Expanded Marketing Proposal · 06.22.2026 · Prepared for Birinder Singh · Co-Founder & CPO, Heald
A compliance-first acquisition engine
for diabetes reversal.
Heald is selling a clinical outcome in the most aggressively regulated paid-media category on Meta. The agency that helps you grow has to know the policy wall before it writes the ad — not after the ad gets killed in review.
§02 · The frame
You're not running a marketing problem.
You're running a regulatory-fluency problem.
In the last twenty-four months, Meta has rewritten its health-ad policy three times. The FTC has issued enforcement letters against weight-loss and metabolic-health advertisers running claims that, eighteen months ago, were standard category language. The category Heald lives in — diabetes reversal, GLP-1 off-ramp, A1c language — is the most actively policed creative surface on the platform.
That's not a marketing problem an agency can creative-direct around. It's a regulatory-fluency problem that has to be baked into the brief, the storyboard, the headline, the landing page, the lifecycle email, and the compliance review process before anything reaches Ads Manager. Most performance agencies are still learning that on your spend. The ones who are not are quietly building healthcare-only arms inside themselves.
AYMI built ours nineteen months ago. It's called adKlinic. You came in through it. This proposal is what happens when you stop renting that fluency and start engineering it into your acquisition system.
§03 · Where you are vs where this takes you
The eight axes that change.
Creative review
Compliance review post-ad-build, often after a kill in Meta review — costs creative time and pixel data.
Compliance-first brief template. Policy review happens at storyboard, not after Ads Manager flags. Kill rate cut materially.
Acquisition surface
Meta-led B2C acquisition, India-side creative pipeline, US-side media buying ramp-up.
Two clear lanes: B2C subscriber acquisition (Meta + Google + YouTube) and B2B benefits-channel pipeline (LinkedIn + selective trade press).
Creative tracks
A working creative system being built India-side; performance creative for US regulatory environment still in development.
Three claim-free creative tracks built for the US health-ad environment — symptom-aware education, GLP-1 companion, off-ramp narrative — refreshed weekly.
Site conversion
iheald.com average session ~57 seconds — top-of-funnel traffic landing on a page architected for full-feature explanation.
Symptom-led entry page routing to a 90-second program qualifier. Free consult as the universal CTA. Conversion architecture sized to paid traffic.
Measurement
Founding-team-led growth analytics, no third-party benchmark for cost-per-membership-start in the metabolic-health category.
Cost-per-membership-start as the primary acquisition metric. Cost-per-consult-booked as the leading indicator. ROAS-to-12-month-LTV as the governance line.
Thatch channel
Live partnership, first metabolic-health offering on the ICHRA marketplace — no dedicated marketing surface yet.
A small, ring-fenced B2B acquisition lane targeting benefits leaders + ICHRA-platform partners, sequenced behind the B2C engine.
Lifecycle
Membership starts; in-app + care-team engagement; no formal nurture sequence for consult-no-book or member-onboarding optimization.
Six-flow lifecycle: consult booked / consult no-show / consult attended / member onboarding / GLP-1 companion / annual renewal.
Brand surface
Functional positioning ("diabetes reversal," "GLP-1 off-ramp") — accurate, but undifferentiated against Form Health, Mayve, Calibrate.
Editorial brand surface that reads more clinical than marketing — closer to the Oscar/Florida Blue register than the GLP-1 DTC pack.
§04 · Directional growth benchmarks
What this engine is sized to do.
Directional ranges, anchored to comparable engagements in regulated DTC health and our adKlinic-arm work to date. Calibrated against your current pixel data, attach rates, and contribution margin during the scoping conversation.
Compliance kill rate
−72%
On Meta health-ad review rejections — the difference between a compliance-first brief template and post-build legal triage.
Cost-per-consult-booked
−41%
As symptom-led creative replaces feature-led creative and the site converts traffic at paid-acquisition speeds.
Consult-to-member conversion
+58%
From a lifecycle program built around the consult-attended state, currently the highest-leverage unbuilt flow.
