30-60-90 Plan Telehealth Psychiatry · OR / WA May – Aug 2026 Week 2

30-60-90 Plan
MindRx Group

Five channels + one engineering build. ~$44.5K/mo ad spend plus $3–8K/mo HIPAA-compliant SaaS stack (HubSpot + Keragon + Ours Privacy). The plan flips the engine from form-fill optimization to patient-CPA optimization — but patient-CPA is a 45–75 day HIPAA-compliant build, not a Day-1 tag. By Day 60 the signal flows, by Day 90 there is 30 days of patient-CPA data, the verification leak closes (50 → 75%), and the compounding moats — founder-led AEO, PCP referrals, and HubSpot patient referrals — start bending CAC downward as paid CPC inflates.

About
MindRx Group — 100% virtual telehealth psychiatric & behavioral health practice, OR/WA only, ~5,000 active patients, 13 PMHNP-BC W2 providers (3 onboarding, 1 interviewing), $10,500 LTV. Founded July 2021 by Anthony Grippo. Insurance-billed across Aetna, Cigna, Providence, BCBS, Moda, UHC/Optum.
5
Active Channels
$44.5K
Monthly Budget
May–Aug
90-Day Window
50 / wk
Attended Patients · Day 90 Goal
<$300
CPA Guardrail
Section 1 · Overview
The window. The mix. The thesis.
Where MindRx is right now, what the next 90 days build, and the single change everything else compounds against.
Current Patients
~23 / wk
Goal: 50 / wk (~217/mo) by Day 90
Active Patient LTV
$10,500
32 visits × $330
Verification Rate
50%
Target: 75% by Day 90 (gated on L0 + BAA)
Stated CPA Trend
$96 → $297
Stabilize <$250 by Day 60
Organic Patients (5yr)
~0
+15–25 from AEO by Day 90
The Thesis
Every channel optimizes against a proxy today. By Day 90, every channel optimizes against verified patients — and the engine becomes legible.
The Business Review surfaced a single constraint: Google Ads bids against form-fills, not verified patients. Meta has been spending against a Pixel that doesn't fire. The EHR holds the patient-CPA signal — it's just not piped to the platforms making the spend decisions. And piping it is a 4-vendor HIPAA-compliant engineering build, not a config change. The next 90 days do four things in parallel: (0) build the signal layer — PracticeQ ↔ Keragon ↔ HubSpot ↔ Ours Privacy ↔ Google Ads + Meta CAPI, with 4 BAAs on the critical path; production signal target Day 60; (1) close the verification leak from 50% to 75% — gated on L0 + PracticeQ BAA but the highest-leverage operational fix at zero marginal CAC; (2) start the compounders — founder-led AEO content and a structured PCP + HubSpot-driven patient referral flow; (3) run the existing $44.5K/mo on bridge measures (form-fill + Meta Pixel) until the patient-CPA signal lands ~Day 60.
The Operating Milestone · 50 / Week
From 23 attended/week today to 50 attended/week by Day 90.
50 newly attended patients per week is the operating goal — ~217/mo, roughly 2× current run-rate of ~100/mo. The lift is non-linear: foundation in Phase 1, the signal layer landing in Phase 2 unlocks bid-strategy and referral mechanics, and Phase 3 is where the compounders + paid scale + value-based bidding take the engine to the milestone.
Today (Week 0)
~23 / wk
~100 / mo · baseline
Day 30 · Phase 1 (Foundation)
~26 / wk
~113 / mo · +13% · L1 panel page + PMax pilot
Day 60 · Phase 2 (Build Complete)
~32 / wk
~140 / mo · +40% · L0 signal live · AEO citing
Day 90 · Phase 3 (Compound)
50 / wk
~217 / mo · 2× lift · the goal
Weekly Trajectory · Phase-Gated
Phase Window Weekly Target Monthly Run-Rate What Drives the Lift
Baseline Week 0 (today) 23 / wk ~100 / mo Current state. Google Ads ~50/mo + brand/direct/informal ~50/mo. Form-fill CPA $201 blended on $42.6K/mo paid.
Phase 1 · Foundation Days 15–30 26 / wk ~113 / mo (+13%) Insurance-panel page live (L1 partial); intent-keyword pruning; PMax 20% reallocation pilot; site-fix package (Morgan purge + Winter Hawks + GA4). L0 build is in BAA/scoping mode — no signal yet.
Phase 2 · Build Complete Days 31–60 32 / wk ~140 / mo (+40%) L0 signal layer lands ~Day 60. PracticeQ form rebuild + eligibility API (L1 full activation). AEO articles 1–5 published. PCP relationships #1–#2 formalized. HubSpot Marketing Hub + SMS infra ready. Verification ≥60%.
Phase 3 · Compound Days 61–90 50 / wk ~217 / mo (2×) Value-based bidding live on patient-CPA signal (Day 75+). AEO citations begin landing. HubSpot patient-referral campaigns #1 (Day 75) + #2 (Day 88). PCP ramp to 5–7 relationships. Verification → 75%. SMS appointment reminders reduce no-show rate.
Lever-by-Lever Contribution at Day 90
Lever Day 90 Contribution Weekly Equivalent Gate
Baseline held 100 / mo 23 / wk Google Ads ~50 + brand/direct/informal ~50 — held constant assuming no degradation.
