Case Studies | Josh Blicker
While Holding $150 CPA at 10x Spend
This is what happens when you treat paid media like a growth engine, not a guessing game.
A South Florida depression treatment provider offering TMS and ketamine wanted to expand aggressively.
The goal was simple: open more locations, fill schedules, and keep acquisition costs under control while scaling spend. We did exactly that.
3 locations in South Florida. Strong service.
Clear demand. Growth ambitions.
Paid media was active, but budget and structure were not built for scale. The business needed a repeatable acquisition system that could expand location-by-location without CPA blowing up.
Paid does not exist in a vacuum. We collaborated directly with the SEO team to map and expand into tier-2 keyword themes that patients research before they are ready to convert. This built a broader demand net and supported long-term growth.
Examples of expansion topics: Alternative treatment options, Medical psychedelics, Anxiety treatment
SEO widened the top of funnel. Paid Search harvested demand. YouTube warmed cold audiences. Local targeting converted by location.
We built the system around one rule: win bottom-of-funnel first, then expand outward. Paid Search became the core driver because it captures high-intent patients already looking for treatment. For two straight years, Paid Search was the number one driver of patient volume. Execution was disciplined.
Keyword categorization was structured to dominate bottom-of-funnel terms, with roughly 70% of budget committed to high-intent categories. We continued increasing investment into winning keywords until efficiency started to drop, then reallocated. We layered in YouTube Ads at roughly 10% of spend to expand reach without sacrificing trust. Creative used UGC-style assets and testimonial formats to lower skepticism and build conversion momentum. Local targeting was engineered deliberately. Near me intent. Location-specific terms. Tight geo targeting around each center. This allowed each location to behave like its own acquisition unit instead of one blended campaign.
Over 3 years, the company scaled from 3 locations to 9 locations across South Florida. Spend scaled from roughly $3.5K to $35K while maintaining efficiency.
Key outcomes: Locations: 3 to 9 in 3 years, Spend: $3,500 to $35,000, CPA: held at approximately $150 per lead at 10x spend, Lead volume: scaled approximately 10x with budget, Primary acquisition driver: Paid Search remained number one for 2 years
This was not a one-time spike. It was sustained, repeatable growth driven by structured allocation and disciplined scaling.
Most advertisers scale by turning dials up and hoping CPA holds. We scaled by earning the right to spend more. Bottom-of-funnel dominance first. Local intent second. Expansion channels third. Reallocate the moment efficiency drops. No guesswork. No vanity metrics. Just disciplined spend tied to patient acquisition.
If you want to scale locations, you need a system that scales with you. Own bottom-of-funnel demand. Build local acquisition units by location. Layer in expansion channels that build trust. Coordinate paid and SEO so demand compounds. That is how you grow from 3 locations to 9 without losing control.
