Every duplicate tool is a haircut on your exit multiple
Forty practices on three PMSs plus six agency add-ons doesn't trade at the same multiple as forty practices on a clean stack. Your buyer's diligence team already knows.
CareRMFor DSOs and PE-backed dental platforms
One operator across the platform. Not another agency at every doc’s desk.
Most DSOs end up with a different marketing vendor at every acquired practice, a different PMS underused at every site, and zero through-line on attribution. We run one engineering-grade playbook across the portfolio. And we kill the duplicate vendor line items along the way.
What the portfolio model actually looks like today.
Inherited agencies, inherited PHI liability
Acquired practices come with the previous owner's agency contracts and the previous owner's tracking-pixel setup. Most of them are non-compliant. We audit on day one. You'd rather find this before your buyer does.
Set-it-and-forget-it doesn't scale to 40 practices
The deliverable model breaks at two locations. You're past that. You need a function, not a vendor list. The agency category was never built to run portfolios.
Engineered for portfolios. Designed for the board.
$0
Net-new software spend
Pilots reallocate existing per-practice marketing dollars. Tech consolidation typically recovers redundant SaaS spend that funds the engagement. EBITDA-positive, not an expense line.
1
Operator across the platform
Same playbook on every location. PMS optimization, vendor kill-list, server-side Meta, attribution. Per-location predictability instead of a different agency at every doc.
90 days
Pilot to portfolio decision
Two or three practices first, attribution data in hand by month three. Rollout to the rest of the platform happens on numbers, not a sales pitch.
Portfolio diligence
What we find in a typical 20-practice audit.
We document the gap and the cleanup path. Useful whether you’re operating, recapping, or selling.
Redundant SaaS line items
$1,500 to $3,800 per practice per month, typical. Usually three outside vendors duplicating modules already in the PMS.
Single points of failure
One freelancer hosting nine practices on identical aging templates. A single inbox handling lead delivery for the whole portfolio. The kind of risk that surfaces in QofE.
PHI in tracking pixels across multiple practices
Meta Pixel and GA quietly capturing PHI in URLs and form fields. Active class actions over exactly this failure. Most portfolios haven’t been audited because nobody knew to ask.
No unified attribution
Per-practice agencies all claim credit. Nobody can tell you what the portfolio CAC actually is, much less what each ad cohort drove.
Per-location metrics the board can actually compare.
Same dashboard, same definitions, every location. No more reconciling twelve PDFs from twelve vendors.
$150
Target per-location new-patient CAC.
20 → 30
New patients per practice per month.
100%
Attribution back to spend.
20+
Practices on a single portfolio dashboard.
Common questions
How does this work mid-acquisition?
We audit the target's marketing stack and tracking-pixel exposure pre-close as part of diligence, then take over the engagement at close so the platform doesn't inherit a non-compliant setup. We've done this several times. The PHI piece in particular tends to surface things buyers want documented before signing.
Will you sign a portfolio-wide BAA?
Yes. We sign portfolio-wide BAAs and require our subprocessors to as well. The PHI architecture assumes patient data is sensitive by default across every location.
What does the data look like in a CIM?
Per-location CAC and new-patient counts, unified attribution by source and procedure, recovered SaaS spend, audited PHI compliance posture. Numbers the diligence team can defend without footnotes.
Who owns the creative on exit?
You do. The brand-owned creative library is yours from day one. If the engagement ends, the assets stay. We retain the right to reference the work in our portfolio if you're comfortable with that, nothing more.
Do you replace our in-house marketing person?
Usually we work alongside them. The fractional CMO model fills in where the in-house person is stretched (creative production, paid acquisition, attribution architecture, vendor management). If you don't have someone in seat yet, we fill the role until you hire.