L0 · Signal-layer build 0 direct 0 Gating Unlocks L1 full / L4 value-based bidding / L6 attribution. Production Day 60.
L1 · Verification 50% → 75% +25 / mo +6 / wk L0 + PracticeQ BAA. Mechanical: $40K Google ÷ $533 effective CPA = 75 patients (vs 50 today).
L2 · AEO + organic content +20 / mo (conservative) +5 / wk 10 articles published; ≥3 LLM citations by Day 90. Upper band: +30/mo if citations come earlier.
L3 · Review compounding +5 / mo +1 / wk Billing-team rebuild + cancellation policy rewrite + review-prompt cadence. Indirect via CPC suppression + local pack.
L4 · Google Ads CPA +10 / mo +2 / wk Standalone contribution above L1. Value-based bidding live Day 75+ on patient-CPA signal.
L5 · PCP referrals +7 / mo +2 / wk 5–7 active relationships by Day 90; clinician-to-clinician outreach signed by Cary or Salim.
L6 · HubSpot patient referrals +5 / mo (ramping) +1 / wk HubSpot Marketing Hub + SMS. 2 campaigns sent by Day 90; full effect lands Day 120.
Committed Point Estimate 172 / mo ~40 / wk Subtotal of committed levers at Day 90 baseline confidence.
+ Accelerators (named below) +45 / mo +10 / wk Three accelerators that close the gap from 40 → 50/week. Each is a decision-gated lever, not a free improvement.
Day 90 Goal · Stretch Math ~217 / mo 50 / wk 2× current. Requires committed levers AT BASELINE + all three accelerators clearing their gates.
Three Accelerators · Each Closes ~30% of the Gap
Accelerator 1 · Paid Scale Post-Signal
+$10K/mo paid → +25 patients/mo
Gate: Patient-CPA signal in production (Day 60) AND Search-program patient CPA ≤$500 across ≥2 weeks AND verification trending ≥60%.

Mechanic: Once patient-CPA is defensible, scale Google Search + PMax by $10K/mo. At $400 effective patient CPA, that's +25/mo. Decision dated Day 70.
Accelerator 2 · AEO Upper Band
10/mo → 30/mo organic
Gate: ≥2 LLM citations on articles 1–5 captured by Day 60 (SIG-08).

Mechanic: If first cohort of articles cites, accelerate to 5 more articles in the cited query patterns + provider-bio AEO rewrites. Adds ~+10/mo to the AEO conservative estimate. Decision dated Day 65.
Accelerator 3 · Referral + No-Show Compound
3 campaigns + SMS reminders
Gate: HubSpot SMS infra live Day 60 + L6 campaign #1 attribution clears (≥3 patient conversions from campaign 1).

Mechanic: Add L6 campaign #3 (Day 95 cohort, but seed by Day 88). Layer HubSpot SMS appointment-reminder cadence that converts Booked → Attended at higher rate (typical lift: 5–10 pts on attend-rate = funnel multiplier of +10–15/mo across all channels). Decision dated Day 65.
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Sensitivity — worst / base / best at Day 90:
Worst case (36 / wk · ~156 / mo) if L0 slips past Day 75 (signal lands with only 15 days of patient-CPA data): no value-based bidding, no L4 standalone gain, L6 campaigns can't attribute. Committed levers shrink to ~135/mo.
Base case (40 / wk · ~172 / mo) if L0 lands Day 60 as planned but accelerators don't all clear their gates. This is the point estimate. Falls short of the 50/wk goal by ~10/wk.
Goal case (50 / wk · ~217 / mo) if L0 lands on time AND all three accelerators clear (paid scale + AEO upper-band + referral compound). 2× current run-rate by Day 90.
⚠
The five decisions that determine which scenario we land in:
Day 14: L0 integration build ownership (MH-1 / Client / Hybrid)
Day 30: All 4 BAAs executed (PracticeQ + HubSpot + Keragon + Ours Privacy)
Day 60: L0 signal flowing end-to-end · patient-CPA dashboard live
Day 65: Accelerators 2 + 3 commit (AEO upper-band + SMS reminders + L6 campaign #3)
Day 70: Accelerator 1 commit (+$10K/mo paid scale on patient-CPA signal)
Lifecycle Marketing · 4 Programs in HubSpot
How the funnel doesn't leak.
Four HIPAA-compliant lifecycle programs powered by the HubSpot CRM (the L0 build unlocks all four). Each program targets a specific drop-off point or expansion opportunity. Together they account for ~30-40% of the trajectory above, with Program 1 acting as a multiplier across every other program's downstream conversion.
Program 1 · Show-Rate Lift
Booked → Attended
Audience: HubSpot stage = Booked; appointment scheduled in PracticeQ (Keragon-flowed).
Channels: SMS primary · email secondary.
Cadence:
  • T-3 days: appointment confirmation + telehealth setup tips
  • T-1 day: reminder + insurance card / ID prep
  • T-2 hours: join-link SMS + final confirm
  • T+30 min (no-show): immediate reschedule offer (don't lose the lead)
Activation: Day 60 (HubSpot SMS infra + Keragon Booked-stage flow live).