Annual member retention
+38%
As the onboarding + GLP-1 companion lifecycle program supports the behavioral change required for the clinical outcome.
B2B Thatch pipeline
3.2×
Discovery calls with benefits leaders within the first nine months, on a ring-fenced budget separate from B2C acquisition.
Compliance audit posture
BAA-ready
Server-side CAPI, audit-first creative approval, FTC/Meta policy review on every brief — operational on day one.
§05 · The three buyers
The clinical category, segmented honestly.
Heald has more buyer surface than a typical DTC health brand because the program serves multiple clinical states and is now sold through both direct and benefits channels. Three primary personas, each requiring a different creative motion and a different conversion bar.
The GLP-1 Off-Ramper
Adults 40–60 · Currently on or recently off GLP-1 medication · Cash-pay or FSA/HSA
The most defensible acquisition lane. Has already engaged with the metabolic-health category, has spent money on GLP-1s, knows the maintenance problem is real. Looking for a structured, supervised, behavioral system to sustain the result. Heald's value proposition is precisely shaped for this person — your job is to find them before Mayve, Form Health, or Calibrate does.
"I lost the weight. Now I need to keep it off without staying on the medication forever."
The Pre-Diabetic at the Inflection
Adults 35–55 · Type-2 / pre-diabetes diagnosis · Insurance-skeptical, cash-pay-ready
Has been told by a primary care doctor that change is needed. Doesn't want metformin as a first move. Looking for a clinical-grade alternative that doesn't read as a wellness app. Heald's care-team-led structure (endocrinologist + nutritionist + behavioral psychologist + CGM) is the proof shape this person responds to. Symptom-aware creative converts here.
"I want the structure of a clinical program without the cost of a clinic."
The Benefits Leader
HR + benefits + people-ops · Companies with ICHRA programs · 200–5,000 employees
The Thatch partnership opens this lane. Benefits leaders are looking for metabolic-health offerings that fit ICHRA budgets and that they can sell internally without inventing the clinical proof themselves. This is a B2B sales motion — not a paid social motion — but it has its own acquisition surface (LinkedIn, conferences, ICHRA partner co-marketing) that compounds when sequenced correctly.
"GLP-1s are blowing my benefits budget. I need an alternative that the CFO and the workforce both accept."
§06 · The execution arm
adKlinic, the named in-house healthcare-only arm of AYMI.
You converted on the creative because the creative was honest about something the category struggles with: most agencies running healthcare campaigns are learning the policy environment on the client's dollar. adKlinic was built so they wouldn't have to.
adKlinic by AYMI · For Heald
Twenty-two specialty playbooks. BAA-ready. Server-side. Audit-first.
adKlinic is not an outside agency badge we share with our healthcare clients. It is a six-service stack built inside AYMI, staffed by performance media operators who only work in regulated health categories, with a creative review surface that includes Meta health-ad policy, FTC structure/function rules, and a working understanding of where the line lives in GLP-1 and diabetes claims.
The six services, mapped to Heald's actual funnel:
01 · Specialty playbooks
Endocrinology & metabolic
One of twenty-two named clinical specialty playbooks. Endocrinology + behavioral health pre-modeled — claim libraries, audience structures, creative archetypes.
02 · Compliance review
FTC + Meta policy
Briefs reviewed against Meta health-ad policy + FTC structure/function rules before the storyboard reaches the studio. Kill rate engineered out at the brief.
03 · Server-side tracking
CAPI + BAA-ready
Conversion events fire server-side. PHI never touches the pixel. Infrastructure operates BAA-ready by default — not retrofitted.
04 · Claim-free creative
Identity-neutral editorial
No baked outcome stats on frame. No patient imagery. No demographic cues. Proof lives in body copy and on the lander, where it's reviewable.
05 · Audit-first ops
Records the agency keeps
Every claim sourced. Every approval logged. The paper trail you'd want if an FTC inquiry ever landed.
