Why Search-First Payer Marketing Is Hitting a Ceiling with Craig Blake and Aaron Mauck

The last two AEP cycles handed payer marketers a strange gift: chaos. 

Plan terminations, benefit disruptions, and widespread member displacement sent consumers scrambling—and search volume spiked along with them. For a moment, the bottom-of-funnel playbook looked more effective than ever.

Most plans responded the way any rational team would: they put more money into what was working. Google Search budgets went up. Direct response stayed the hero channel. The performance metrics looked good.

What's harder to see from inside that feedback loop is that the spike was situational, not structural. It reflected market disruption, not a sustainable expansion of consumer demand. And now, as the dust from that disruption begins to settle, the strategies that rode it are starting to plateau—at exactly the moment when the underlying consumer behavior is shifting in ways that make the old playbook harder to sustain.

Craig Blake has watched this play out firsthand. He leads agency growth at Amsive Health, where his team runs multi-channel campaigns for health plans across the country. Aaron Mauck is Chief Research Officer at Oboe Healthcare Insights, where he tracks how consumer behavior in the Medicare market is evolving and what it means for how plans need to show up.

Their conversation with Freshpaint CMO and Marketing Rounds host Ray Mina is a frank assessment of where payer marketing is right now—and what the teams that get ahead of the next disruption are doing differently.

1. The Ceiling Is Real—and Most Teams Won't See It Until They've Already Hit It

Here's the pattern that's playing out across payer marketing right now: search budgets go up, leads come in, and the channel gets more credit. 

From there, the optimization loop reinforces itself until, quietly, the returns start compressing. Cost per lead creeps up. Volume plateaus. The team pushes more budget in to compensate, and the compression gets worse.

The underlying problem behind all of this is structural. 

Search is an intent-capture channel—it can only convert consumers who are already actively looking. It doesn't create demand; it harvests it. And the pool of Medicare-eligible consumers actively searching for a plan at any given moment is finite. You can bid more aggressively to capture a larger share of it, but you can't make the pool bigger by spending more.

What made the last two AEP cycles feel like exceptions to this rule was genuine market disruption. Consumers whose plans were terminated or whose benefits changed had urgent, immediate questions—and they went to Google to answer them. 

Craig watched the spike happen in real time.

“Gas was pouring on the fire in the past two years,” he says, “People are going to search to figure out what they should do, because they're hearing their plan is being terminated or their benefits are changing, causing significant angst and disruption across the industry. The challenge is marketers by default say, oh, bottom of funnel, we gotta pump money in there. The reality is diminishing returns—you're not getting more for the money you're spending.”

That disruption-driven spike also coincided with a longer-term behavioral shift that's harder to reverse: seniors going digital. 

Five years ago, direct mail was the hero channel in Medicare marketing for a reason—the population wasn't reliably online. That's changed faster than most plans adjusted for. And the shift is now accelerating further as AI enters the picture.

“Very few of us actually go to search first,” Aaron says. “A lot of people are going to AI first or other media first as their central approach. And as that evolution takes place, the standard approach that we've taken will be less and less relevant going forward.” 

Consumers who two years ago might have searched Google for Medicare plan comparisons are increasingly going to AI interfaces instead. They get a synthesized answer without having to navigate competing search results. Craig flagged it bluntly: 5% of all global queries on AI platforms right now are healthcare-related. That's not a future trend. It's current behavior, and it's intercepting the intent signal that payer marketers have been relying on.

What this means for you

The warning signs that you've hit the search ceiling tend to show up gradually before they show up all at once. Watch for:

• Cost per lead or enrollment rising even as search volume holds steady
• Click-through rates declining as you expand keyword targeting to compensate
• Branded search volume flattening or declining—a signal that fewer consumers are arriving at Google already thinking about your plan
• Conversion rates dropping from search traffic even without significant changes to your landing experience

If you're seeing two or more of these simultaneously, the issue probably isn't execution. It's that you've saturated the available demand in your market and you're spending more to compete for a shrinking share of it.

2. Diversification Is a Market Question Before It's a Channel Question

The most common mistake teams make when they decide to expand beyond paid search is pick a channel. 