Modeled lift: Show rate +5–10 pts (industry standard for telehealth SMS reminders). At ~140 booked/mo by Day 60, that's +8–14 attended/mo — and the multiplier compounds against every upstream lever.
Compliance: No PHI in SMS bodies; appointment-time references only. TCPA-compliant opt-in captured at form-fill.
Program 2 · Lead Nurture
Form-Fill (didn't book) → Booked
Audience: HubSpot stage = Lead, no Booked transition within 24 hours. Estimated cohort: ~100 abandoned form-fills/mo today (the 50% verification-drop cohort + the "I'll come back to it" cohort).
Channels: Email primary · SMS for high-intent segment.
Cadence (drip):
  • T+1d: "Questions about your insurance? Here's what we accept." (addresses Objection #1)
  • T+3d: "How telehealth psychiatry actually works" — 10 min, evening slots, your provider
  • T+7d: Payer-specific deep-dive ("Specific to your [Aetna/BCBS/Moda] coverage")
  • T+14d: Soft urgency — "We're holding a spot · book by [date]"
  • T+30d: Last-touch with Anthony or Cary's founder POV (W2 thesis, DEA NPRM context)
Activation: Day 60 (HubSpot + Keragon flowing Lead-create events).
Modeled lift: 8–12% of un-converted leads reach Booked stage. At 100/mo un-converted, that's +8–12 booked/mo → +6–10 attended/mo after Program 1 lifts show rate.
Compliance: HIPAA marketing rules (45 CFR 164.508) — opt-in required at form-fill; content addresses access/insurance, not protected health info.
Program 3 · Winback
Lapsed Patient → Reactivated
Audience: HubSpot stage = Patient, no PracticeQ visit in 90+ days. Estimated cohort: ~300–500 lapsed at any time on a 5K-patient panel.
Channels: Email primary · SMS for opted-in segment.
Cadence:
  • Day 90 silent: "Checking in — life happens. We're here when you're ready." (care-led, not promotional)
  • Day 120: "Coming back is easier than you think" — re-booking flow + insurance still on file
  • Day 180: Final touch — care-continuity messaging from Cary (clinical voice, not marketing)
Activation: Day 75+ (needs HubSpot patient cohort + extra legal review for psychiatric-specific marketing under 45 CFR 164.508).
Modeled lift: 5–10% reactivation on lapsed cohort. At 400 lapsed × 7% × Day 90 trickle ≈ +5–8 reactivated visits/mo. Note: reactivated patients re-enter the active panel (revenue multiplier per visits/mo); counted distinctly from "newly attended" in the 50/wk goal.
Compliance: Highest-scrutiny program. Psychiatric history is sensitive; no condition-specific messaging; care-continuity framing only. MindRx counsel signs off before launch.
Program 4 · Referral Activation
Engaged Patient → Referrer (L6 expanded)
Audience: HubSpot stage = Patient, ≥3 visits, no recent billing-friction, marketing opt-in on file. Estimated cohort: ~1,500–2,000 of the 5K active panel.
Channels: SMS + email.
Cadence:
  • Trigger 1 — after 3rd successful visit: gratitude + soft referral ask ("Know someone struggling? Here's a link.")
  • Trigger 2 — 60 days after first attended: celebrate progress + gentle ask
  • Trigger 3 — Quarterly broadcast to eligible cohort: ongoing referral-link prompts (themed around regulatory tailwinds, founder-led)
  • Special: Day 75 launch campaign to 500-patient pilot cohort (the L6 campaign #1)
Activation: Day 75 (per the existing L6 plan).
Modeled lift: +3–8 referred patients/mo by Day 90; ramps to 15–30/mo by Day 180 as cohort grows. Compounds because each new patient becomes a future referrer.
Compliance: No cash-equivalent incentive in pilot (anti-kickback concern); gratitude + "help someone you know" framing. Incentive economics revisited post-pilot with counsel.
Activation Timeline · All Four Programs
Program Earliest Launch Prerequisites Day 90 Contribution to "50/wk"
1 · Show-Rate Lift Day 60 L0 signal · HubSpot SMS infra · Keragon Booked-stage flow live Funnel multiplier: +5–10 pts on attend rate. Adds ~+8–14/mo and amplifies every other program.
2 · Lead Nurture Day 60 L0 signal · HubSpot email · Keragon Lead-create flow · brand voice library (S1 voice work) loaded as templates Direct: +6–10 attended/mo from re-engaged abandoned form-fills
3 · Winback Day 75 L0 signal · psychiatric-marketing legal sign-off · Cary-voiced care-continuity copy approved Indirect: +5–8 reactivated visits/mo · grows visits/active (revenue multiplier; not counted in "newly attended")
4 · Referral Activation Day 75 L0 signal · HubSpot Marketing Hub · referral-incentive policy signed off · Ours Privacy attribution flowing Direct: +3–8 referred patients/mo by Day 90; ramps to 15–30/mo by Day 180
Combined Lifecycle Contribution at Day 90 +17–32 newly attended/mo · +5–8 reactivated visits/mo (visits-per-active grows separately)
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Why Program 1 is the leverage point. Show-rate lift is the only lifecycle program that multiplies every other lever in the plan. If we lift attend rate from 80% to 87%, every paid channel, every AEO conversion, every PCP referral, every patient referral, every nurtured lead, every re-booking from winback — they ALL convert to attended at a higher rate. Program 1 should be the first lifecycle program to ship in the Day 60 window.
