CFOs are putting marketing on trial
SEPTEMBER 2025
In Q3 earnings calls, one phrase keeps surfacing: discipline in spending. From health systems to health plans, CFOs are tightening the screws. Every dollar must prove its worth.
Marketing is no longer immune. The era of “brand lift,” impressions, and activity reports is over. The only language that counts in the boardroom: ROI.
The Shift
What this means for operators:
Budgets are under the knife → Non-performing spend will be slashed.
Metrics must translate → CEOs and CFOs want dashboards in financial terms: cost per lead, cost per acquisition, contribution margin, lifetime value.
CMOs on the hot seat → The marketing function is being redefined—from cost center to growth operator—or cut down to “comms only.”
Winners emerge → Systems that tie marketing directly to EBITDA will gain credibility, capital, and C-suite influence.
This isn’t just belt-tightening. It’s a structural reset in how healthcare leaders view marketing.
The Move
Recast marketing as an investment class, not an expense line.
Leaders should act now:
Translate marketing into finance
Build dashboards in CFO language: ROI, LTV, CAC. Replace vanity metrics with hard financial outcomes.Redesign the growth model
Integrate brand and performance marketing into one accountable system. Cut duplication across agencies, vendors, and internal teams.Prove contribution to EBITDA
Tie marketing campaigns to growth levers—new patient acquisition, member retention, service-line utilization.Give marketing governance
Apply the same rigor to marketing spend as capital projects: approval gates, ROI benchmarks, performance reviews.
“SPIRTO Insight: Health systems and plans that operationalized marketing ROI not only defended their budgets but secured new growth capital—even in cost-cutting environments.”
Closing Thought
CFO scrutiny isn’t a threat—it’s an opportunity. For CEOs and CMOs willing to rewire marketing as a disciplined growth engine, the payoff is more than survival. It’s influence, credibility, and capital.
Because in today’s healthcare economy, ROI isn’t marketing’s report card—it’s its license to operate.
About Paula Serios & SPIRTO
Paula Serios, Founder + CEO of SPIRTO, is a 35+ year healthcare operator who has led marketing for $175M–$30B organizations and partnered with more than 100 healthcare brands to drive up to 3× revenue lifts through M&A, value-based care, and digital transformation.
At SPIRTO, she leads fractional CMO/CGO teams and the AI-enabled Growth Lab, an executive-led system that connects brand, demand, and access into one accountable growth engine—delivering board-ready ROI plans in 90 days for mid-market health systems and plans.