How a Specialty Healthcare Provider Cut CPC by 50% With Freshpaint and Invoca

The Mission

As a leading provider of orthopedic and musculoskeletal care, this organization serves patients at more than 20 locations across the East Coast.

The Challenge

Every patient journey starts with a decision: a search, click, or phone call.

For many healthcare organizations, that phone call is where both the patient journey and the marketing data diverge. Patients continue moving toward care, but marketing loses visibility into what happens next. Advertising platforms can measure who clicked an ad, and some can tell if they placed a call, but not whether that conversation resulted in a booked appointment, a dead end, or a missed opportunity.

That was exactly the issue facing one specialty healthcare provider. Nearly 80% of its appointments were booked by phone, but marketing had no compliant way to connect those conversations back to the campaigns that generated them.

The marketing team optimized campaigns using the metrics readily available in ad platforms: clicks, click-through rate (CTR), and cost per click. But those metrics captured only the beginning of the patient journey. Once a prospective patient picked up the phone, marketing had little visibility into what happened next—or whether advertising dollars actually resulted in booked appointments.

That lack of visibility created three fundamental challenges:

1. Inaccurate conversion data. Roughly 80% of appointments were booked by phone, so call data plays a major role in campaign optimization. Yet any conversation lasting more than two minutes was automatically counted as a conversion. Calls about parking, insurance, prescription refills, or other routine questions were treated the same as booked appointments, feeding inaccurate signals back into advertising platforms and training algorithms to optimize for low-value interactions.
2. Keyword optimization driven by volume instead of intent. Without visibility into downstream outcomes, keyword strategy naturally favored search volume over patient intent and booked appointments. Broad terms like "hip pain" generated more clicks and consumed more budget, while highly specific clinical searches — often made by patients who had already received a diagnosis and were actively seeking treatment — appeared less valuable simply because they generated fewer impressions.
3. No closed-loop attribution for phone appointments. Most importantly, there was no HIPAA-compliant way to connect phone conversations with website sessions and downstream appointment data. Advertising platforms could see clicks and call starts, but they couldn't distinguish which campaigns produced actual patients. Without access to real conversion outcomes, optimization decisions were based on proxies rather than the metrics that mattered most.

The Resolution

The organization began evaluating Freshpaint and Invoca as complementary solutions to solve two interconnected problems:

• Accurately determine what happened during each patient phone call.
• Deliver those conversion outcomes to advertising platforms in a HIPAA-compliant manner.

Invoca addressed the first challenge by replacing the organization's simple call-duration rule with AI-powered call classification. Instead of measuring whether someone stayed on the phone for two minutes, Invoca identified whether a conversation resulted in a meaningful business outcome, including booked appointments.

Freshpaint addressed the second challenge. Serving as the organization's privacy-first healthcare marketing platform, Freshpaint receives call events and outcome data from Invoca, applies governance controls (including PHI filtering, masking, and destination allowlists) and then securely routes compliant conversion data to advertising platforms such as Google Ads, Adobe, Meta, The Trade Desk, and others.

Rather than sending call information directly from the call intelligence platform to advertising destinations, conversion signals pass through Freshpaint first. This architecture enables Invoca to provide the data  advertising platforms need to optimize toward meaningful outcomes while Freshpaint provides additional protection of patient information throughout the process.

The Results 

The organization had already invested several years building a modern analytics foundation that connected website activity with appointment records through its internal data infrastructure. Freshpaint and Invoca completed the final link in that chain: connecting AI-classified call outcomes with compliant conversion signals that advertising platforms could actually optimize against. This resulted in a 50% reduction in CPC, and a new level of marketing accountability.

Invoca + Freshpaint changed far more than campaign reporting 

This technology partnership transformed how marketing measured performance, allocated budget, and demonstrated business impact, through:

1. Smarter optimization and more efficient media spend. With advertising platforms now optimizing toward confirmed appointment bookings instead of clicks or generic phone calls, campaign performance improved steadily over time. Every round of optimizating Invoca’s AI produced stronger signals, leading to more efficient bidding, less spend on high-volume, low-intent keywords, and broader keyword coverage without increasing budget. Across the organization's two largest service lines, cost per click fell by 50%.
   
   
2. Clear evidence of marketing's business impact. The organization could now visualize approximately 18 months of marketing activity alongside confirmed appointments, giving leadership a clear view of how digital marketing contributed to patient acquisition. Paid digital grew to represent an attribution share comparable to organic search and direct traffic, allowing the marketing team to move beyond reporting on sessions, clicks, form fills, and call volume to demonstrating measurable business outcomes tied directly to media investment. With reliable attribution in place, marketing could show that paid media was generating incremental patient growth—not simply cannibalizing existing demand.
   
   
3. Operational insights beyond marketing. The same attribution data uncovered opportunities to improve the patient experience itself. Analysis of patient conversations showed that callers who weren't an immediate fit for a particular physician were often redirected, creating unnecessary friction. Those insights prompted changes around centralized scheduling and triage, with the goal of helping patients reach the right provider more efficiently while preserving visibility across the entire patient journey. Instead of relying on anecdotal observations, operational teams now had data to guide improvements.

Ready to connect your ad spend to real patient outcomes? See how Freshpaint and Invoca work together →