The ABA therapy marketing agency landscape has expanded significantly in recent years. Practices that were previously working with general healthcare agencies, local digital marketing firms, or handling things in-house now have access to agencies claiming, with varying degrees of accuracy, to specialise in ABA therapy marketing.
Choosing the wrong agency is an expensive mistake. Not just in fees, but in the months of learning curve during which the agency is being educated about ABA at the practice’s expense, the HIPAA compliance risk from an agency that doesn’t understand healthcare data requirements, and the opportunity cost of an 18-month contract with an underperforming partner.
Here are five questions to ask any marketing agency before signing an ABA marketing agreement.
Question 1: How long have you worked exclusively with ABA therapy providers?
The word “exclusively” is doing work in that question. Many agencies say they work with ABA practices. Very few have built their systems, reporting frameworks, and domain knowledge exclusively around ABA.
The distinction matters because ABA marketing is genuinely different from general healthcare marketing:
- The authorisation cycle means that conversions take weeks to manifest. A Google Ads agency that doesn’t understand this will misread campaign performance data.
- HIPAA compliance in digital advertising requires specific technical implementations that most healthcare agencies haven’t had to build.
- The parent decision journey in ABA is specific. A parent navigating a recent autism diagnosis, insurance complexity, and school decisions requires messaging frameworks that aren’t transferable from, say, dental or orthopaedic marketing.
An agency that has spent five years working exclusively with ABA practices arrives with knowledge the practice doesn’t have to teach. An agency that “also works with” ABA clients is learning at the practice’s expense.
Reputation Elevation has worked exclusively with ABA therapy providers since 2018. That exclusivity is deliberate. It produces better results for clients.
Question 2: Can you show me ABA-specific results, with named metrics?
Not healthcare marketing results. ABA results. Named metrics: cost per qualified ABA therapy enquiry, enquiry-to-assessment conversion rate, cost per authorised client.
If an agency presents “impressions” or “click-through rates” as primary success metrics for ABA marketing, they’re measuring the wrong things. If they can’t tell you what their average ABA client achieves in terms of cost-per-authorised-client, they don’t have that data, which means they aren’t tracking it, which means they aren’t managing to the metric that matters.
Case studies with real numbers (not “we increased leads by 40%” but “we reduced cost per authorised client from $1,800 to $900 over six months”) are the evidence to look for.
Question 3: How is your tracking and reporting HIPAA-compliant?
This question will immediately separate ABA-experienced agencies from general healthcare agencies.
Standard Google Ads and Facebook Pixel configurations aren’t HIPAA-compliant for ABA marketing. Health-related URL data, form field contents, and user identity combined with health information can constitute PHI, and transmitting PHI to Google or Meta’s advertising systems without appropriate safeguards is a HIPAA violation.
An agency with genuine ABA experience will have specific answers: server-side tagging for conversion events, URL exclusion configurations for the Facebook Pixel, no form field data in conversion events. An agency that looks blank when the question is asked is working out whether to pretend they know what you’re talking about.
The second part of this question: is your CRM / marketing automation platform covered by a signed Business Associate Agreement? Standard SaaS tools (HubSpot, Mailchimp, ActiveCampaign) aren’t HIPAA Business Associates by default. If the agency is using standard tools to store your intake data without a BAA arrangement, that’s a compliance exposure.
Question 4: Do you offer performance guarantees?
A good ABA marketing agency should believe in its systems enough to commit to specific performance outcomes. Not unlimited guarantees, there are legitimate variables (market conditions, competition, the practice’s own intake performance) that affect results. But some performance commitment, in writing.
The existence of a performance guarantee is a quality signal. It indicates the agency has enough confidence in its results, and enough data from past performance, to put something at risk.
Reputation Elevation offers contractual performance guarantees on select plans. We don’t offer them on every programme because legitimate market variability means we can’t guarantee specific outcomes in every context. But on programmes where the conditions are right, we back our work.
Ask any ABA marketing agency about their performance commitments. If the answer is “we can’t guarantee results in digital marketing,” they’re either covering for historically poor performance or they don’t have enough ABA-specific data to know what to commit to.
Question 5: What happens to my data if we part ways?
This is a practical question that most practice owners don’t ask and later wish they had.
Your Google Ads account data (campaign history, keyword performance data, conversion data) is an asset. It represents months or years of optimisation. When an agency sets up a Google Ads account in their own account structure (which most do), that data stays with them when the relationship ends. You start over.
Ask the agency to confirm that your Google Ads and Analytics accounts are in your name, under your ownership, and that you will retain full access to all campaign data if the relationship ends. We set up all client accounts in the client’s name by default. Not all agencies do.
The same question applies to your website. If the agency built it on their platform, who owns it and what happens to it?
These five questions won’t guarantee a perfect agency relationship. But they will eliminate a large proportion of the unsuitable options quickly, and they will help you have a much more productive first conversation with any agency that passes all five.
Reputation Elevation is a Chicago-based digital marketing agency working exclusively with ABA therapy providers since 2018. We’re happy to answer all five questions, and more, on a strategy call.