• CTV because a vendor pitched it
• Programmatic display because a competitor seems to be running it
• Direct mail because someone remembered it used to work.

Whatever channel they choose, they run it, watch for direct conversions, see none, and reallocate back to Google.

The problem wasn’t the channel. It's that they skipped the step that would have told them which channel to pick in the first place.

Craig's starting point for any diversification conversation with a client is always the market—not the media plan. Who is the member you're trying to reach? Where do they actually spend time? What does their day look like? And critically: what is the realistic infrastructure of their digital life?

“Each CMO has to take a look at their market first,” Craig explains. “If you're a health plan in the rural Midwest versus Southern California, it's way different strategies and way different considerations as far as what that channel mix could look like.” That example sounds simple, but it cuts against how most channel decisions actually get made—top-down, based on industry trend reports or what larger plans are doing nationally, rather than from an honest look at the specific market.

The same logic applies when teams move into non-search digital channels. Aaron has watched urban plans run effective campaigns through bus shelter ads and billboards—not because digital doesn't work, but because those analog formats build brand recognition and drive digital engagement together, rather than competing with it. 

All of this depends on audience intelligence—knowing your highest‑converting segment well enough to reach them across multiple touchpoints instead of betting everything on catching them the instant they search.

Once you have that, the budget question changes. It’s no longer “How much for direct mail vs. programmatic vs. paid search?” It’s “How do we surround a specific, well‑defined audience across the channels where they actually live?” Each dollar becomes more effective because it’s doing a precise job, not a broad one.

What this means for you

Start with your audience, not your media plan:

• Can you define your highest-converting member segment with enough specificity to activate them across channels—not just in search?
• Is your channel mix based on an actual understanding of how your market behaves, or on what the industry broadly does?
• If you're a regional plan, have you done the honest audit of whether digital-first assumptions hold in your specific geography?

Evaluate upper-funnel channels on the right metrics:

• Direct conversions are the wrong benchmark for awareness and consideration channels—they're built to create demand, not capture it
• Branded search lift is a useful proxy: if search volume for your plan name rises after a CTV or OOH campaign, those channels are doing their job
• Assisted conversion data—how often do upper-funnel channels appear in the journey before a search-driven conversion—tells you more than last-click attribution ever will

Build the analytical foundation before you scale:

• Audience modeling doesn't require a massive data science team, but it does require investing in it before you diversify, not after
• The plans seeing the strongest results from non-search channels aren't spending more—they're spending more precisely

3. The Brand Problem Is Quiet, Compounding, and Almost Nobody Is Solving It

During the disruption of the last AEP cycle, displaced members came to regional health plans because they were the only option available. Enrollments went up without a corresponding increase in marketing effort. So those plans turned the brand investment dial down. It made sense in the moment—if members are arriving on their own, why spend on awareness?

The flaw in that logic doesn't show up immediately. According to Craig, it shows up years later. “If you never turned on [brand campaigns] with that 60-year-old who's now aging into Medicare? They're not gonna know who you are.”

Aaron frames this as a version of the Eisenhower matrix problem: brand investment is often considered “non-urgent but important” and non-urgent things are exactly the things that get kicked down the road, year after year, until it suddenly becomes urgent. “You may be the only game in town or the dominant player in a small regional market at one point in time—until a large commercial competitor decides to come in,” Aaron warns. “Each year, there are fewer and fewer non-competitive markets out there.”

There's a deeper structural shift underneath this, too. The payer market is moving away from transactional acquisition and toward something closer to longitudinal member relationships. The most sophisticated plans are already thinking about members across multiple AEP cycles—not just whether someone enrolled this year, but whether they re-enroll, whether their experience generates referrals, whether they stay through plan changes. 

Brand investment is the foundation that makes that arc possible. Performance marketing can drive the enrollment. It can't build the relationship that keeps the member.

