Five services, one operating system.
Compound.
Every Macbach product runs the same methodology. Local first, organic second, paid third. Site underneath all of it. AI Overview citation as the newest surface. The five services are independently useful; they earn more together.
The organic discipline is the engine behind most of it. Read the program as healthcare SEO, or by specialty for dental SEO and medical SEO.
Ground
The foundation.
Google Maps foundation for every practice. Citation management, GBP optimization, review velocity, schema.
Engine
The engine.
Organic search keeps paying after the work stops. Medically-reviewed content, technical SEO, pillar-and-cluster architecture.
Lift
The accelerator.
Paid search and social when the economics work. Multi-platform, HIPAA-aware, ad spend never marked up.
Site
The asset.
Custom sites on Next.js + Vercel. Core-Web-Vitals-green, WCAG AA, HIPAA-compliant forms.
Source
The answer-engine surface.
Schema-graph engineering, llms.txt, citation monitoring across Google AI Overview, ChatGPT, Perplexity, Claude. The newest visibility surface, run as its own product.
Most agencies don’t.
we think that’s the wrong default.
Most healthcare marketing agencies treat pricing as something you earn the right to see, via a discovery call, a qualification form, a follow-up email, a fit conversation. The argument is that “every engagement is different, so pricing depends on scope.” In our experience, that’s true of the top 10% of engagements and untrue of the other 90%.
For the 90%, published pricing is honest. A practice at $3M in collections looking at Ground Growth should be able to see, in sixty seconds, whether $600/month fits their budget, without scheduling a sales call to find out. If it doesn’t fit, both of us have saved an hour. If it does, the first call is a fit conversation, not a pricing negotiation.
For the top 10% (the Architect engagements, the genuinely custom Site Dominance builds) pricing is scoped, and those are the conversations that reasonably begin with a discovery call. But even there, the ranges are public: Architect starts at $8,000/month, Site Dominance starts at $45,000 build plus $1,800/month maintenance. No one is surprised after the call.
If this reads as unusual for the industry, that’s because it is. We think that’s our advantage, not our vulnerability.
Start with the audit.
The Practice Audit returns a real read on where the practice stands, and which service (or which combination) would actually move the number. Ten questions, three minutes.