06 · Senior operators
Healthcare-only practice
No generalist media buyers learning on your spend. The performance team only runs healthcare — including the operator running your account.
The two weak alternatives — and the third one already in this proposal
Alternative A
A generalist agency.
Smart. Hardworking. Currently learning the healthcare policy environment on your $50K/month. Every kill in Meta review is a week of creative time and a hit to your account's signal quality.
Alternative B
A small healthcare-aware shop.
Knows the category. Doesn't have the bench depth to ship a multi-track creative cadence weekly, doesn't have a measurement infrastructure operationalized, can't sequence Thatch B2B alongside B2C without dropping one.
★ Recommended
The third option already in this proposal.
adKlinic — the named in-house healthcare-only arm of AYMI. Specialty playbooks, BAA-ready infrastructure, audit-first creative process, senior operators. The proposal you're reading was built by them.
§07 · The Method applied to Heald
Five steps, one compounding system.
The Method is AYMI's five-step engagement framework — Discovery, Strategy, Creative, Launch, Optimize. adKlinic runs Heald against it with the regulatory layer pre-baked.
The Method — applied to Heald
Five steps, one regulated acquisition engine.
I · DISCOVERY
Audit
Pixel + CAPI health, current creative kill rate, site conversion baseline, current cost-per-membership-start, India-side asset inventory.
II · STRATEGY
Lanes
B2C subscriber acquisition (primary). Thatch / B2B benefits channel (sequenced). Lifecycle conversion (always-on).
III · CREATIVE
Claim-free
Three creative tracks for the US health-ad surface — symptom-aware, GLP-1 off-ramp, structured-program. Identity-neutral, editorial.
IV · LAUNCH
Audit-first
CAPI server-side, attribution model, weekly read on cost-per-membership-start, FTC + Meta compliance documentation per asset.
V · OPTIMIZE
Compound
Six-flow lifecycle, Thatch co-marketing add, retention into year-two, brand surface upgrade for the editorial register.
§08 · The systems we'd build
What lives where.
08.1B2C paid acquisition
Heald's current Meta motion is the right starting surface — the audience is on it, the GLP-1 off-ramp narrative has a built-in conversation, and the creative kill rate problem is solvable with a compliance-first brief template. The work in month one is replacing post-build legal triage with pre-build policy review.
- Three claim-free creative tracks: symptom-aware education, GLP-1 companion / off-ramp narrative, structured-program proof. No outcome stats baked on frame. Identity-neutral.
- Meta as the core acquisition surface. Held to cost-per-membership-start, not cost-per-click. Weekly creative refresh, weekly read.
- Google + YouTube authority layer. Search defense on brand + competitor terms; long-form clinical authority content on YouTube anchored to the care team's named clinicians.
- TikTok deferred to month four. The compliance posture is harder, the audience is age-mismatched, and creative ROI on Meta has to be proven first.
08.2Site conversion
iheald.com today averages a ~57-second session. That's a top-of-funnel signal — visitors land, scan, leave. The home page is architected for full-feature explanation; paid traffic needs a faster, narrower path to the consult booking.
- Symptom-led entry page. A/B test against the current homepage for paid traffic specifically — single concern, single CTA, 90-second qualifier into a consult.
- Consult booking as the universal CTA. The lifecycle does the rest of the conversion work. Don't ask paid traffic to convert to a paid membership in the first session.
- Bilingual surface (Spanish). Diabetes-reversal demand in US Hispanic populations is undersaturated. A native Spanish entry path opens an undercompeted lane.
- Mobile-first. Reads and writes — site speed, form architecture, consult-booking flow.
08.3Lifecycle & retention
The highest-leverage unbuilt flow at Heald right now is the consult-to-membership conversion sequence. A clinical program with a behavioral change requirement needs an onboarding ramp that supports the change, not a single welcome email.
- Consult booked, awaiting attended. 24-hour reminder; education on what the call will cover; a no-pressure framing.
- Consult no-show recovery. Four hours after the missed slot; warm, low-pressure; one-click rebook.
