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.
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These metrics are not universal targets. They are reference points for asking better questions about whether acquisition, conversion, retention, and payback can survive scale.
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.
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.
Value ratio
Lifetime value divided by acquisition cost. A high CAC can work when repeat visits, subscriptions, gross margin, and retention support it.
Runway test
How long it takes gross profit to recover acquisition cost. This is often more useful than CAC alone for cash-sensitive teams.
Funnel trust
The share of visitors or leads who book, buy, or complete intake. Weak conversion can make even reasonable media costs look broken.
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.
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.
Blended efficiency
~2x-5xPublic 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.
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.
Acquisition cost
Back-solveThere 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.
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.
Runway pressure
6-12 moFor 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.
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.
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.
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.
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.
Visitor mix
No fixed targetProspecting 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.
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.
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.
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.
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.
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%.
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?