Healthcare Isn’t the Only System Bleeding Money
Healthcare leaders talk about value-based care every day. Doctors and health systems are moving away from fee-for-service (FFS) models — paying for volume — and toward value-based care (VBC) — paying for outcomes.
But here’s the blind spot: most healthcare companies still run their marketing like it’s stuck in fee-for-service.
- Agencies are paid by the hour or project, regardless of results.
- Internal teams get budget increases because they’re “busy,” not because they’re efficient.
- Growth spend is justified by impressions and clicks — the marketing equivalent of “tests ordered” in medicine.
If value-based care is the future of medicine, then value-based marketing leadership is the future of growth. And the model that delivers it? The Fractional CMO.
If you want a full breakdown of what a fractional CMO does in healthcare, see our Complete Guide to Fractional CMOs for Healthcare & MedTech
Fee-for-Service Marketing vs Value-Based Marketing
Let’s make the analogy explicit:
Healthcare ModelMarketing EquivalentThe ProblemFee-for-Service (FFS)Pay agencies/teams for volume (hours, projects, impressions)Misaligned incentives → high cost, low efficiencyValue-Based Care (VBC)Pay for outcomes (improved CAC, better LTV/CAC ratio, compliant funnels)Aligned incentives → lower cost, better ROI
In FFS medicine, volume drives revenue whether outcomes improve or not.
In FFS marketing, activity drives budget whether revenue improves or not.
Both models are broken.
Fractional CMOs as the Value-Based Alternative
A fractional CMO doesn’t sell hours, vanity metrics, or busywork. They install systems that tie directly to outcomes that boards and investors care about:
- Lowering CAC while maintaining compliance.
- Improving LTV/CAC ratios to unlock funding rounds.
- Building board-ready dashboards that prove marketing ROI.
- Preventing compliance disasters that can shut off millions in revenue overnight.
Just as value-based care rewards physicians for healthier patients, fractional CMOs are judged on healthier marketing economics.
Why Full-Time CMOs and Agencies Stay Stuck in FFS
- Agencies: Paid for output, not outcomes. They don’t care if your CAC is $800 or $400 — they care if you approve the next campaign.
- Full-Time CMOs: Locked into $500K+ salaries whether or not the systems they install work. You’re paying for presence, not performance.
- Fractional CMO: Tied to strategic clarity, faster ROI, and proving capital efficiency. No bloated overhead, no misaligned incentives.
Case in Point
A telehealth startup burning $200K/month on ads was treating its agency like a fee-for-service vendor. Busy campaigns, zero ROI clarity.
When a fractional CMO stepped in, three things changed:
- CAC dropped from $800 → $470 through compliant funnels.
- Investor dashboards were built in 30 days.
- Spend was tied directly to board-level outcomes.
The difference wasn’t more activity. It was shifting from FFS marketing to value-based growth.
The Future: Value-Based Growth Leadership
Healthcare will continue its shift to VBC. Marketing needs to follow.
- Boards demand capital efficiency.
- Investors demand proof of ROI.
- Regulators demand compliance-first systems.
Fractional CMOs are built for this world. They de-risk growth, cut CAC, and install outcomes-based systems that prove marketing is worth the spend.
If healthcare can’t afford FFS in medicine, you definitely can’t afford it in marketing.
Call to Action
👉 Ready to see if your marketing is still running like fee-for-service medicine?
Book a Growth Clarity Diagnostic™ and uncover:
- Where CAC is bleeding margin.
- Which funnels are compliance risks.
- How to build a 90-day roadmap for value-based growth.
Frequently Asked Questions: Value-Based Marketing & Fractional CMOs
1. What is fee-for-service marketing?
Fee-for-service (FFS) marketing is when agencies or teams are paid based on activity — hours worked, campaigns launched, or impressions delivered — rather than actual business outcomes.
2. How does value-based care apply to marketing?
Just as value-based care rewards physicians for outcomes, value-based marketing rewards leadership for results like reduced CAC, higher LTV/CAC ratios, and compliant growth systems.
3. What is a Fractional CMO’s role in value-based marketing?
A fractional CMO installs frameworks, dashboards, and compliance-first funnels that tie marketing spend directly to board-level outcomes instead of vanity metrics.
4. How does value-based marketing reduce CAC?
By aligning spend with outcomes, value-based marketing eliminates wasted campaigns, focuses on qualified patient acquisition, and creates systems that consistently lower CAC by 20–50%.
5. When should a company move from FFS marketing to value-based marketing?
Growth-stage healthcare companies (typically $5M–$50M ARR) should adopt value-based marketing early, before high CAC and compliance risks erode margins or block future funding.
