> ## Documentation Index > Fetch the complete documentation index at: https://learn.outboundsystem.com/llms.txt > Use this file to discover all available pages before exploring further. # Portiva > Portiva spent $16,200 over 9 months and generated $168,000 in revenue — a 9.4x return. Healthcare virtual assistants with 1,000+ implementations. Cost-comparison framework targeting practices with active admin job postings. 56 meetings, 31 responses per month. # Portiva — 9.4x ROI Portiva turned 1,000+ implementations into a consistent outbound pipeline: 56 meetings booked over 9 months with 31 qualified responses per month. The ROI math did the selling — $35K-$45K for in-house admin staff vs. \$10/hour through Portiva. When practice managers saw the cost comparison paired with 1,000+ implementation proof, the trust barrier dissolved and conversations turned into contracts. \$16,200 \$168,000 9.4x 56 \$289 \$18,667 | Detail | Info | | ------------- | ----------------------------- | | Industry | Healthcare Virtual Assistants | | Company Size | 50-200 employees | | Services Used | Email + AI Calling + LinkedIn | | Duration | 9 months | ## The Challenge Healthcare practices are drowning in admin work, but convincing them to trust a virtual assistant with patient-facing tasks requires proof at scale. Portiva had 1,000+ implementations but needed systematic outreach to surface that proof to the right buyers at the right time. The staffing pain was real but the trust barrier was high. Practice managers needed massive social proof and clear ROI math before considering virtual assistants for patient-facing work. Limited outbound wasn't surfacing the ROI math or social proof from 1,000+ implementations effectively, and there was no targeting based on active hiring intent. **Before Outbound System:** * No systematic outbound despite 1,000+ implementations * Trust barrier for virtual assistants in healthcare * ROI math not surfaced early in conversations * No targeting of practices actively hiring admin roles **After Outbound System:** * 56 meetings booked over 9 months * 31 qualified responses per month on average * Steady, predictable pipeline matching onboarding capacity * Cost-comparison messaging driving qualified conversations ## The Solution Built around making the 1,000+ implementation number impossible to ignore. Targeting focused on practice managers actively hiring for admin roles — a signal they were feeling staffing pain right now, not hypothetically. Messaging led with cost comparison: $35K-$45K for in-house vs. \$10/hour through Portiva. ### Cold Email Sequences surfacing ROI math early and following with social proof from comparable practice types. The cost-comparison framework drove the narrative — not capability descriptions, but specific savings calculations. ### LinkedIn Outreach Engaged practice owners with content around healthcare staffing challenges and operational efficiency, building credibility in the healthcare staffing space before the meeting ask. ### AI Cold Calling Targeted multi-location practices where staffing cost savings at scale justified a direct conversation. A 60-second call about admin staffing costs converted phone-first healthcare buyers. ### Beyond the Meetings * **Market Intelligence:** Targeting practices with active admin job postings proved the strongest intent signal, converting at 3x the rate of demographic-only targeting. * **Pipeline Insurance:** Three-channel coverage kept outreach consistent across 9 months, with no single-channel failures disrupting the steady 31 responses/month pipeline. * **ICP Refinement:** Multi-location practices showed highest engagement because cost savings multiplied across locations, making the ROI case even more compelling per practice. * **Capacity-Matched Pipeline:** 31 responses per month created pipeline matching Portiva's onboarding capacity, avoiding feast-or-famine cycles that strain operations. ## Campaign Timeline Intent-signal targeting built around practices with active admin job postings. Cost-comparison messaging developed with specific savings calculations. Healthcare-specific infrastructure configured. First qualified responses within 8 days. ROI math resonating immediately with practice managers feeling active staffing pain. AI calling added for multi-location practices. LinkedIn building healthcare credibility. 31 replies/month pace established and sustained. 56 total meetings over 9 months. Steady flow matching onboarding capacity. Pipeline compounding as earlier leads continued converting. ## Full Metrics Breakdown | Metric | Result | | ---------------------------------- | --------- | | Total Spend with Outbound System | \$16,200 | | Campaign Duration | 9 months | | Qualified Leads Generated | 279 | | Cost Per Qualified Lead | \$58 | | Meetings / Calls Booked | 56 | | Cost Per Booked Meeting | \$289 | | Show Up Rate | 76% | | Revenue Generated (cash collected) | \$168,000 | | New MRR Added | \$18,667 | | ROAS (on cash collected) | 10.37x | | **Total ROI** | **9.4x** | *All revenue figures reflect cash collected, not contract value.* > "The lead quality has been great. I'm super happy with Outbound System." > > — **Sanju Zachariah**, Owner & President at Portiva ## Get Results Like Portiva Portiva's campaign proved that cost-comparison frameworks turn trust-heavy sales into ROI-driven conversations that practices can act on immediately. If you sell into [healthcare](/industries/healthcare), the approach is the same: surface the cost math early, target practices showing active staffing pain signals, and let 9 months of sustained outreach build a predictable pipeline. See how our [cold email service](/services/cold-email) maintains deliverability into healthcare inboxes and our [multi-channel outbound](/services/multi-channel) keeps long-duration campaigns producing consistently. See how cost-comparison messaging and intent-signal targeting would work for your healthcare pipeline.