Digital Ad Campaign Leads to Huge ROI for Cardiovascular Institute

Concord Hospital is a regional, acute care health center serving 150,000 people in the 30 towns comprising New Hampshire’s Capital Region. The hospital is home to a comprehensive cardiovascular program that draws patients not only from throughout the state, but also from New York, Vermont, Maine, Alaska, and Florida. It’s a critical, lifesaving program in New Hampshire, where heart disease is the second-leading cause of death.

In 2021, the organization consolidated all its heart and vascular services into a single new entity — Concord Hospital Cardiovascular Institute. The change was a fundamental reorganization more often seen in much larger medical centers, with a leadership structure designed to improve care and increase patients’ access to that care. With most services available under one roof, the institute offers an integrated approach to treatment.

Targeted Reach for New Patient Acquisition

For help generating awareness for the Cardiovascular Institute and attracting new patients, Concord Hospital worked with its web and digital marketing partner, Geonetric, on a digital advertising campaign. The campaign aimed to reach prospective patients ages 55 and older living in the Capital and Lakes Regions of New Hampshire. Geonetric’s paid media team recommended a channel mix between display and paid social while strategically advising not to invest in paid search due to the hospital’s strong organic presence, which has little to no competitive pressure. The advertising creative and copy leaned into core brand RTBs (reasons to believe) that focused on different aspects of the Cardiovascular Institute: provider expertise, the institute’s capabilities, the ease of receiving service, patient support, or the potential to improve quality of life.

Geonetric tracked two primary conversion points: clicks to call and “Request Appointment” form submissions from a landing page the hospital wrote highlighting a cardiac patient’s success story. To track appointments that patients scheduled and attended, Concord Hospital’s web manager worked closely with clinical stakeholders. Each time a user completed the online form to request an appointment, the marketing team emailed the information to a cardiology care coordinator. The coordinator contacted each patient to schedule a visit, and then reported back to the web manager how many leads resulted in new-patient appointments. By working together, Geonetric and the hospital were able to track conversions throughout the full funnel, from selecting and scheduling to keeping an appointment.

A/B Testing, Close Monitoring & Continuous Optimization

Geonetric ran new paid social copy early in each month, using the performance data from the previous month’s ads to direct the new creative. The agency also compared the performance of messages that focused on certain strengths of the institute. One version of the copy was the clear winner after the first week. At that point, most digital marketers would have stopped running other variations of the ad. But Geonetric’s paid media team continued to run multiple ad variations to give Facebook’s machine-learning algorithms time to respond to changes in performance due to ad fatigue. Over time, the early front-runner’s performance declined, and other ad versions rose to the top. Geonetric’s approach thus helped Concord Hospital make the most of its advertising investment.

For Google display ads, Geonetric ran new creative monthly, keeping the messaging and formatting consistent with the landing page. The agency used HTML5 to create high-quality, professional, animated creative in several sizes. Geonetric had an ongoing hypothesis they’d see the best performance from looping ads, which would let users see the animation on an ad that appeared “below the fold” even if they didn’t scroll down to the ad during the first six-second animation cycle. Testing proved that hypothesis correct, so Geonetric switched all non-looping display ads to looping ads to maximize performance.

The agency’s familiarity with Google display ads also helped Concord Hospital maximize target audience reach while avoiding violations of Google’s policy on health in personalized advertising.

For both display ads and paid social, Concord Hospital provided photos of their cardiologists, patients, and heart technology. A Facebook ad featuring a Concord Hospital Medical Group physician drew many positive comments from the doctor’s patients — powerful, free promotion and organic reach for the organization. Geonetric kept the imagery consistent between the Google display ads and social ads, but changed the photos regularly to keep the content fresh. Each new image typically increased ad performance. But when the fifth swap didn’t lead to the usual boost, the agency applied a more dramatic background to the photo of a cardiologist. This simple change significantly improved results.

Dramatic, Measurable Results

Concord Hospital initially contracted with Geonetric for a three-month campaign. But after seeing positive results, the hospital extended it to four months to take advantage of built-up momentum across the two channels. The hospital spent $22,323 on the campaign, which led to:

  • 32 conversions
  • 9 trackable new-patient appointments
  • $100,374 net revenue
  • 450% return on investment (ROI)

PPC Campaign Attracts New Patients

Concord Hospital’s Center for Urologic Care ranks in the top seven percent nationwide in patient satisfaction surveys (Press Ganey). With scores like that, Concord Hospital’s marketing team wanted to spread the word. They partnered with Geonetric to reach health consumers in Concord, NH and the surrounding areas with a three-month PPC campaign.

The campaign focused on growing service line volume and increasing visibility outside their primary service area. To achieve their goals, our team worked through our five-step process for PPC campaigns: conceive, develop, implement, analyze, and test.


