MediCare's Google Ads Turnaround: From 2.1x to 7.2x ROAS in 90 Days

MediCare Clinics had been running Google Ads for 3 years with the same structure — a single broad campaign, broad match keywords, and no conversion tracking beyond phone call approximations. ROAS sat at a chronic 2.1x. They were spending $45K/month and unable to distinguish which campaigns, keywords, or locations were driving actual patient appointments versus low-quality leads.

We started with measurement — implementing GA4, Google Tag Manager, and enhanced conversion tracking that could accurately credit phone calls, form fills, and appointment bookings to specific campaigns. With clean data for the first time, we restructured the entire account: separate campaigns per service line (GP, Specialist, Urgent Care), per location (8 clinic locations), and by match type. We introduced ad scheduling based on clinic open hours, implemented location bid adjustments, and launched a Performance Max campaign alongside traditional Search. We also built a negative keyword framework of 1,200+ terms to eliminate irrelevant traffic.

Within 30 days of the rebuild, cost-per-acquisition dropped 38%. By day 90, ROAS had climbed from 2.1x to 7.2x — the highest in the business's history. Monthly ad spend efficiency improved so dramatically that the same $45K budget was generating 3.4x the patient volume. CPA fell from $186 to $71. The measurement infrastructure also revealed that Tuesday-Thursday 9AM-3PM was 2.8x more efficient than weekend campaigns — a finding that drove a 22% budget reallocation and immediate cost savings.