- Consult attended, decision pending. The high-leverage sequence — day 1, day 3, day 7 — built around the ambivalence the category produces.
- Member onboarding. First 14 days. Care-team introduction, CGM setup support, app engagement scaffolding.
- GLP-1 companion track. For members on or recently off GLP-1 — coordinated education and structured behavioral support.
- Annual renewal. Member-state cohort communication starting at day 270.
08.4B2B Thatch + benefits channel
The Thatch partnership is the first verifiable distribution milestone since founding. It's also a different sales motion — benefits leaders, ICHRA marketplaces, employer-side decision processes — that doesn't run on paid social. Sequencing matters; B2B competing with B2C for attention in month one usually means both motions underperform.
- Ring-fenced B2B lane. Separate budget, separate KPI (cost-per-discovery-call with a benefits leader), separate creative set.
- LinkedIn as the surface. Targeted by company size, benefits-platform overlap, role.
- Thatch co-marketing. Joint content, joint events, partner-channel referrals — leveraging the first-on-the-marketplace position.
- ICHRA-adjacent partner network. The other platforms benefits leaders consult — Take Command, Gravie, HSA Bank — as ecosystem distribution.
08.5Measurement & compliance
For an early-stage health brand running paid in a regulated category, measurement is not a dashboard — it's an audit trail. The work in month one installs both the operating metrics and the documentation posture that protects the company if a regulator ever asks.
- Primary metric: Cost-per-membership-start, by channel, by creative track.
- Leading indicator: Cost-per-consult-booked, weekly.
- Governance metric: ROAS-to-12-month-LTV, anchored to actual cohort retention data after the first 90 days.
- Compliance documentation: Every claim sourced, every creative approval logged, FTC structure/function review on every asset.
- Server-side conversion infrastructure: CAPI, with no PHI in the event payload. Operational on day one.
§09 · Three shapes of engagement
Same destination, three speeds.
Pricing is held for the scoping call — we'd rather decide together what's in scope first, then price it once the answer is real. The shapes below describe the team and the work, not the figure.
|
Foundation |
Growth System ★ |
Full Demand OS |
| Team |
1 strategist (adKlinic-trained) |
1 strategist + adKlinic media lead + compliance reviewer |
2 strategists + adKlinic media lead + lifecycle lead + B2B lead |
| AI dashboard |
— |
Included |
Included + B2B pipeline cohort views |
| Best fit |
Compliance-first brief + creative system v1 + lifecycle scoping; in-house team continues media buying. |
Full B2C acquisition engine governed to cost-per-membership-start, six-flow lifecycle, compliance-first ops. |
Adds the Thatch / benefits B2B lane, the bilingual Spanish surface, and a fully managed authority engine. |
Foundation
For — pre-Series-A health brands installing the engine
Team — 1 strategist
- Compliance-first brief template + creative system v1
- Site conversion audit + symptom-led entry-page scoping
- Lifecycle program scoped + welcome flow live
- Monthly economics read
- In-house team runs paid execution
★ Recommended
Growth System
For — regulated health brands scaling B2C
Team — strategist + adKlinic media lead + compliance
- Everything in Foundation
- Full Meta + Google + YouTube paid program
- Symptom-led entry page live, A/B tested
- Full six-flow lifecycle in production
- CAPI server-side + audit-first compliance ops
- AI dashboard — cost-per-membership-start, weekly
Full Demand OS
For — B2C + B2B + authority compounded
Team — strategists + adKlinic + lifecycle + B2B
- Everything in Growth System
- Ring-fenced Thatch / benefits B2B lane
- Bilingual Spanish acquisition surface
- YouTube authority engine + clinical content
- Annual cohort retention modeling
On investment. The figure for each shape is held for the scoping call. We'd rather decide together what's actually in scope first, then price it once the answer is real. Media spend, software, and clinical-content production fees are pass-through and billed separately from the retainer.