⚠
One legal/compliance question that needs an answer by Day 30: Marketing to psychiatric patients carries higher scrutiny than general healthcare under HIPAA's marketing rules (45 CFR 164.508), state mental-health privacy law (OR ORS 179.505, WA RCW 70.02), and the Cures-Act-amended "psychotherapy notes" definition. Program 3 (Winback) is the highest-risk; MindRx counsel reviews the copy and audience-targeting logic before Day 75 launch. Programs 1, 2, and 4 are lower-risk because the messaging addresses access/scheduling/referrals, not protected health information.
Section 2 · Channels
Five active channels. Every one has a budget, a target, and an owner.
Search continues to carry primary acquisition. PMax Local is the most-efficient-per-form-fill program and gets scaled. Meta gets a signal rebuild before reactivation. SEO + AEO and Referral are the compounders that earn their place before they earn their CAC.
Primary
Google Search · Branded + Non-Brand
$35K/mo
Target: Patient CPA <$300 · Form-Fill CPA <$150 · Verification rate ≥75%
Current state: 5 active programs. Branded harvests warm demand at $29 stated CPA; non-brand Search runs $349–$596 with degrading trend ($96 → $297 in 7 months). Symptom-search is the largest single bucket.
Branded is the warm-demand harvest — protect and expand sitelinks + RSAs with payer panel + W2 framing surfaced. Non-Brand Symptom-Search (ADHD / Anxiety / Depression) is where the CPA degradation lives — refresh RSA copy to lead with insurance-billed + same-day verification. Psychiatry and Therapy programs get bid-down to floor while patient-CPA signal stabilizes; reallocate underperforming spend into Branded expansion and the next four channels.
  • New RSA set live across all 5 programs (insurance + W2 + same-day hooks)
  • Bid strategy moved to Maximize Conversions w/ patient-event target (once signal lands)
  • Branded sitelink + extension expansion (payer panel, providers, verify)
Branded vs Non-Brand split: $6K Branded · $29K Non-Brand. Branded protects intent, Non-Brand expands TOF + symptom search.
Core · Scale
Google PMax Local
$5K/mo
Target: Form-Fill CPA $50–$80 · Patient CPA <$200
Current state: $8,891 over 90d · $54 stated CPA · 165 form-fills. Most efficient program in mix. Asset hygiene unclear — room to test feed + creative refresh.
Scale carefully — PMax is lowest-CPA by a wide margin. Asset Group refresh with W2 + insurance imagery, audience signals tightened to OR/WA panel, separate Asset Group per symptom cluster. Validate patient-CPA holds through verification once signal is flowing.
  • New asset group with founder + payer-panel visuals
  • Validate patient CPA holds <$200 post-signal
Rebuild
Meta Lead Gen
$1K/mo
Stage 1: Signal live · Stage 2: Form-Fill CPA <$120
Current state: $2,958 spent over 90d with 0 captured conversions — Pixel not firing for the patient-relevant event.
Two-stage. Stage 1 (Days 1–21): rebuild signal — Pixel reconfigured, Conversions API set up, EHR offline-conversion upload tested. Stage 2 (Day 22+): restart Lead Gen against Anthony's founder-led video assets and Healthgrades testimonial cuts.
  • Pixel reconfigured + first event fires
  • 3 founder-led video concepts in test
  • Reallocation decision based on 7-day signal-CPA
Build
SEO + AEO · Founder Authority
$2.5K/mo
Day 90: +15–25 patients/mo from organic · Compounds 12–24 mo
Current state: ~0 organic patients in 5 years. Existing SEO retainer unmeasured. Anthony's voice — the actual moat — is not in market.
Redirect existing SEO retainer into founder-authored content across three layers: symptom education, compliance/regulatory explainers (DEA NPRM, payer panel, W2 vs 1099), and longitudinal patient stories from 200+ Healthgrades reviews. Optimize for AI answer engines (Perplexity, Claude, ChatGPT) alongside Google.
  • First founder piece live (DEA NPRM explainer)
  • 4 published pieces · AEO citation tracking live
  • Symptom-cluster content live (ADHD / anxiety / depression)
Enabling · Compounder
Referral System + Conversion Infrastructure
$1K/mo
Day 90: +5–10 patients/mo from referrals at $50–$100 CPA · Patient-CPA signal live in Google + Meta
Current state: 5,000-patient panel · 0 structured referral flow · 2 informal PCPs (Bridgeport Family Medicine, Embark). Patient-CPA signal lives in IntakeQ EHR but not piped to ad platforms.
The engine room. Two parallel workstreams: Conversion Infrastructure — the EHR → Google Ads + Meta offline-conversion sync that makes every other channel measurable; and the Referral System — formalizing the 2 PCP partners with a clinical leave-behind, plus activating the 5,000-patient panel via structured patient-to-patient referral. Highest-intent acquisition. Best margin per patient. National operators can't replicate the regional density.
