Eight things to check, the questions that expose a generalist inside ten minutes, and the cases where you shouldn’t hire an agency at all.
Anatolie Clevan · Founder, LeadsACE · Updated 2026-08-25Strip the category page and the work is fairly ordinary. Positioning and messaging. A site that explains the product to a clinician and to a CFO at the same time. Content, paid acquisition, some outbound, a CRM that doesn’t lose people. Reporting on all of it.
What makes an agency a healthtech agency is not the deliverable list. It is knowing who signs. A clinic administrator, a medical director, an IT lead, a compliance officer and whoever controls the budget all have to end up in the same room, and each of them can stop the deal quietly without ever telling you. An agency that has never met that room will still produce good-looking campaigns. They just won’t convert.
There is also a scope line worth naming early, because it is where most engagements go wrong. Marketing agencies generate interest. They almost never work the pipeline. If nobody on your side is going to run discovery calls, chase the security questionnaire and push a pilot toward a signature, an agency will hand you a list of curious people and the quarter will end where it started.
The mechanics transfer fine. Ads are ads, sequences are sequences. The buyer is what breaks.
Gartner’s May 2025 sales survey, run across 632 B2B buyers in late 2024, found buying groups now range from five to 16 people across as many as four functions, and reported that 74% of buyer teams hit unhealthy conflict during the decision. In healthcare, several of those functions are people marketing never speaks to: privacy, IT security, the EMR vendor’s integration queue. One enthusiastic clinician is the start of a long internal argument you are not present for. The full map is in our guide to selling to the healthcare buying committee.
Compliance is the second wall, and it moves. The 2022 OCR bulletin on online tracking technologies pushed a lot of health organizations off standard analytics. Then on 20 June 2024 a federal judge in the Northern District of Texas, ruling in the case brought by the American Hospital Association, vacated the part of the March 2024 revised bulletin that treated an IP address plus a visit to a public health page as protected information, holding it exceeded HHS authority under HIPAA. OCR withdrew its appeal that August. Plenty of agencies are still quoting the vacated rule as gospel, and plenty of others act as though nothing applies. Both are wrong. We wrote the current picture up in HIPAA-compliant marketing.
Third wall: the EMR. If your product needs to sit next to Epic, athenahealth or ModMed, the integration story is part of the marketing whether you like it or not. We run live listings on ModMed and athenahealth and wrote down what they actually buy you in EMR marketplace listings. An agency that has never touched one will not know why your demo requests stall at the IT review.
Eight checks. The third column is what to actually say on the first call, because every agency will claim the middle column.
| What to check | What good looks like | How to test it |
|---|---|---|
| Buyer knowledge | Names the roles in your specific committee unprompted | “Walk me through who has to say yes at a 12-provider dermatology group.” |
| EMR literacy | Knows which EMRs your buyers run and what integration costs you in sales cycle | “Which EMRs do our buyers use, and how does that change the pitch?” |
| Compliance handling | Can state where PHI enters the funnel, and where it doesn’t | “Do you need a BAA from us? Why or why not?” |
| Who does the work | The person on the call is the person in your account | “Who runs this day to day, and can I meet them now?” |
| Definition of a lead | Written, and tied to a real buying signal | “Write down what counts as a lead. We’ll put it in the contract.” |
| Handoff to sales | Clear on who works the pipeline after the lead lands | “What happens between the form fill and the signed pilot?” |
| Proof shape | Named accounts with revenue outcomes, not impression counts | “Show me one where you can name the client and the revenue.” |
| Exit terms | You keep the CRM, sequences, data and creative | “If we stop in month four, what do we own?” |
Nothing here is exotic. It is just uncomfortable to ask, which is why most founders don’t and find out in month five.
Most quotes arrive in one of a few shapes. A monthly retainer for ongoing execution. Project pricing for a defined build such as a site or a launch. A fractional leadership arrangement where you buy senior judgement by the day, sometimes bolted onto a junior delivery team. Media spend sits on top of all of it and is usually not included, which surprises founders more often than it should. Sourced ranges for the fractional model are in how much a fractional CMO costs.
Price is the wrong first question anyway. A cheap retainer that produces MQLs nobody can close is more expensive than a large one that produces four signed clinics, and you find out which you bought about five months in.
Ask instead what share of the fee is tied to something a CFO would recognise. If the answer is none of it, you are buying activity, and you should at least buy it knowingly. Founders start with us on a scoped 30-day pilot: if pipeline isn’t taking shape, you walk, with no commitment past the pilot.
That last set is not modesty. We tell people this on audit calls and lose the deal sometimes. It is a cheaper outcome for everyone than a retainer aimed at the wrong bottleneck.
What we do differently is the part most agencies leave out. We build the engine and then we sell with it: the operator on your account runs the outreach, takes the calls and works the deals, across the twelve mechanisms, assembled in the order your stage needs. That is how a cold-start clinical AI product reached 12 signed clinics and a $6.2M Series A at Voxira, and how Caesar Health got to a roughly $640K clinic pipeline on a $0 ad budget.
A healthtech marketing agency builds demand for health software and clinical products. The work usually covers positioning, website and content, paid acquisition, and some form of outbound. What separates a healthtech agency from a generalist one is buyer knowledge: who signs in a clinic or a health system, what procurement will ask for, and how the EMR shapes whether a product can even be used.
The demand-generation mechanics are the same. The buyer is not. A clinician can love your product and still have no budget, no authority and no path through IT or compliance. Gartner's May 2025 sales survey, based on 632 B2B buyers, found buying groups now range from five to 16 people across as many as four functions, and in healthcare those functions include people marketing never speaks to. A campaign that produces cheap leads in SaaS produces unclosable interest here.
Only if it creates, receives, maintains or transmits protected health information on behalf of a covered entity or business associate. An agency running top-of-funnel campaigns for a software vendor usually touches no PHI and needs no BAA. An agency touching patient lists, intake forms, a CRM holding patient records, or a clinic's own site analytics is a different case. Ask the question before the contract, not after, and get the answer in writing.
Agency retainers vary too widely to quote one honest band, and media spend normally sits on top of whatever the fee is. Sourced 2026 ranges do exist for the fractional-leadership model, which we collected on our fractional CMO cost page. What matters more than the number is what it buys: a retainer that buys activity is expensive at any price if nothing reaches a signature, so tie at least part of the scope to qualified conversations rather than deliverables shipped.
The five archetypes, and which one fits your stage.
What a lead actually means in each vendor category, and the red flags.
The 7-step motion, from committee mapping to procurement.