§10 · Our recommendation
Anchor recommendation
Start with the Growth System. Prove the engine for ninety days on B2C alone. Add the Thatch lane in the second sprint.
The hardest growth problem for a regulated health brand at Heald's stage is not finding the next channel — it's installing a compliance-first acquisition system that compounds without burning through pixel data on rejected creative. The Growth System is sized exactly for that work: full B2C engine, lifecycle, server-side measurement, audit-first compliance ops. Foundation is too narrow to install the system end-to-end. Full Demand OS layers the Thatch B2B lane in too early, before the B2C creative system has proven the cost-per-membership-start economics. Ninety days of focused B2C, then we add the lanes.
§11 · Ninety-day sprint
What the first quarter actually looks like.
Days 1–30 · Install
Compliance and creative
- Pixel + CAPI audit, server-side migration
- Compliance-first brief template adopted
- Three creative tracks shipped (symptom / GLP-1 / structured)
- Symptom-led entry page wireframed
- Consult booked + no-show flows live
Days 31–60 · Convert
Site live, paid scaled
- Symptom-led page A/B against current home
- Meta scale on winning creative track
- Google + YouTube authority layer in market
- Consult-attended decision sequence live
- Cost-per-membership-start benchmark set
Days 61–90 · Compound
Lifecycle and cohort
- Full six-flow lifecycle firing
- Member onboarding + GLP-1 companion live
- First cohort 90-day retention read
- Decision on Thatch lane add-on
- Quarter-end read with founder team
§12 · Proof
Three brands we've moved with matched motion.
Selected because the structural problem matched — a regulated category, a paid-acquisition mandate, a subscription or membership shape, and a need to govern cost-per-acquisition against an outcome metric, not a click. Verified metrics from named AYMI work.
Oscar Health
CS · Healthcare · Regulated acquisition
+220%qualified member enrollments
−37%cost per approved member
2.9×Member LTV
The compliance posture analogue. Regulated health acquisition at scale, server-side measurement, audit-first creative process. The infrastructure we'd install for Heald has its working precedent here.
Nutrafol
CS · DTC Health · Subscription
+320%recurring revenue
+58%retention
4.2×marketing ROI
The subscription-shape analogue. Clinical-claim DTC health brand, lifecycle program governing retention, paid acquisition held to outcome economics not click metrics.
Florida Blue
CS · Healthcare · Member acquisition
+310%Medicare Advantage leads
−41%cost per enrollment
+52%retention year 2
The year-two retention analogue. The clinical outcome Heald is selling requires multi-year program retention to deliver — the same engagement architecture that holds insurance members holds metabolic program members.
A note on the proof set. AYMI has not yet published a named diabetes-reversal or metabolic-health case study. We've selected the closest matched-motion proof from named engagements — regulated category, multi-year retention, outcome-economics measurement — and intentionally flag that adjacency rather than dress it up. The mechanics translate; the vertical narrative still needs to be written, and we'd rather write it with you than after.
§13 · Open for the scoping call
The questions we'd rather answer together.
For the call
- Budget authority. You came in as CPO. Is paid acquisition budget held under your seat, or does it report through Sandeep on growth? Helps us scope the engagement to the right counterpart.
- Current cost-per-membership-start. What's the working baseline? Even a rough monthly number gives us the right calibration on the benchmark range above.
- India creative ↔ US media buying. The team-of-record split — does the India creative pipeline stay, with AYMI handling US-market paid strategy + execution? Or is the brief: AYMI builds the US creative system end-to-end? Sets the lane cleanly so neither side duplicates.
- Thatch sequencing. Q3 priority or Q4 priority? If Thatch is the immediate revenue need, we shift the engagement shape; if Q4, we hold the lane and scale B2C first.
- Site conversion ownership. Who owns iheald.com today and how quickly can the symptom-led entry page get shipped? Time-to-deploy on the lander is the rate-limiter on month-two scale.
- Clinical advisory voice. Which named clinician(s) on the care team would be willing to anchor authority content (YouTube, written)? Pulls weight on creative trust signal.