24-Hour Freestanding Emergency Room in New Braunfels, TX
Cutting Cost Per Lead by 56% Through Smarter Google Ads Management
Cost Per Verified Lead
Location
Services Used
Google Ads Management
Campaign Restructure and Device Segmentation
Conversion Tracking and Call Attribution
Google Business Profile Integration
Negative Keyword Strategy
Competitor-Focused Search Strategy
About Lonestar 24HR ER
Lonestar 24HR ER is a locally owned, physician-founded freestanding emergency room serving New Braunfels, Texas and the surrounding Hill Country communities. The facility provides 24-hour emergency care with board-certified ER physicians, on-site diagnostic imaging including CT, X-ray, EKG, and ultrasound, an on-site laboratory, and treatment for both adult and pediatric patients. Unlike a hospital emergency room, Lonestar offers dramatically reduced wait times, with most patients seeing a physician within minutes of checking in. As an independent ER, they compete directly with hospital-affiliated emergency rooms and urgent care networks throughout the region.
For an emergency care provider, visibility at the exact moment someone searches for help is everything. Patients do not comparison shop for days. They search, they call, and they go. That makes paid search one of the most important channels for a freestanding ER, and it makes accurate call tracking absolutely critical to understanding what is working. Funnel Boost Media’s pay-per-click management approach for emergency and urgent care providers starts with trustworthy data before optimization begins.
Prior to partnering with Funnel Boost Media, Lonestar 24HR ER’s Google Ads account was managed by another agency. On paper, the account appeared to generate a steady flow of leads. In reality, the reporting could not be trusted. Conversion tracking was misconfigured and double counting leads, which inflated performance and masked a high true cost per lead. The account was also spending aggressively on broad, low-intent traffic under an automated bidding strategy built for click volume rather than patient inquiries.
The Challenge
When Funnel Boost Media took over the account in May 2026, a full audit revealed problems that went deeper than day-to-day optimization. Conversion data was unreliable, with double-counted leads overstating results and making the reported $142.39 cost per lead look better than the true figure. The account ran on a Maximize Clicks bid strategy that prioritized traffic volume over lead quality, and the client’s Google Business Profile was still linked to the previous agency’s account, cutting off location features and call reporting.
The campaign structure compounded the problem. Non-brand traffic ran through a single service campaign with six ad groups stuffed with phrase match keywords, ranging from 16 in one ad group to over 70 in another. At that scale, ad copy cannot stay relevant to the search and there is no control over which keyword triggers. Branded keywords were also duplicated across two campaigns, forcing the account to compete against itself while cheap brand clicks inflated reported performance, a pattern we regularly untangle in healthcare marketing PPC accounts inherited from other agencies.
They Also Faced:
- Double-counted conversions inflating reported lead volume
- No reliable call attribution to verify which campaigns drove patient inquiries
- Ad groups stuffed with 45 to 70+ phrase match keywords, making relevant ad copy impossible
- Location targeting set to “Presence or Interest,” wasting spend on searchers outside the service area
The Solution
Services We Provided
Conversion Tracking and Call Attribution Repair
Google Business Profile Reintegration
Complete Campaign Restructure
We replaced the catch-all service campaign with a structure built for control, matching the account architecture we use for urgent care PPC clients competing in defined service areas. Non-branded campaigns were split by device, each containing two tightly themed ad groups with just two exact match keywords apiece, so every ad is written for exactly the search it serves and every dollar maps to a known, high-intent query. Branded keywords were consolidated into a single dedicated campaign, eliminating internal competition and keeping cheap brand clicks from masking non-brand performance. Location targeting was corrected from “Presence or Interest” to Presence only, so ads serve exclusively to people physically in the area a walk-in emergency room can actually treat.
Bid Strategy Overhaul
We moved the account off Maximize Clicks and onto Manual CPC, giving us direct control over what each click is worth. In emergency care, not all searches carry equal intent, and automated click-volume bidding treats them the same. Manual bidding paired with the exact match structure let us pay more for high-intent searches and pull back everywhere else. Average CPC rose from $7.84 to $9.65, but conversion rate nearly tripled, proving the account was buying better clicks, not just more of them.
Negative Keyword and Search Term Cleanup
A full search term audit identified the broad, irrelevant queries draining budget under the previous structure. We built negative keyword coverage across the account to filter out low-intent traffic and keep spend concentrated on searches that indicate someone actually needs emergency care now.
Competitor-Focused Search Strategy
With tracking verified and waste eliminated, we launched a dedicated competitor-focused search campaign built on exact match keywords and manual bidding. The campaign positions Lonestar 24HR ER in front of patients actively searching for other emergency care options in the area, capturing demand at the moment a care decision is being made.
The Result
In the first 50 days under Funnel Boost Media management, the account’s efficiency transformed. Conversion rate jumped from 5.55% to 15.38%. Cost per lead dropped from $142.39 to $62.75, a 56% improvement, and that comparison actually understates the gain because the previous agency’s lead count was inflated by double counting while every current lead is verified.
The account now generates more than twice as many leads per dollar spent, on data the client can fully trust.
Cost Per Lead
Conversion Rate
Leads Per Dollar Spent
Built for Sustainable Emergency Care Growth
With accurate call attribution, a restructured bidding strategy, and clean account infrastructure, Lonestar 24HR ER now has a Google Ads program built on verified data rather than inflated reporting. Every optimization decision going forward is grounded in real patient inquiries, and the account is positioned to scale efficiently as budget grows. Ongoing search term refinement and competitor strategy expansion will continue to strengthen their position in the New Braunfels emergency care market, the same way we approach lead generation for high-intent, time-sensitive services.
Cost Per Lead
First 50 Days
Conversion Rate
First 50 Days
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