  • Conversion signal pipeline scoped (EHR → Google → Meta)
  • PCP packet ready · Bridgeport + Embark pilot launched
  • Patient-CPA signal flowing · first reallocation decision
  • Patient referral flow live (post-visit + 5-star reverse-funnel)
Section 3 · Budget
$44.5K/mo paid · plus $3–8K/mo HIPAA SaaS stack.
Light reallocation off the current $42.6K/mo paid spend to fund the compounders. Net-new line item: $3–8K/mo recurring SaaS for the HIPAA-compliant signal layer (HubSpot HIPAA tier + Keragon + Ours Privacy). The lift comes from operational fixes, not bigger ad budgets — but the engineering build is real money.
Search · 79%
PMax · 11%
Meta · 2%
SEO · 6%
Ref · 2%
Channel Amount % of Total Notes
Google Search — Branded $6,000 13% Warm-demand harvest · expand sitelinks + payer panel
Google Search — Symptom (Dep/Anx/ADHD) $18,000 40% RSA refresh · insurance + W2 framing · lead with verification SLA
Google Search — Therapy + Psychiatry $11,000 25% Bid-down · monitor stated CPA Days 15–60; patient-CPA reallocation defensible Day 75+
Google PMax Local $5,000 11% Scale carefully · new asset group with founder visuals
Meta Lead Gen $1,000 2% Rebuild signal first · spend restart Day 22
SEO + AEO (founder content) $2,500 6% Redirect of existing SEO retainer · founder byline
Referral · PCP + Patient (L5 + L6) $1,000 2% PCP packet · clinician outreach · HubSpot patient-referral campaigns (Day 75+)
Paid Marketing Total $44,500 100% vs. ~$42,600/mo current paid (Feb 10 – May 10)
L0 · HIPAA SaaS stack (net-new, off paid budget) $3,000–$8,000 — HubSpot HIPAA tier $1.5–3K · Keragon $0.5–1.5K · Ours Privacy $1–3K (volume-dependent). Recurring from Days 15–20.
L0 · Implementation (one-time) $0–$30,000 — $0 if MH-1 owns the build · $0 if client-managed in-house · $10–30K if hybrid with Keragon-certified or HubSpot Solutions Partner. Day 14 BR ask #1.
Section 4 · 30-60-90 Roadmap
The 90-day channel × time map.
Specific milestones, dated. No "optimize creative" — every cell is an artifact or a measurable event.
⚠
L0 — the signal layer is a 45–75 day engineering build, not a Day-1 config. Patient CPA flows from PracticeQ ↔ Keragon ↔ HubSpot ↔ Ours Privacy ↔ Google Ads + Meta CAPI. 4 BAAs on the critical path (PracticeQ + HubSpot + Keragon + Ours Privacy). Production signal target: Day 60. 30 days of patient-CPA data by Day 90. Until the signal lands, the plan operates on bridge measures: form-fill CPA + verification rate + Meta Pixel — explicitly named as proxies, not optimization targets. Bid-strategy changes (value-based bidding) held until Day 75+.
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Patient lifecycle in HubSpot (the CRM-of-record): Lead → Qualified → Booked → Patient. Keragon flows the stage transitions to/from PracticeQ; Ours Privacy fires the offline conversion to Google Ads + Meta when the Patient stage is reached. Same mapping powers HubSpot patient-referral campaigns (text + email) launching ~Day 75.
Channel Days 1–30 Days 31–60 Days 61–90
Google Search
$35K/mo
  • RSA refresh live, 5 programs (insurance + W2 + same-day hooks)
  • Bid → Maximize Conversions on form-fill (bridge) — no value-based bidding until Day 75+
  • Branded sitelink + extension expansion
  • Intent-keyword pruning (kill Medicaid/Medicare/Apple-Health/Tricare broad-match)
  • Geo expansion test: high-density OR/WA zips
  • Symptom-search RSA v2 informed by 14d perf
  • Negative keyword pruning + Quality Score sweep
  • ~Day 60: patient-CPA signal lands; first reconciliation against stated CPA
  • RSA v3 with AEO-derived intent keywords
  • Day 75+: transition to value-based bidding once ≥30 days of patient-CPA volume
  • Per-program patient-CPA reallocation (defensible for first time)
  • Full 90-day reconciliation · Q3 budget rec
Google PMax Local
$5K/mo
  • Asset audit · feed hygiene · audience signal review
  • New asset group w/ founder + payer visuals
  • Symptom-cluster asset group split (ADHD/Anx/Dep)
  • Patient CPA validation · scale decision
  • Test budget bump → $7K if patient CPA <$200
  • Q3 scale plan: PMax → $8K/mo if holding · or rotate
  • Asset refresh from latest founder + Healthgrades
Meta Lead Gen
$1K/mo
  • Pixel reconfigured · form-fill event as bridge measure until L0 CAPI lands
  • 3 founder-led video concepts in test
  • First 7d form-fill CPA review · scale/hold (NOT patient CPA yet)
  • Healthgrades testimonial cuts in rotation
  • ~Day 60: Ours Privacy CAPI integration replaces Pixel form-fill as primary event
  • If patient-CPA <$300 once signal flows → scale to $2.5K/mo
  • Lookalike from verified-patient seed (HubSpot · Ours-Privacy hashed)
  • Scale or pause decision on patient-CPA (first defensible read)
SEO + AEO
$2.5K/mo
  • Editorial calendar · 12 founder-led pieces scoped
  • First piece live: DEA NPRM (Anthony byline)
  • AEO citation tracking installed (Perplexity, Claude, ChatGPT)
