Stop Wasting Your Ad Dollars By Cutting This Hidden Tax

Most healthcare marketing teams believe their primary growth constraint is new patient acquisition. 

But there’s a quiet and expensive problem hiding in this growth model—one that doesn’t show up cleanly in dashboards and doesn’t get flagged in monthly reviews: You’re paying to re-acquire existing patients. 

During a panel at House Call New York last summer, Justin Olson, now CMO at Smile Partners, described this dynamic from his time at Fast Pace Health. “We see existing patients actually coming back to us from non-brand search,” he explained, “They’re typing ‘urgent care near me.’ And we have to win them back.” 

We call the hidden cost of paying full auction prices for patients you should already own the re-acquisition tax.

This isn’t just a clever name—it’s a line item you can actually reduce. So read on to learn how teams are redesigning their acquisition strategy so less budget goes to winning back yesterday’s patients and more goes to creating tomorrow’s.

How the Re-Acquisition Tax Quietly Burns Marketing Budgets

A meaningful share of what gets reported as “new” patient acquisition is actually re-acquisition of existing patients. This is often a result of marketers building an over-reliance on digital search tactics, as defensible KPIs on bottom-funnel activities are scarce without the proper data infrastructure. Unfortunately, yielding more “acquisition” budget to recapturing existing patients leaves fewer dollars to nurture demand, capping downstream growth.

Consider this common scenario: A patient once visited you for a flu shot or a sprained ankle. Months later, a new health issue pops up. They’re not thinking about provider names or local healthcare brands. They’re thinking about their care needs. So they open Google and type:

• urgent care near me
• same day doctor appointment
• [symptom] specialist

Your ad appears at the top of search results. They click it, book an appointment, and even show up. 

In your analytics, everything looks great. Clean CPA, search gets credit, and the “new patient” box gets checked. But in reality, they were already in your system. And you just paid auction rates to win them back. 

This is how the tax compounds. 

Healthcare is episodic. As Jeremy Rogers, VP of Digital Marketing and Experience at IU Health, explains, the patient journey is not one funnel but a series of funnels. 

Each care episode resets the funnel. Each reset pushes patients back into generic search behavior unless the brand is strong enough to bypass it. When that happens, you are back in the auction, paying again to win someone you’ve already served.

The financial impact shows up slowly, then all at once. 

More of your “acquisition” budget goes to recapturing existing patients. Costs rise just to maintain flat volume. Optimization delivers diminishing returns because the underlying tool isn’t actually growing. Finance sees higher spend without proportional growth and becomes more risk-adverse, reinforcing reliance on the very channels that drive the tax.

How to Stop Paying the Re-Acquisition Tax

The solution isn’t to abandon paid search campaigns or to chase experimental channels. The solution is to reduce your dependency on Google Search ads and build a true multi-channel motion that has three parts.

1. Create demand before intent exists

If search is the moment demand is captured, then something else has to be responsible for creating it.

In healthcare, that means reaching patients when they are not actively looking for care but are still forming impressions about who feels credible, familiar, and trustworthy. Awareness channels—such as video, audio, programmatic display, and other broad‑reach media—do this work. Their role is not to drive immediate appointments. It is to ensure that when a care episode eventually occurs, your brand is already mentally available.

In practice, “good” awareness isn’t random top-of-funnel spend—it’s a deliberate, always-on later layer that makes you the obvious choice when a need arises. Structure it around your priority service lines and markets and judge it by leading indicators like branded search lift, direct traffic, and lower blended cost per new patient (over quarters, not days). 

When framed this way, awareness becomes easier to justify internally. It’s not fluffy brand spend, it’s part of your mix that reduces dependence on expensive last-click search and shrinks the re-acquisition tax. 

2. Reinforce familiarity between care episodes

The objective here is simple: when a patient needs care again, your brand should feel remembered, not rediscovered. Without reinforcement, familiarity decays.

This is where first‑party data, retargeting, and owned channels matter. When patients have interacted with your organization—visited your site, booked an appointment, downloaded information—you have signals that allow you to stay present without relying on generic search. Thoughtful retargeting, email, and content keep the brand alive between episodes so the relationship doesn’t go dormant the moment a visit ends.

3. Use search to capture preference, not make introductions

Search still plays a critical role. But as a lever in your multi-channel marketing strategy, it captures demand that already prefers you, rather than serving as the first point of contact.

When upstream demand and reinforcement are working, search performance changes:

•  Branded search volume increases. 
• Click‑through rates improve. 
• Cost per click stabilizes. 

Search becomes more efficient precisely because it is no longer doing all the work alone.At that point, optimization actually compounds value instead of chasing diminishing returns.

Get the Full Playbook on Multi-Channel Healthcare Marketing

Once you recognize the re-acquisition tax, a number of familiar frustrations start to make sense. Rising CPCs without corresponding growth. Flat volume despite higher spend. Increasing pressure to defend budgets instead of expand them.

The issue was never simply that search got more expensive. It was that search was being asked to carry the entire burden of growth—including work it was never designed to do.

Understanding this shift is the first step toward fixing it.

In Beyond Google: The Multi-Channel Playbook for Healthcare Marketers, we go deeper into how healthcare teams are redesigning their acquisition systems to reduce re-acquisition costs, create demand upstream, and make growth defensible again.