What this means for you

Before you cut brand investment to protect performance budget, pressure-test the decision against these questions:

• What is your brand awareness among 60 to 64-year-olds in your market? They are your most predictable near-term pipeline. If they don't know your plan before they age into Medicare eligibility, you're starting every conversation from zero.
• What is your year-one retention rate? Members who joined because they had no other option are not loyal members. High churn among new enrollees is a signal that acquisition is outrunning the experience and brand equity needed to hold them.
• How competitive is your market, really? The “we're the only option here” assumption has a shorter shelf life than it used to. Commercial payers have been expanding into regional markets consistently. Being comfortable in a non-competitive market is a bet on conditions that may not hold.
• Is your marketing function integrated with member experience? The plans with the strongest retention are increasingly treating these as one function—not because it's organizationally elegant, but because the consumer doesn't experience them as separate.

4. The Post-AEP Hangover Forfeits Next Year’s Success

Most payer marketing teams treat Q1 as a recovery period. And it makes sense—AEP is exhausting. When it ends, the instinct is to rest, let the dust settle, and return to planning mode gradually. 

The problem with this tradition is that the teams who do this return to planning mode already behind. 

Aason is direct about what Q1 should actually look like, saying: “The most successful plans are the ones that are really on overdrive all the time, thinking very deliberately about next year's annual enrollment period first thing afterwards.”

The AEP cycle also reinforces a narrow view of what marketing is supposed to accomplish: get enrollments. That framing made more sense when members stayed on plans for decades, chose their coverage through a broker, and only revisited the decision when something significant changed.

Craig remembers that market—and notes how thoroughly it's been dismantled. “As long as the drugs didn't change or their doctors didn't drastically change, they kinda hung out,” he explains. “Well, with the disruption, we've seen the focus on full-lifecycle marketing—retention and acquisition as one full holistic cycle—is so critical.”

What changed? The market disruption of the last two years has done something specific to consumer behavior that most payer marketers haven't fully reckoned with: it has conditioned members to shop. Consumers who were displaced from their plans discovered that switching was survivable—and some discovered that shopping around produced better options.

For plans that acquired large numbers of displaced members over the last two cycles, the critical metric to watch right now isn't the size of the new member cohort. It’s year-one retention. 

“[Year-one retention is] really gonna be how viable a plan is—because the reality is some people went to you because they had no other choice, and if you don't take care of 'em, they're gonna go somewhere else,” says Craig.

What this means for you

Use Q1 as a strategic window, not a recovery period:

• The plans that begin next year's AEP strategy in January are building a structural advantage over the ones that start in spring
• The questions worth asking now: What did your member acquisition data from this AEP actually tell you? Which segments converted well and retained? Which converted but churned quickly?
• Where did your non-search channels perform, and what would it take to scale them before next AEP?

Treat year-one retention as a leading indicator:

• If a significant share of new enrollees from the disruption years are churning at first renewal, the issue is downstream of acquisition—and more enrollment spending won't fix it
• Retention data surfaces which member segments you're actually able to serve well, which should feed back into your acquisition targeting

Break the acquisition-only mindset:

• The member experience after enrollment—onboarding, communication, benefits navigation—is a marketing problem, not just an operations one
• The plans building longitudinal member relationships are treating every post-enrollment touchpoint as an opportunity to build the loyalty that makes the next AEP easier

The Shift Healthcare Marketing Must Make Today

The bottom-of-funnel playbook that's dominated payer marketing for the last decade wasn't wrong. It worked.

But it was built for a market where members were stable, search was the primary discovery mechanism, competition was largely regional, and acquisition and retention were different departments solving different problems.

What Craig and Aaron are describing isn't a set of new tactics. It's a different orientation: 

• Audience intelligence before channel selection
• Brand investment as a long-term asset rather than a discretionary line item
• Retention as a marketing metric rather than an operations problem
• Strategy as a continuous practice rather than something that happens between AEP cycles

The plans building toward that model now are accumulating advantages that compound over time. The ones optimizing last-click efficiency while the market shifts around them will eventually feel the wall—and at that point, the options get harder and more expensive.

Experience the full conversation where Craig and Aaron discuss why rural payer markets still run half a billion pieces of direct mail a year, how to make the internal case for shifting budget away from last-click channels, what the data on senior AI adoption means for plan discoverability, and why the teams that use Q1 deliberately will outperform the ones that treat it as a recovery period.