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Benchmark guide

Telehealth growth metrics reference.

Public-company marketing benchmarks plus plain-English definitions for CAC, ROAS, LTV, payback, conversion, and retention before you hire an agency or scale spend.

1 Metric definitions founders can actually use in agency conversations.
2 Public filing snapshots from Hims, Teladoc/BetterHelp, and LifeMD.
3 A practical read on what to ask before you spend more.
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Metric glossary

The numbers to know before buying growth.

These metrics are not universal targets. They are reference points for asking better questions about whether acquisition, conversion, retention, and payback can survive scale.

CAC / PAC

Acquisition cost

What it costs to acquire one new customer or patient. In telehealth, this is only useful when paired with margin, retention, and payback.

ROAS

Ad return

Revenue attributed to ads divided by ad spend. Useful, but often too narrow if patients convert later, churn quickly, or return for repeat care.

LTV:CAC

Value ratio

Lifetime value divided by acquisition cost. A high CAC can work when repeat visits, subscriptions, gross margin, and retention support it.

Payback

Runway test

How long it takes gross profit to recover acquisition cost. This is often more useful than CAC alone for cash-sensitive teams.

Conversion

Funnel trust

The share of visitors or leads who book, buy, or complete intake. Weak conversion can make even reasonable media costs look broken.

Retention

Repeat value

Whether patients come back after the first visit or purchase. A low first-order CAC can still be expensive if retention is weak.

Working ranges

Numbers to pressure-test before the agency call.

These are not universal targets. They are planning ranges that help founders ask better questions about margin, creative, funnel quality, retention, and whether spend should scale yet.

MER / nMER

Blended efficiency

~2x-5x

Public DTC telehealth examples in this guide cluster closer to 1.8x-2.6x revenue per marketing dollar. Ecommerce operators often use 3x-5x as a stronger all-up benchmark, but break-even depends on contribution margin.

ROAS

Campaign return

2x-3x+

Below 1.5x usually needs a strong retention or margin story. A 2x-3x range can be workable, while 3x+ is healthier if the revenue is real, incremental, and not just platform-attributed. A 2026 study of 500 DTC ad accounts found Google Shopping/PMax leading at 3.4x ROAS, Meta at 2.8x, and TikTok trailing at 2.1x, useful context for platform mix even though telehealth was not broken out separately.

CAC / nCAC / CPA

Acquisition cost

Back-solve

There is no clean, audited telehealth CAC benchmark. Split cost per lead, intake, approved patient, and activated patient, then ask whether gross profit can recover CAC inside your payback window. One paid-social agency's July 2026 blended numbers, self-reported and single-source, put ED around $70-$140, GLP-1 around $180-$320, and mental health at $200-$400+, with ADHD running 30%-50% higher because of platform ad restrictions. For a filing-level look at what one public company actually spent, see the Hims CAC breakdown.

LTV:CAC

Value ratio

3:1+

On a gross-margin basis, 3:1 is a healthy operating target, 2:1 is strained, and 4:1-5:1 can signal room to invest if capacity, compliance, and service quality can hold.

Payback period

Runway pressure

6-12 mo

For smaller motions, 6-12 months is often considered strong. DTC or cash-sensitive telehealth teams may need faster payback; longer payback only works when retention and financing support it.

Conversion rate

Funnel trust

5%-12%

Healthcare search benchmarks show high single-digit to low double-digit lead conversion rates in related categories. Promodo's 2026 healthcare benchmark report puts paid search at 2.6% click-to-lead, the best-converting paid channel in the category, with average cost per lead at $53.53 versus $30 for top performers. Track each step separately: visit, quiz start, intake, approval, and paid start.

CPC / eCPNV

Traffic cost

$5-$15+

Healthcare clicks can move from single digits into low double digits fast, especially for high-intent conditions. eCPNV is the cleaner check: CPC divided by the percent of visitors who are actually new.

AOV / nAOV / margin

First-order economics

50%-85%+

Gross margin determines what CAC is survivable. Subscription telehealth can have high reported gross margins, but medications, labs, provider time, refunds, and support can change the real room for acquisition.

Retention

Repeat value

40%-60%+

For recurring care, month-two or first-refill retention is often the first number to watch. Under 40% can make CAC fragile; 60%+ usually gives the business more room to scale. A 2026 DTC subscription churn index found replenishment models, telehealth included, running 5%-8% monthly churn versus 8%-12% for curated-box models, meaning telehealth subscriptions should be benchmarked against razors and coffee, not against subscription apps broadly. More on what actually breaks after the first visit in why retention drops off after month 2.

nWV / rWV

Visitor mix

No fixed target

Prospecting should raise new website visits. Retargeting, email, branded search, and content should lift returning visits. If spend rises but new qualified visitors do not, the media mix may be hiding the problem.

Public-company snapshots

What public telehealth filings suggest.

Public filings usually do not disclose true CAC by channel. These are marketing-efficiency proxies: marketing spend as a share of revenue, segment ad intensity, and acquisition-spend language.

Hims & Hers, 2025

DTC telehealth

~39%

Marketing expense was about $919.3M against about $2.35B of revenue. Hims also disclosed $798.5M of customer acquisition costs, or about 34% of revenue.

BetterHelp, 2025

Consumer mental health

~55%

BetterHelp advertising and marketing was about $518.5M against about $950.4M of segment revenue, showing how marketing-heavy consumer behavioral health can be.

Teladoc Integrated Care, 2025

Enterprise virtual care

~8%

Integrated Care advertising and marketing was about $130.0M against about $1.58B of segment revenue, a very different model from DTC acquisition.

LifeMD, 2025

Subscription telehealth

~44%

LifeMD reported about $86.1M in selling and marketing expenses against about $194.1M of telehealth revenue, with telehealth gross margin around 86%.

The point is not to copy a public company. The point is to know which model you are building. DTC telehealth, consumer mental health, and enterprise virtual care can have radically different marketing intensity, payback expectations, and agency needs.
Agency questions

Ask this before you scale spend.

What CAC can the business afford after gross margin? What conversion point is the bottleneck? How quickly does CAC pay back? What happens after the first visit? Which claims or promises create review, trust, or compliance risk?

Sources and notes Hims & Hers 2025 Form 10-K: SEC filing Teladoc Health 2025 Form 10-K: SEC filing LifeMD 2025 Form 10-K: SEC filing LocaliQ 2025 Search Advertising Benchmarks: healthcare CPC and conversion benchmarks Umbrex CAC analysis guide: directional payback and LTV:CAC guardrails MetricKit MER guide: break-even MER and contribution-margin framing Human ecommerce MER guide: general ecommerce MER benchmark discussion Telehealth Media 2026 vertical CAC benchmarks: self-reported agency paid-social spend data Promodo 2026 Healthcare Digital Marketing Benchmarks: CPL, conversion, and marketing-spend benchmarks MHI Growth Engine, "We Analyzed 500 DTC Ad Accounts" (2026): platform-level ROAS and CPA benchmarks Eightx 2026 DTC Subscription Churn Index: replenishment vs. curated-box churn comparison All percentages are approximate. Public-company figures are calculated from cited annual filings; agency and vendor benchmarks are self-reported and directional, not audited. These are benchmarks for discussion, not investment advice or performance targets.
Keep reading

The thinking behind this tool

Why is my CAC going up every month even though nothing else changed?

A higher CAC is a finding, not a cause. Four different problems end at the same number, and they belong to four different owners.

How much should a telehealth practice budget for marketing?

Build the budget from patient capacity and the acquisition cost your margin can carry, then cap it by cash.