Each case study below describes a real engagement. Client names are withheld out of business courtesy. Numbers are real.
Home Care
A multi-location home care agency in the Southwest
393 leads per week at $15.49 CPL
The challenge. A growing home care agency operating across multiple Southwest states needed to fill caregiver hours and add new clients in 7 distinct metro markets at once. The existing setup was a single Google Ads campaign pointed at a generic landing page. Cost per lead was inconsistent across markets, and the team had no clear read on which states were producing serviceable inquiries versus tire-kickers. Conversion tracking was partially broken and the in-house intake team was burning hours on unqualified calls.
What we did. The first move was rebuilding the conversion tracking stack so every form fill and phone call routed to the right campaign with full source attribution. Then we restructured paid media into one campaign per state, each pointed at a dedicated state-specific landing page that named the city served, the licensure under which the agency operated locally, and the specific services available in that market. Meta was layered on for in-feed lead generation with audience segmentation by caregiver demographics and family-decision-maker demographics. A GoHighLevel intake workflow handled SMS and email nurture inside the first 5 minutes of any new lead so the family was contacted while the inquiry was still warm.
The result. Within 60 to 90 days the program stabilized at roughly 393 qualified leads per week at a blended cost per lead of $15.49 across all 7 states. Two months after launch the intake team reported the leads were materially better qualified than the prior campaign, with a higher rate of leads converting into paid hours of care. Daily monitoring caught two creative fatigue events and one ad set zero-spend bug before the client noticed any drop in volume. The program continues to run, with periodic creative refreshes and one state added every quarter as the agency expands its license footprint.
ABA Therapy
A multi-state ABA therapy provider
Stable Medicaid intake volume across multiple states
The challenge. An applied behavior analysis (ABA) provider serving families of children with autism needed to grow intake in two states with very different Medicaid waiver rules, payor mixes, and clinical staffing realities. Prior agencies had run boilerplate Facebook campaigns that produced large volumes of unqualified leads from outside the service footprint, and the clinical intake team was spending most of its day filtering noise. The clinical leadership had also raised concerns that ad copy from past vendors had crossed compliance lines, claiming guaranteed insurance coverage and using medical-style claims that the company could not stand behind.
What we did. The first deliverable was a compliance framework: copy gates that explicitly disallowed individualized insurance coverage assertions, medical outcome promises, and any guaranteed-result language. Creative and copy passed through that gate before any spend went live. Then we built one campaign structure per state with geo targeting locked to actual covered counties (presence-based, never interest-based), and per-state landing pages that named the specific waivers accepted and the qualifications of the local clinical team. Lead intake routed into GoHighLevel with an in-take qualifying flow that asked the payor question before the family ever spoke to a human, so the clinical team only handled families that were inside the coverage footprint.
The result. Within two to three months the program reached stable weekly intake volume in both states with significantly higher qualified rates than the prior agency baseline. Clinical intake hours per qualified lead dropped because the upstream filters caught most out-of-network families before they reached a human. The compliance framework has held across every quarterly creative refresh: no copy has been flagged by leadership for crossing the medical-claim or insurance-coverage line. The provider has since added a third state on the same structural pattern.
Med Spa
A Beverly Hills med spa group
5x return on ad spend
The challenge. A premium aesthetics group with multiple Los Angeles area locations was running Meta lead generation campaigns that produced inquiries but not booked treatments. The booking funnel relied on the in-house front desk to call back leads at the end of the day, which meant most leads went cold before a real conversation happened. The creative was generic stock imagery that did not differentiate the group from any of the dozens of nearby competing med spas. Average return on ad spend hovered well below what the group needed to make the paid program a winner.
What we did. The offer was reworked to lead with a specific signature treatment at a defined intro price rather than the prior generic consultation prompt, which gave creative a concrete reason to click. Location-aware creative was built so each ad set named the closest neighborhood and the specific provider associated with that location. Booking moved from end-of-day callback into an instant-response automation that texted the lead within minutes of form submission with a link to live calendar availability. The instant text used the location and provider name from the ad attribution so the message felt like a personal response rather than a generic auto-reply. Lookalike audiences were rebuilt off actual booked-and-paid customers rather than the prior raw form-fill audience, so the algorithm started learning from real revenue rather than noise.
The result. Trey has publicly attested to a 5x return on ad spend outcome for a med spa group of this type. The mechanics were the same combination described above: a real concrete offer, instant-response booking automation, location-aware creative, and lookalikes rebuilt off paid customers. The booking automation in particular was the single largest unlock, because most med spa leads do not have any tolerance for a half-day callback delay in a competitive local market.
DTC E-Commerce
A premium natural water delivery business in the Northeast
Steady cost-per-acquisition reductions, subscription growth
The challenge. A premium natural spring water delivery brand operating in the Northeast US was running paid social campaigns with broken conversion tracking. The team could see clicks and could see Shopify orders, but had no clear link between the two, so every budget decision was based on guesswork. Subscription versus one-time order economics were not separated in reporting, which meant the actual customer lifetime value of a paid acquisition was invisible. Creative had drifted into product-shot carousels that performed well on engagement metrics but produced poor purchase volume.
What we did. The first job was rebuilding conversion tracking properly: server-side events through the Conversions API so iOS opt-out and ad blocker noise did not silently erode reporting, separate event types for subscription starts versus one-time purchases so the team could finally see which audiences and creative produced repeat customers, and proper UTM hygiene across every ad so post-purchase attribution surveys had something real to map against. With reporting fixed, the creative direction moved away from product-shot carousels toward sourcing-story and lifestyle creative that explained why a premium water subscription mattered for a specific kind of household. Audiences were rebuilt off the subscription-start event rather than any-purchase, so the algorithm learned which prospects became long-term subscribers rather than one-time orders.
The result. Cost per acquisition declined steadily over the engagement as the algorithm learned from cleaner data and as creative iterated toward what actually converted. Subscription mix improved as a percentage of total acquisitions, which materially shifted the unit economics of every paid dollar in the brand's favor. The brand continues to expand its delivery footprint, with paid social funded against the now-reliable subscription LTV figure rather than the previous guesswork.
Apparel E-Commerce
A consumer e-commerce apparel brand
6.5x return on ad spend
The challenge. A consumer apparel brand wanted to scale paid social profitably. Earlier campaigns had hit a ceiling because the account was structured around one large catch-all audience that the algorithm could not effectively segment, and creative was the same product imagery used in organic posts with no variant testing. Landing pages were generic collection pages without any continuity from ad creative to product detail, so the post-click experience felt like starting over.
What we did. Audiences were segmented by product category and by intent signal, so different creative could speak to different motivations. Creative shifted into a continuous testing cadence with multiple primary text formats running in parallel for every campaign, paragraph and bullet-list variants tested against each other to see which voice fit the audience. Landing pages were built per campaign so each ad pointed to a dedicated page that carried the creative through to the call to action with no design discontinuity. Reporting was rebuilt around return on ad spend measured against actual fulfilled orders rather than initiated checkouts, which exposed which audiences were producing genuine revenue versus padded checkout starts.
The result. The campaign achieved a 6.5x return on ad spend over a sustained period. The drivers were audience segmentation working with the algorithm rather than against it, continuous creative testing keeping the account out of fatigue, and post-click experiences that did not give up the momentum the ads built. The result took time to develop because the algorithm needed enough conversion volume to confidently distinguish among the new audience segments. First-month numbers were real but well below peak.