We began by learning about Concord Hospital’s urology services, specialized programs, and the benefits to patients. After we understood Concord Hospital’s services, we imagined the types of people affected by different conditions—their age, gender, and topics that interest them. The campaign focused on conditions including:

  • Enlarged prostate
  • Prostate cancer
  • Erectile dysfunction
  • Incontinence
  • Kidney stones
  • Pelvic pain

We conducted keyword research for each condition. Our team searched for keywords that had high traffic and provided good value.

In addition to the PPC work, we talked with Concord Hospital’s marketing team about the conversion journey to provide a larger context for the campaign and recommend best-practices. We discussed the importance of making each step easy for potential patients and provided advice on which landing pages to set up for the ads. These discussions helped establish a consistent user experience throughout the conversion journey, from seeing the PPC ad to requesting an appointment.


The keyword research informed the development of text ads in Google and Bing. Our team focused the ad copy on patients’ needs and highlighted the benefits of the Center for Urologic Care.

In addition, we used dynamic keyword insertion to personalize the ads. By including brackets { } in the text ads, Google and Bing pull the keyword that triggered the ad. While we control which keywords can appear through a target keyword list, it adds a personal touch that makes the ads more relevant to users.

We also developed display ads, working collaboratively with Concord Hospital’s team to choose the right images and copy.


We implemented text ads on Google and Bing. We also launched display ads on Twitter, Facebook, and Google (see examples).

Four text ads used in the urology campaign. The top left one says: "Erectile Dysfunction Treatment. Make An Appointment. Get The Latest Treatments For Erectile Dysfunction At Concord Hospital." The top right one says: "Experiencing Kidney Stones? Trust The Urological Experts. Seek Relief From Your Kidney Stone Pain With Shock Wave Lithotripsy Treatments." The bottom left one says: ""Relief From Urinary Pain. Get Expert Care. Don't Let Urinary Pain Impact Your Life. Concord Hospital Can Help." The bottom right one says: "Difficulty Urinating? Enlarged Prostate Treatment You May Have An Enlarged Prostate. Find Relief At Concord Hospital. Learn More."

Two display ads used in the urology campaign. The left one has a picture of a middle-age woman and says, "Have Pelvic Pain? Make An Appointment Today." The right has a picture of an elderly woman. The caption says, "Take Back Your Life. Seek Bladder Control Care Today." Both display ads have a banner at the bottom with the Concord Hospital logo and the text "Learn More."

Two Facebook ads used in the urology campaign. The left one says "An enlarged prostate can cause difficult urination. For expert prostate care, talk to a specialist at Concord Hospital." Then there's an image of a man with the caption, "Difficulty Urinating?" The right one says, "Seek compassionate pelvic care from a specialist at Concord Hospital." There's an image of a woman with a caption that says, "Pain during intercourse?"


After the launch, we began analyzing the data. We monitored traffic and conversions generated by the ads. Our team reviewed the campaign’s performance on an ongoing basis and optimized targeting and budget for the keywords, ads, and platforms that performed best. For example, we paid attention to the keywords that got better results, such as “Erectile Dysfunction” or “E.D.”

While we made small adjustments throughout the entire campaign, we made major recommendations in monthly meetings where we delivered a monthly performance report. Major changes included shifts in platforms and changes to the ads themselves.

Platform Shifts

From the beginning, we identified Twitter as the lowest performing platform. The click-through-rate (CTR) was low for industry averages. For the people who did convert, they spent very little time on the landing page. After a month, we ended the Twitter ads and shifted the ad spend to Facebook, which was performing well.

While Google performed well in the beginning, Bing improved over time. By the end of the second month, we decided to shift some ad spend from Google to Bing to increase ROI.

Ad Changes

In addition to monitoring the general performance on each platform, we examined the performance of individual ads and ad groups. For example, between months two and three, we made enhancements to the kidney stone text ads to optimize the keywords. We also made changes to display ads, such as swapping genders in some images and improving the ad copy (see examples).


This is the original display ad. It has Concord Hospital's logo on the left. The caption says, "Have kidney stones? Talk To A Specialist." On the right, there's a picture of a woman.
This is the original display ad. It has Concord Hospital's logo on the left. The caption says, "Kidney stone pain? Make An Appointment." On the right, there's a picture of a man.


We tested the results of each change we made. Here’s some highlights:

  • The decision to end Twitter ads and move that ad spend to Facebook paid off. In the remaining months, Facebook’s CTR was three times higher at 2.99 percent, with the cost-per-click being almost half as much. By making the switch, Concord Hospital increased traffic at a lower cost.
  • While Google outperformed Bing in the first month in CTR and number of clicks, Bing surpassed Google in the last month. While the CTR was about equal, Bing brought in over twice the traffic with a cost-per-click that was 27 percent lower. Bing reached the right people, which helped increase traffic and appointment requests.
  • By optimizing the copy for the kidney stone text ad group, the CTR doubled. Swapping the image for the kidney stone display ad improved number of clicks and average CTR.


The campaign ran for three months. The ads drove 9,570 visits to their site, and resulted in 17 appointment requests. The ads raised awareness for the Center for Urologic Care and generated new revenue.