How Rancho Health grew clinics from 13 to 32 new patients a week across an 11-brand medical network

Overview

Rancho Health runs patient acquisition in-house for 11 primary care brands — among them Rancho Family Medical Group (RFMG), a primary-care group with 12 clinics across South Riverside County, and Rancho Pediatrics, a fee-for-service pediatric clinic in Temecula. Every acquired group gets the full treatment: new logo and colors, a new website, a new Google Ads account, Google Business Profile listings, and paid campaigns on Google and Meta, with connected TV and direct mail in the mix. An internal team does 99% of it; Stephen, who leads AI for the organization on top of marketing and growth, oversees the operation.

The exception was one San Diego brand, where Rancho's investment firm wanted to try a large national agency: about $15,000/month in ad spend, a 20% management fee on top, and roughly $60,000 upfront for creative — a $250,000–$325,000 twelve-month commitment that is still not close to breaking even. Most of that brand's patients come from the small campaigns Rancho runs on the side. Stephen tested Helena head-to-head against a direct competitor for two months, picked Helena for its usability and pace of new integrations, and started with a single brand. The internal team with Helena now out-produces the agency, and Rancho is rolling Helena out to all 11 brands.

The Problem

Marketing an MSO is marketing many businesses at once:

1. Eleven brands, one team: Each medical group needs its own Google Ads, Meta campaigns, SEO, and reporting — and with AI where it is, hiring two or three more staff to cover the gap was a non-starter.
2. A creative bottleneck, not a content problem: Rancho has photographers and videographers on staff and a 20-terabyte drive of doctor photos and videos. The bottleneck is turning that library into the carousel, story, and square formats Google and Meta want — and then pushing, running, and managing it all. Even the paid agency is only inside the ad accounts a small amount of time.
3. SEO and local listings basically untouched: SEO was “basically non-existent” for the department, and the network's 100+ Google Business Profile listings got created and then never maintained — a problem for smaller brands trying to rank in the map pack against giants like Kaiser with a three-doctor clinic.
4. Agency economics that never penciled: $15,000/month in spend, 20% management fees, and ~$60,000 upfront creative on one brand — a $250,000–$325,000 annual investment — while underperforming the small campaigns Rancho ran itself.
5. Budget control and compliance: Search and PMax campaigns silently overspend daily caps without someone watching every day, and healthcare messaging rules mean nothing can go live without human sign-off.

The Solution

After a two-month head-to-head trial against a competing AI marketing product, Rancho chose Helena, connected Google Ads, Meta Ads, Google Analytics, Search Console, and self-hosted WordPress, and put her to work per brand:

1. Onboarding that already knew the market: From just a URL, Helena produced a brand synopsis and named Rancho's top competitors — the exact four Stephen would have listed himself, including small primary-care groups down the street (one run by a doctor Rancho is trying to acquire). She then proposed five prioritized actions; Stephen started by simply saying “do number one.” Where she can't act directly, she hands over precise recommendations — down to the negative keywords to add.
2. Google Search & Performance Max: For RFMG, Helena runs seven search campaigns — same-day-visit, primary-care, and 65+ senior lines split by location — alongside PMax. Rancho Pediatrics adds its own Search, PMax, and concierge/FFS campaigns.
3. Meta Ads with a physician-safe creative pipeline: Traffic and same-day-visit campaigns on Instagram and Facebook. Because doctor likenesses can never risk AI alteration, the team produces physician creative in its own stack — Claude plus Runway, turning a quick photo of a doctor seeing a kid into a 15-second video clip — then hands it to Helena: “run this campaign, here's our audience.” Campaigns are built paused for approval, then activated on a schedule.
4. Daily campaign intelligence: Every weekday Helena pulls the prior day from Google Ads and Meta, compares to the 7-day average, and emails a plain-English digest flagging overspend, insurance-related search terms to negative out, and pixel/tracking gaps.
5. Local SEO & reporting: A weekly local-SEO article auto-drafts to WordPress across RFMG's 12 clinics — Helena emails “are you good with these?” and Stephen approves — plus weekly per-campaign performance reports by email, monthly paid-vs-organic audits, appointment-page conversion checks, and Search Console keyword reports.

Actions and Complex Workflows

The daily digest is where the money shows up. On Rancho Pediatrics, Helena repeatedly caught a search campaign overspending against its daily cap, quantified the monthly waste, and recommended the exact fix. It flagged insurance-related search terms to add as negative keywords, and surfaced a Meta pixel that wasn't firing on the pediatrics site so spend wasn't flying blind.

On RFMG, she watches every campaign against the CTR threshold she has set and flags anything that drifts, while the weekly WordPress articles compound organic search week over week.

Rancho has also benchmarked Helena's targeting directly: audiences she builds comp within 1–2% of audiences built by expert agencies Rancho has paid — on brand-new campaigns, before any optimization window. And because none of the campaigns touch patient data, the whole setup stays clean for healthcare: connecting Google and Meta involves no PHI at all.

Everything runs human-in-the-loop: Helena builds the campaigns, monitors spend, and drafts the content, but launches sit paused until Stephen approves them — often from a single Monday-morning email. That design is what makes it safe for regulated, patient-facing marketing while giving a lean in-house team the reach of a full department across every brand.

The Result

One in-house team now runs paid and organic marketing across the network:

1. The two pilot clinics became the network's best performers: The first two clinics put on Helena are now Rancho's top two for incoming new patients. Both had been on “go to green” underperformance plans; both are now off those plans entirely, with the new-patient trend driven mostly by campaigns built off Helena's suggestions.
2. 13 to 32 new patients a week: Rancho Pediatrics averaged about 13 new patient visits a week before Helena went on in early June. The weeks after: 20, 17, 22, 14, then back-to-back weeks of 32 — alongside the clinic's highest schedule-utilization week ever. A 32-patient week represents roughly $40,000 in annual revenue against about $1,000 of ad spend.
3. Doing more for less: Roughly $6,000/month in direct savings — and closer to $10,000–12,000/month counting the SEO, listings maintenance, and reporting the team simply wasn't doing before. As Stephen puts it, “we're able to do more that we couldn't do six months ago, and we're not hiring three more people to do it.”
4. Spend under control, reach measured: Daily guardrails catch overspend — like the ~$1,400/month Pediatrician Main leak — while one brand's Meta delivered 130,551 impressions and 2,225 clicks in a single week at a 1.70% CTR, with organic clicks up 19.8% WoW.
5. Scaling to the whole network, and beyond: Rancho's Director of Marketing is putting all 11 brands on Helena (14 by year-end as three acquisitions close), and the company is weighing ending its $250,000–$325,000/year agency contract now that the internal team out-produces it. Stephen has personally set up four other companies on Helena — including a $40-million-a-year insurance agency he co-runs in Texas — describing her as “a full marketing team for pennies on the cost.”

Want to see how Helena can run your marketing? Reach out at support@enrichlabs.ai to see how we can help!