Here is a detailed breakdown of what each package includes.

Activate:

• Technical onboarding & governance — Complete tracking matrix (pixels, GTM, call tracking), CRM field mapping, HIPAA-compliant intake forms, and a signed SLA for data handling.

• Paid media mastery — Keyword intent laddering, SKAG/DSA hybrid campaigns, responsive search & dynamic remarketing, audience sequencing, negative keyword hygiene, and weekly budget optimization with algorithmic bid strategies.

• Conversion funnel engineering — Landing page frameworks (F-shaped copy, trust signals), micro-conversion scaffolding, CRO backlog with estimated ROI uplift and prioritized sprint plan.

• AI booking automation — Bi-directional SMS + email bot (NLP-based confirmations), calendar syncing, no-show triggers and automated reminder cadence to reduce attrition.

• Email lifecycle & reactivation — Welcome, nurture, clinic-education and reactivation tracks with segmentation, deliverability triage and win-back offers.

• Reputation & compliance — Review capture workflows, templated replies, and basic reputation monitoring; HIPAA checks on form & messaging flows.

• Analytics & reporting — Single-source-of-truth dashboard (leads, CPL, conv. rate, CPA), weekly alerting, and a 30-day performance blueprint with next-step recommendations.

• Risk & budget controls — Fraud filters, negative keyword sweeps, conversion value tagging and overspend protection.

• Deliverables — Ad creative pack, funnel wireframes, tracking proof, and a signed launch checklist.

Elevate:

• SEO systemization — Technical site audit with crawl fixes, schema markup (local & service schema), site speed remediation, canonical strategy, and on-page topical clusters targeting buyer intent queries (e.g., “best chiropractor [city]”, “desk-related low back pain [city]”).

• Local ecosystem optimization — Google Business Profile optimization, citation network clean-up, geo-targeted content hubs, review velocity campaigns, and map-pack penetration tactics (GMB insights + Q&A optimization).

• Advanced paid social — Value-based lookalike modeling, dynamic creative optimization (DCO), cross-platform audience stitching (CRM → Meta → Google) and social conversion lift tests.

• Content & authority playbook — Pillar pages, patient education videos, case-study VSLs, local PR outreach, and guest placements on local health portals to drive topical authority and referral traffic.

• Citations & local partnerships — Directory saturation, physician referral outreach templates, local employer partnerships (occupational health), and community sponsorship campaigns.

• Reputation engineering — Proactive review generation, sentiment monitoring, response playbooks, and dispute resolution support.

• Conversion velocity — Multi-channel attribution, appointment-to-treatment funnel optimization, secondary offers (telehealth follow-ups, membership trials) and loyalty loop design.

• Reporting cadence — Bi-weekly KPI pack, SEO ranking heatmap, channel-level ROAS, and tactical experiment pipelines with anticipated impact estimates.

• Compliance & security — HIPAA risk review for messaging + data flows, consent capture, and secure patient intake integrations.

• Deliverables — Local SEO playbook, monthly backlink report, social creative suite, and quarterly growth roadmap.

Dominate:

• Leadership & retainer structure — Fractional CMO, account director, growth engineers, media ops lead, SEO director, content studio, analytics team, and an on-demand implementation squad. Executive cadence: weekly leadership pods + monthly executive steering committee.

• Valuation acceleration blueprint — Unit economics optimization (CAC → LTV modelling), recurring revenue design (memberships, subscriptions, corporate contracts), revenue diversification playbook (telehealth, courses, corporate wellness) and documented playbooks to increase practice EBITDA multiples.

• Exit & M&A readiness — Seller’s due diligence prep (marketing SOPs, repeatable revenue playbooks, compliance stack), data room creation (traffic, retention, CAC, LTV cohorts), buyer-facing growth narratives, and coordination with legal/financial advisors for deal structuring and earn-out optimization.

• Go-to-market & expansion system — Market selection model, TAM/SAM/SOM analysis, test-launch campaigns (local pilot with controlled CPA caps), rollout automation (replicable playbook for new sites), and centralized ops for multi-location scale.

• Commercial operations & pricing engineering — Pricing tests (anchoring, value tiers), revenue waterfall modelling, package & membership design, and promotions calendar to maximize ARPU and reduce churn.

• People ops & hiring engine — Front-desk scorecards, setter KPI dashboards, interview funnels, recruiter partner management, and training modules (role-play, QA, script library). We can run recruitment campaigns and handle onboarding until bench is stable.

• Sales & conversion stack — Setter team playbook, conversion scripts, analytics-backed objection handling, call-recording QA, ramp plans, and bonus structures tied to revenue metrics.

• Brand & creative ops — In-house video studio for VSLs & patient case studies, long-form content pipeline, PR outreach to healthcare press, and reputation vault (case studies + testimonials + aggregated NPS).

• Strategic partnerships & enterprise channels — Employer health partnerships, corporate wellness contracts, physician referral networks, partnerships with gyms/physio centers, and LSA/insurance-driven visibility strategies.

• Enterprise analytics & governance — Custom BI, advanced cohort LTV modeling, predictive churn modeling, CAC payback clocks, and monthly board decks with growth scenarios and capital-use recommendations.

• Regulatory & compliance governance — HIPAA audit readiness, consent & intake governance, and security posture reporting for buyer diligence.

• Deal advisory & transaction support — Prep: clean analytics room, KPI standardization, growth narratives, buyer outreach support (if requested), and advisory on earn-outs, valuation levers and negotiation positioning.

• Deliverables & outcomes — Annual growth blueprint, 90/180/365 day execution roadmap, staffed teams with SLAs, valuation uplift scorecard, and M&A-ready data room artifacts.

• Guarantees & governance — Quarterly OKRs, performance reviews tied to KPIs, corrective action plans, and optional equity/incentive alignment structures for long-term engagements.

Broad KPIs We Track

• Activate: Leads per month, cost per lead (CPL), website conversion rate, booking conversion rate, email open & re-engagement rate, new patients booked per month, new-patient CAC, CAC→LTV efficiency ratio, and first-visit revenue attribution.

• Elevate: Everything in Activate + Organic visits, local-pack visibility rank, combined CPL (Search + Meta), appointment-to-treatment conversion, review velocity & sentiment, new organic patients per month, revenue per organic/local patient, and Organic CAC→LTV ratio.

• Dominate: Everything in Elevate + Revenue per location, patient LTV, CAC vs LTV, new-location validation metrics, EBITDA margin improvement, valuation-multiple uplift targets, churn & retention rates, total new patients across all channels, scaled CAC→LTV ratio, and topline revenue growth per clinic.

Per Tier