In the tidy diagram, a buyer enters at the top of a funnel and emerges at the bottom as revenue. In a hospital system, almost nothing happens so politely. A chief financial officer reads a trade story. A clinical leader sees a colleague complain in a private forum. A procurement team searches a phrase nobody put on the campaign brief. Six people join a demo, each carrying a different definition of risk. Fuoco, a Nashville marketing agency focused on B2B healthcare, has built its business around this untidiness.
The agency’s shorthand is that the buyer journey is a maze, not a funnel. Its longer answer is Media Engine Optimization, or MEO: map the conversations that influence a buyer, establish a defensible narrative, then coordinate content, public relations, paid media, sales tools, and measurement around it. The name is proprietary. The operating principle is older and sounder: do not let the press release, search ad, sales deck, and CEO interview tell four different stories.
Fuoco’s connected signal system
ONE NARRATIVE → MANY TOUCHPOINTS → A SHORTER PATH TO REVENUE
The accidental fire starter
Kriste Goad did not set out to own an agency. She trained as a journalist at Auburn, covered politics, became a speechwriter for the governor of Tennessee, then moved into corporate healthcare communications and agency work. When her last agency was acquired, she left with a noncompete and an awkward open space where a job used to be. In a 2023 interview she described the first move plainly: she would sit out on her own and see how it went.
For roughly a year, Fuoco was Goad and a network of freelance collaborators. Client demand made the next decision for her. Within two years, the consultancy had become an agency. The Italian name means fire, a nod to her mother’s side of the family and an excellent excuse for the title “Chief Fire Starter.” The playful branding covers a fairly sober specialization: helping healthcare companies explain complicated things to cautious buyers.
The founder’s reporting background matters. Healthcare marketing is full of claims that wilt under one follow-up question. Fuoco’s services begin before production: brand audits, buyer interviews, competitor analysis, signal mapping, and research. Only then come the narrative, content, press, campaigns, and dashboards. This is how the agency distinguishes itself from a generalist shop or an in-house team buying disconnected specialists. It wants to own the connective tissue.
“Out of one research study, you could get a year’s worth of marketing campaigns.”Kriste Goad, speaking to Swaay.Health
Fix the plumbing before buying traffic
The Availity case study is a useful glimpse of what that means in practice. Availity operates a large real-time health information network serving more than one million monthly users, but Fuoco’s audit found a website with a health score of 45 out of 100. Broken links, mixed HTTP and HTTPS pages, poor Core Web Vitals, weak internal linking, and toxic backlinks made a sophisticated company look simpler and smaller online than it was.
The first failure, then, was not creative. It was infrastructure. Fuoco repaired links and 404s, enforced HTTPS, rebuilt the sitemap and robots file, planned the CMS migration, reorganized material into topic hubs, and optimized more than 40 high-value pages. In the three months after launch, Fuoco reports that site health rose to 79, average Google position moved from 13.9 to 9.6, and click-through rate rose from 50.6 percent to 60.9 percent. A campaign could finally land on something that deserved the visit.
Change the buyer, change the question
VidaTalk presented a different problem. Its bedside app helps nonverbal, intubated, and limited-English patients communicate in more than 40 languages. Nurses and speech pathologists immediately understood the need. Executives often treated it as another translation tool. Clinical enthusiasm did not become C-suite urgency.
Fuoco changed the frame from feature to consequence: “What is silence costing your health system?” Patient communication became a safety, readmission, and financial-risk issue. The agency paired ICU stories with numbers, gave clinicians and executives different routes into the same argument, and built a conference campaign with paid search, retargeting, nurture emails, sales tools, media outreach, and a booth experience. Fuoco reports more than 150 qualified leads across three conferences and over $1 million in pipeline, three times the forecast.
What failed first
The message reached champions, not check writers.VidaTalk had clinical believers but lacked an executive case tied to safety and cost.
What changed the frame
A product claim became a risk question.“What is silence costing?” made an overlooked communication gap legible to leadership.
For Smarter Technologies, speed was the constraint. New Mountain Capital was combining three revenue-cycle businesses into one company and needed a name, visual identity, website, executive story, media plan, and demand campaign in weeks. Fuoco says it ran a 30-day multichannel launch built on analyst briefings, tier-one media, executive thought leadership, paid search, social, YouTube, and a conference road show. Reported results included 10.24 percent video engagement, 12.62 percent organic engagement, and 17.16 percent paid-search click-through.
These examples reveal the actual product Fuoco sells. It is not a logo, an ad, or even a good story. It is agreement. A complex organization agrees on what it means, the market hears that meaning repeatedly, and the sales conversation begins closer to the point.
The $100,000 answer
Asked in 2024 how she would spend a hypothetical $100,000 marketing budget for a functioning health IT company, Goad chose original thought-leadership research, ideally produced with an association, industry voice, or media partner. One body of evidence can become a report, webinar, white paper, articles, executive talks, social posts, sales material, and a PR campaign. It is a particularly efficient answer when budgets are being approved quarter by quarter and leaders want results before compounding work has had time to compound.
Her broader advice was to narrow the field to one or two channels that can move the needle, then double down when a campaign works. This is the most copyable part of the Fuoco method. A team does not need the MEO label to stop making unrelated things.
- Interview customers before inventing the campaign. Find the language they already use for the problem.
- Choose one claim with evidence behind it. Original research is valuable because competitors cannot copy the proof.
- Build the substantial object first: a study, case analysis, or point of view worth citing.
- Adapt it for each channel instead of pasting the same asset everywhere.
- Give sales the same story and track movement from visibility to qualified conversation.
An agency with a Dolly rule
Fuoco’s culture is unusually easy to remember because one of its values is “Be Like Dolly.” The company translates that as inclusive, kind, genuine, and hard-working, with an instinct to lift people up without demanding the spotlight. The other values are more conventional but consistent: be curious, be present, and bring your whole self. Its careers language reduces the formula further to progress over perfection and impact over ego.
Culture did not eliminate the operational strain of growth. In 2022, Goad described hiring an Entrepreneurial Operating System implementer, a fractional chief operating officer, and consultants for the agency’s project, people, and finance software. That investment is the unglamorous companion to the Inc. 5000 recognition that followed in 2023. Creative businesses eventually discover that good taste does not schedule the work.
Today, Fuoco sits among specialist healthcare agencies such as KNB Communications, Amendola, Unlock Health, and Hedy & Hopp, and competes with the familiar alternative of stitching together freelancers, software, and internal teams. Its best fit is a growth-stage or mid-market healthcare company with a real product, access to customers and evidence, a complicated sale, and leaders willing to agree on one story. The approach becomes less useful when the offer has not earned proof, when nobody can interview customers, or when leadership wants a quick splash without changing the underlying message or website.
There is a nice symmetry here. Goad built Fuoco after an acquisition interrupted the orderly career path. Fuoco now helps companies when their own orderly diagrams fail: three businesses must become one, a clinician’s favorite tool must reach a CFO, a giant network must look like one online. The agency is in the business of turning mess into a sentence people can repeat. In healthcare, that may be as close to starting a fire as marketing should get.
Performance figures in this story are reported in Fuoco’s published client case studies.