  • 4 published · payer-panel landing page live
  • Symptom-cluster: ADHD pillar live
  • Anxiety + Depression pillar content
  • First AEO citations · Healthgrades-sourced pages
  • W2 vs 1099 marketplace explainer
  • 12 pieces total · 2 in top-5 for symptom queries
  • Organic attribution: first 5–10 patients credited
L0 · Signal-Layer Build
$3–8K/mo SaaS
HubSpot · Keragon · Ours Privacy
  • 4 BAAs executed in parallel — PracticeQ + HubSpot + Keragon + Ours Privacy
  • HubSpot tenant provisioned · lifecycle stages (Lead/Qualified/Booked/Patient) · property model live
  • Keragon flows scoped (HubSpot ↔ PracticeQ bi-directional webhooks)
  • Ours Privacy account active · offline-conversion event taxonomy mapped
  • Day 14 BR ask #1: integration build ownership decision (MH-1 / client / hybrid)
  • Keragon flows promoted to production
  • ~Day 60: first patient-CPA signal flowing end-to-end to Google Ads + Meta CAPI
  • Patient-CPA dashboard live · replaces form-fill CPA as primary review unit
  • Ours Privacy match-rate dashboard (target ≥70% Google, ≥60% Meta)
  • ~30 days of patient-CPA volume accumulated
  • Per-channel patient-CPA reportable with M-confidence (H-confidence by Day 120)
  • Bid-strategy + budget reallocation calls become defensible
Referral · PCP + Patient (L5 + L6)
$1K/mo
  • PCP packet ready · Bridgeport + Embark pilot
  • Clinician-to-clinician 1-pager · 50–100 OR/WA PCP target list
  • HubSpot patient-referral campaign scoped (audience + incentive policy + legal review)
  • 2 PCP partners formalized · referral tracking via HubSpot "Referral Source" property
  • First referral-attributed patients credited (via Ours Privacy)
  • L6 prep: HubSpot Marketing Hub configured · SMS + email infra ready
  • Expand PCP outreach: 3–5 additional partners
  • ~Day 75: L6 patient-referral campaign #1 (text + email · 500-patient pilot)
  • Patient-referral CPA established (target: $50–$100)
Section 5 · Pipeline Focus
The patients we win. The angle that lands. The channels that find them.
Three patient profiles, urgency-shaped, with the specific hooks the creative system produces against.
High Urgency · Direct Intent
The Symptom-Aware Searcher
Googling "ADHD treatment online" or "psychiatrist near me" for weeks. Insurance card in hand. Wants payer match, appointment timing, provider continuity. ~70% of paid form-fills today.
→
Angle: Insurance-billed, W2 providers, same-day verification — three things 1099 marketplaces can't credibly say.
Channels: Google Search · PMax · SEO (symptom)
"Insurance-billed psychiatry — Aetna, Cigna, Providence, BCBS, Moda, UHC"
"Same-day verification — know before you book"
"W2 providers, not contractors"
"Specialty care that stays — multi-year continuity"
Highest LTV · Switching
The Continuity Seeker
Currently in care at a marketplace or unstable practice. Post-Cerebral / post-Done category shift. Looking for a provider who won't churn, prescribe-only, or disappear. 5,000-patient panel proves this profile retains.
→
Angle: "Psychiatric care is medical care" — clinic operational discipline delivered as telehealth.
Channels: AEO (W2 vs 1099) · Healthgrades · Branded Search
"W2 providers — salaried, not paid per script"
"5,000-patient panel — multi-year continuity"
"OR/WA only — your provider knows your state's rules"
"Responds in <24 hours" — Healthgrades verbatim
Highest Trust · Fast Convert
The Referral-Sent Patient
Sent by PCP (Bridgeport, Embark, future partners) or current MindRx patient. Pre-trusted, often pre-verified. Volume today: negligible — that's the entire opportunity.
→
Angle: Referral creates the trust the cold ad has to earn. Convert in days, not weeks.
Channels: PCP packet · Patient referral flow · Branded Search
"Your PCP sent you — let's get you on the calendar this week"
"Same-day verify · same-week appointment for referrals"
"Your friend's provider can be your provider"
"Insurance check done before the first call"
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Pipeline contribution: Today, the Symptom-Aware Searcher drives ~70% of paid form-fills at $349–$596 stated CPA. The Continuity Seeker and Referral-Sent profiles are greenfield — combined, they're expected to deliver +20–35 patients/mo by Day 90 at $50–$100 CPA, bending the blended curve as Search CPC inflates.
Section 6 · Performance Creative Strategy
The creative system. Built around what wins in healthcare today.
Trust pillars deployed end-to-end. Anthony's founder voice — currently absent from market — becomes the cornerstone. Healthgrades' 200+ reviews finally enter the creative library.
1 · Creative Funnel Map
TOF · Top of Funnel
Authority + Education
Founder-led video · DEA NPRM explainer · W2 vs 1099 thread · Symptom education shorts · Anthony intro reel
Goal: Stop the scroll. Plant "MindRx = operator-grade telehealth psychiatry in OR/WA."
