How We More Than Doubled ROAS for a Multi-Location Private Healthcare Provider
The Challenge
- SituationA private healthcare network operating multiple clinics across Scotland was running Google Ads with reasonable performance — 5.20x ROAS and an £8.25 CPA. However, their campaign structure was heavily weighted toward broad phrase match campaigns at the clinic level, with minimal investment in high-intent exact match and specific service-level targeting.
- ProblemThe account was spending nearly £98,000 annually but lacked precision. High-spend phrase match campaigns for individual clinic locations were generating volume but at mediocre efficiency. There was virtually no investment in non-branded exact match search, no dynamic search ads to capture long-tail queries, and specialist services like prenatal testing were barely being promoted. The account had coverage, but not control.
- StakesIn the competitive private healthcare space, inefficient ad spend directly impacts patient acquisition costs and clinic profitability. Without better targeting and account structure, the client risked losing ground to competitors while overpaying for each new patient booking.
The Results
| Metric | Before | After | Change |
|---|---|---|---|
| ROAS | 5.20x | 12.01x | +131% |
| Conversion Value | £508,131 | £1,142,562 | +125% |
| Cost Per Acquisition | £8.25 | £7.23 | -12% |
| Conversions | 11,851 | 13,157 | +11% |
| Ad Spend | £97,741 | £95,126 | -3% |
| Click-Through Efficiency | 98,079 clicks | 113,028 clicks | +15% |
The Approach
Bark Media implemented a fundamental restructure focused on precision targeting and controlled expansion. The strategy shifted budget away from broad phrase match clinic campaigns toward tightly-controlled exact match search, launched new campaign types to capture additional demand, and introduced service-specific campaigns for high-value procedures.
Launched comprehensive non-branded exact match campaigns, scaling spend from £294 to £43,654 while maintaining strong ROAS, capturing high-intent searches previously missed
Introduced Dynamic Search Ads and BMM campaigns to systematically capture long-tail search queries, generating over 700 additional conversions from previously untapped search terms
Built out service-specific campaigns for high-value procedures like Harmony Prenatal Testing, achieving 34.31x ROAS on targeted exact match keywords
Dramatically reduced spend on underperforming phrase match clinic campaigns (Edinburgh, Glasgow, Falkirk down 88-94%) while increasing exact match investment in those same locations
Scaled exact match campaigns for smaller clinic locations (Motherwell, Falkirk, Greenock) by 500-1200%, proving the model across the entire network
ROAS increased 131% to 12.01x while reducing cost per acquisition by 12%, generating an additional £634,000 in conversion value on nearly identical ad spend
The restructured account generated £1.14 million in conversion value — more than double the previous period's £508,000 — while actually spending £2,600 less. The shift from broad phrase match to precision exact match targeting meant every click was more qualified, driving CPA down even as conversion volume increased. Specialist service campaigns like Harmony Prenatal Testing proved the value of granular targeting, delivering 34x return on ad spend and opening a new patient acquisition channel the client hadn't effectively tapped before.
Campaign structure matters more than budget size — strategic reallocation from broad phrase to exact match nearly tripled efficiency without increasing spend
Don't assume existing campaign coverage is complete — launching non-branded exact match campaigns unlocked 7,000+ conversions that were previously being missed or captured inefficiently
Service-specific campaigns for high-value procedures can dramatically outperform location-based campaigns in healthcare, as demonstrated by 34x ROAS on prenatal testing
Scaling what works beats defending what's familiar — cutting underperforming phrase match spend by 90% freed up budget for exact match campaigns that delivered 400-1200% conversion increases