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Annual report · 2026 edition

The State of
Healthcare
Marketing.

Aggregated performance data across the active Macbach client roster, spanning concierge medicine, specialty medical, dental specialty, weight loss, medspa, and DPC. Anonymized, cross-referenced, and segmented by vertical. Coverage period: January 2025 through March 2026.

Edition
2026, first
Coverage
Jan 2025 to Mar 2026
Verticals
Six, anonymized
Author
Vince Schwellenbach
Published
April 2026
What this report is

An honest read on what worked, what broke, and what moved in healthcare marketing across six verticals over fifteen months.

The data is aggregated from the active Macbach client roster. Every number is anonymized, every client is de-identified, and every vertical is segmented so no individual practice is identifiable. The sampling frame is disclosed in the methodology section and the figures can be stress-tested against it.

This is not a survey and it is not an industry report written from public data. It is a read on what we actually saw inside client accounts. The numbers are narrower than a survey, the conviction is higher, and the margin of error is documented.

Section 01

Executive summary

The top-line read across six verticals, coverage period January 2025 through March 2026. Where healthcare marketing economics moved, where they held, and where the leading indicators are flashing. Five themes carry the year: AI Overview citation as a leading indicator of organic revenue, the collapse of cheap paid search across concierge and specialty medical, review velocity finally displacing review volume as the operative GBP signal, HIPAA-aware paid architecture becoming table stakes, and the LTV:CAC spread widening between operators who measured retention and operators who did not.

Full breakdown coming May 2026.
Section 03

Organic ranking velocity by vertical

Time-to-first-page and time-to-top-three for newly published content across verticals, benchmarked against domain authority, schema-graph completeness, and editorial cadence. Which verticals reward patience and which reward volume, with the backing velocity curves.

Full breakdown coming June 2026.
Section 04

Review velocity benchmarks

New reviews per month per location, median and ninetieth percentile, segmented by vertical and practice maturity. Correlations between review velocity and GBP ranking position, and the threshold at which velocity stops contributing incremental rank lift. A defensible counterargument to the review-volume arms race.

Full breakdown coming June 2026.
Section 05

Patient acquisition cost medians

Blended CAC across organic and paid channels, by vertical and by acquisition stage. Segmentation by new-patient value tier: cash-pay concierge members versus insurance-paid specialty consults versus cash-pay medspa members. The CAC figures that usually show up in agency decks are blended averages; this report segments them.

Full breakdown coming July 2026.
Section 06

LTV:CAC ratios

Median LTV:CAC by vertical, derived from multi-year retention curves on the client roster. Where the ratios are healthy, where they are compressed by commoditization pressure, and how the practices with the strongest ratios are structuring retention into acquisition from day one.

Full breakdown coming July 2026.
Section 07

HIPAA compliance scorecard

Prevalence of common PHI leakage patterns across healthcare marketing stacks: PHI in GA4 events, PHI in remarketing audiences, non-BAA'd form processors, client-side pixel contamination, and uncovered server-side conversion APIs. The numbers are worse than the industry wants to admit; this section does not grade on a curve.

Full breakdown coming August 2026.
Section 08

AI Overview citation patterns

Which healthcare content gets cited in AI Overviews and which gets skipped. Patterns across schema completeness, answer-first structure, credentialed authorship, primary-source citation, and domain E-E-A-T signals. The first longitudinal look at how AI Overview citation translates into revenue on healthcare sites.

Full breakdown coming August 2026.
Section 09

Methodology and data sources

Full methodology disclosure. Client roster size and composition by vertical, anonymization protocol, data aggregation rules, what is included and what is excluded, and the limits of the sample. The reader should be able to stress-test every figure in the report against the sampling frame.

Published with the full report.
Section 10

About Macbach

Macbach is a healthcare-only growth practice founded in Chicago in 2007 and relocated to Tampa Bay in 2010. We run across six verticals: concierge medicine, specialty medical, dental specialty, weight loss, medspa, and DPC. Four productized services and one fractional CMO seat. Pricing published, ad spend pass-through, healthcare-only since day one.

Read the full story at /about.
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Get the full PDF
as each section lands.

The full report releases in phases across May, June, July, and August 2026. Request the PDF and you will receive each section as it publishes, along with the working-paper methodology notes we do not put on the public page.

Download includes the complete methodology, the anonymized sampling frame, and every chart at print-resolution.

Vince Schwellenbach
Founder · Macbach · Published April 2026

Authored and reviewed by Vince Schwellenbach. Published April 23, 2026. Last reviewed April 23, 2026.