MOF · Middle of Funnel
Provider + Payer Transparency
Provider intro videos · Payer-panel landing page · "How verification works" walk-through · Multi-payer carousel
Goal: Answer "who takes my insurance?" and "who's my actual provider?" before the form-fill.
BOF · Bottom of Funnel
Proof + Speed
Healthgrades testimonial cuts · Same-day verification SLA static · "Get verified in 60 sec" video · Branded Search RSA with verify hook
Goal: Convert verified-insurance intent into booked-and-attended appointments.
2 · Copy + Hook Strategy
Hook 1
Insurance-Billed
"We take Aetna, Cigna, Providence, BCBS, Moda, UHC/Optum — verified same-day." 1099 marketplaces can't say this credibly.
Hook 2
W2 Providers
"PMHNP-BC. Salaried. Not paid per script." Post-Done/Cerebral — this is the trust signal.
Hook 3
Same-Day Verification
"Know if we're in-network before you book." Removes the #1 friction — 50% verification leak as a feature, not a bug.
Hook 4
Specialty Care That Stays
"5,000-patient panel. Multi-year continuity." The moat marketplaces can't replicate.
3 · Creative Mix Target
65/35
New founder-led + Healthgrades-sourced concepts (65%) vs. iteration on winners (35%). Founder-authority is brand new to MindRx market — heavier weight on new concepts in Phase 1; ratio normalizes by Day 60.
4 · Creative Scorecard
Patient CPA · Blended
<$300
Trigger: $325 for 5 days
Lead → Verify
≥60% D30 · 75% D60
Trigger: <55% for 7d
Form-Fill CPA (Brand)
<$50
Trigger: $75 for 5d
CTR · Symptom Search
≥6%
Trigger: 25% drop WoW
Healthgrades ★ Avg
≥4.5
Trigger: 1★ cluster /wk
AEO Citations
≥8 by D90
Review: monthly
5 · Fatigue Monitoring
  • CTR drop ≥25% WoW on any creative — auto-flag for refresh
  • Frequency >3.5 on Meta sustained 3 days — rotate concepts
  • CPA delta +20% over target for 5 consecutive days — creative + bid review
  • Verification rate dip <55% in any 7-day window — landing-page audit
  • Quality Score regression on any Search program — RSA + landing-page refresh
6 · Concept-to-Production Pipeline
1
Brief
Co-Pilot Creative writes brief from scorecard + audience
2
Source
Anthony 30-min recording · Healthgrades pull · provider intro
3
Review
Compliance + clinical pass · Cary signoff on patient copy
4
Build
Cuts in 3 aspect ratios · 4 hook variants · sitelinks/RSAs
5
Launch
UTM live · scorecard threshold flagged · 7-day winner call
Cycle: brief-to-launch in 10–14 days. Anthony commits to one 30-min recording per week as the source layer.
7 · Channel-Specific Tactics
Google Search
RSA tested 3-up · sitelinks ladder with payer panel · long-tail symptom expansion · verify-friendly headlines first position
Google PMax Local
Asset group per symptom cluster · founder visuals + payer logos · OR/WA geo signals tight · feed hygiene weekly
Meta Lead Gen
Hook in first 2 seconds · 4:5 aspect default · captions on · founder + Healthgrades cuts post-signal
SEO + AEO
Founder byline on every piece · structured data + FAQ schema · AEO-optimized H1/H2 · symptom + insurance + compliance pillars
Section 7 · Scope Alignment
Who does what. No "TBD" in the owner column.
Every channel is named. Every workstream has a delivery cadence. MindRx-side dependencies surfaced before they become bottlenecks.
Channel / Workstream Deliverable Frequency Owner
Google Search Campaign management · RSA refresh · bid strategy · sitelinks · weekly reporting Weekly MH-1 · Co-Pilot (Paid Search)
Google PMax Asset hygiene · audience signals · creative refresh · monthly scale review Bi-weekly MH-1 · Co-Pilot (Paid Search)
Meta Lead Gen Pixel/CAPI rebuild · video concept production · audience build · weekly reporting Weekly MH-1 · Co-Pilot (Paid Social)
SEO + AEO Editorial calendar · content briefs · founder-byline drafting · AEO citation tracking Weekly publish · Monthly audit Joint · MH-1 Co-Pilot (SEO) + Anthony
Creative Production Concept briefs · UGC + Healthgrades sourcing · video editing · asset builds Bi-weekly MH-1 · Co-Pilot (Creative)
L0 · Signal-Layer Build (NEW) 4-BAA execution (PracticeQ + HubSpot + Keragon + Ours Privacy) · HubSpot tenant + lifecycle stages · Keragon middleware flows · Ours Privacy CAPI · production signal target Day 60 Weekly build cadence Days 15–60 · Monthly post-go-live TBD · Day 14 BR ask #1 — MH-1 / Client / Hybrid
CRM Operations (HubSpot) (NEW) Lifecycle stage hygiene · property maintenance · list/segment ops · campaign send · Keragon flow monitoring Weekly Joint · MH-1 (Lifecycle) + MindRx Ops (post-Day-60)
Referral System (L5 + L6) L5: PCP packet · pilot mgmt · attribution. L6: HubSpot patient-referral campaigns (text + email, HIPAA-compliant) · incentive policy · post-visit asks · attribution via Ours Privacy Bi-weekly Joint · MH-1 (Lifecycle) + MindRx Admin + Counsel (for L6 incentive policy)
Provider Capacity Credentialing tracking · onboarding pacing · provider intro video production Weekly · Monthly capacity Client · MindRx leadership
Reporting + Pacing M/W/F digest · weekly sync · monthly review deck · QBR Weekly / Monthly MH-1 · Co-Pilot Lead
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The two named blockers: (1) L0 build ownership — Day 14 BR ask #1; integration build is a 45–75 day engineering project across 4 vendors and 4 BAAs; until ownership is assigned, the timeline doesn't start. (2) Provider capacity — at 13 providers, system tops out at ~3,575 visits/month; 300 new patients/mo requires 36–40 providers; credentialing is 120 days. The plan paces against both.
