allocation:

• Shift investment based on changing capacity and performance
• Don't set annual budgets and forget them—review quarterly
• Be willing to pause campaigns when constraints emerge

Your job isn't just driving volume. It's driving the right volume to the right services at the right time. That requires seeing the full picture, not just last-click conversions.

The Infrastructure Healthcare Marketing Needs to Grow in 2026

Breaking free from paid search dependency isn't about adding new channels to the media mix. It's about building fundamentally different infrastructure.

Most healthcare marketing organizations are still optimizing for last-click conversions—whoever is actively searching right now. They report on booked appointments as if that's the end goal. They can't track beyond the initial visit to understand lifetime value, health outcomes, or share of wallet.

That approach worked when supply exceeded demand and simple acquisition was the goal. It doesn't work anymore.

Post-pandemic, the equation changed. Capacity is constrained. Talent is scarce. Margins are tight. Competition from new entrants (tech companies, retail health, virtual care) is intensifying at the edges.

The organizations that win won't just capture intent better through Google Ads. They'll build infrastructure that lets them:

• Track beyond last-click to lifetime value and health outcomes ✅ 
• Optimize for multiple funnels across a patient's lifecycle, not one acquisition funnel ✅
• Bridge consumer and patient data through robust first-party data strategy ✅
• Make strategic growth decisions balancing capacity, quality, profitability, and mission ✅

This requires sustained investment. Cross-functional partnership with IT, operations, finance, clinical teams. Data infrastructure that connects disparate systems. New metrics and reporting that prove marketing's impact on what actually matters.

It's not easy. Jeremy's team at IU Health has spent a decade building this capability. But it's become table stakes for healthcare marketing that wants to prove ROI and justify continued investment.

The alternative is continuing to optimize for last-click conversions while wondering why acquisition costs keep rising and patient lifetime value stays flat.

Experience the full conversation where Jeremy discusses NPS as a corporate scorecard metric, why healthcare margins are so tight that payback periods have become radically faster, how AI will unlock automation for both back-office operations and patient-facing care, and why IU Health balances talent acquisition marketing alongside patient acquisition.