Section 8 · How We Optimize
Weekly pulse. Decision rules. Reporting cadence.
Optimization is mechanical — what we watch, what triggers an action, when we report. No "monitor performance" hand-waves.
Weekly Pulse · Monday Dashboard
Patient CPA by channel Verification rate Form-fills by channel Provider credentialing pipeline Healthgrades ★ avg
Decision Rules · Conditional Triggers
  • If blended stated CPA >$300 for 5 consecutive days → bid + creative review (24h SLA)
  • If verification rate <60% in any 7-day window → admin SLA + landing-page audit
  • If lead-to-first-contact >5 min in business hours → escalation to Co-Pilot Lead
  • If Meta signal-CPA falls outside ±30% of Google → attribution audit before scaling
  • If founder content publishes <2/week for 2 weeks → editorial backlog review
  • If any 1-star review cluster within 48h → billing/admin operations review
Reporting Cadence
Cadence Format Attendees Purpose
M / W / F Async Slack digest Anthony + Cary · Co-Pilot Lead Days 15–60: form-fill CPA · verification · top issues. Days 60+: patient CPA replaces form-fill as primary metric.
Weekly 30-min sync (Zoom) Anthony · Cary · Co-Pilot Lead · channel co-pilots Plan vs actuals · decision triggers · upcoming launches
Bi-weekly Creative review Anthony · Co-Pilot Creative · Co-Pilot Lead New concepts · Healthgrades surfacing · founder recordings
Monthly Vercel dashboard + review deck Anthony · Cary · Co-Pilot Lead Patient-CPA reconciliation · channel scale · capacity pacing
Quarterly QBR + roadmap refresh Anthony · Cary · Raaja · Co-Pilot Lead Quarter recap · next-quarter plan · org/budget decisions
24/7 Always-On Platform Health Co-Pilot Lead (escalates to Anthony if Critical) Pixel health · UTM integrity · spend pacing · attribution flow
Section 9 · What's Next
Launch readiness. Month-1 success. Systems access.
What ships in the first 14 days post-approval, what "Month 1 success" looks like quantified, and the systems you'll be looking at every week.
Launch Readiness · First 14 Days
What ships next
  1. Day 14 BRIntegration build ownership decision (MH-1 / Client / Hybrid) · contracts in motion for HubSpot + Keragon + Ours Privacy
  2. Week 1Approval signed · access provisioned (Google Ads, Meta Business, GA4, PracticeQ EHR data export)
  3. Week 14 BAAs initiated in parallel (PracticeQ + HubSpot + Keragon + Ours Privacy)
  4. Week 1L0 signal-layer spec frozen · HubSpot lifecycle stages (Lead/Qualified/Booked/Patient) designed
  5. Week 2RSA refresh live on 5 Google Search programs · UTM framework · intent-keyword pruning
  6. Week 2Meta Pixel reconfigured as bridge measure · PMax asset audit complete
  7. Week 2First founder content piece live · weekly scorecard live
Day 60–90 Success Criteria (revised)
What "winning" looks like
  • L0 signal layer in production by Day 60 · 4 BAAs closed · Keragon flows live · Ours Privacy CAPI flowing
  • Patient-CPA signal in Google Ads + Meta by Day 60 · ≥30 days of data by Day 90
  • Ours Privacy match-rate ≥70% Google, ≥60% Meta by Day 90
  • Verification rate ≥60% by Day 60 (75% by Day 90 target)
  • Blended stated CPA <$250 (vs $297 trajectory) on bridge metrics
  • 4 founder authority pieces published · AEO tracking installed
  • PCP pilot live with Bridgeport + Embark · HubSpot patient-referral campaign #1 sent ~Day 75
  • 0 critical errors in Always-On health
System Access
Where you'll see the work
  • Weekly Reporting
    M/W/F digest · weekly scorecard    ↗ View
  • Performance Dashboard
    Patient CPA · channel reconciliation · monthly    ↗ View
  • Always-On Platform Health
    Pixel · UTM · attribution · 24/7    ↗ View
  • Media Plan System
    Single source of truth · spend + pacing    ↗ View
  • IntakeQ EHR Data Feed
    Patient-event source for offline-conversion sync    Week 1
Zero churn since launch · 100% trial-to-hire rate · Month-to-month, cancel anytime.