Healthwords.aiHealthTech · SaaS / SubscriptionsTwist engagementHow Healthwords.ai unlocked +663% new sessions and shipped an in-house AI creative studio.
Healthwords.ai brought Twist in as Fractional Head of Growth across $16.1M+ in spend. We rebuilt the 2025/26 acquisition strategy, shipped a generative AI creative studio inside the marketing function, and rewired customer lifecycle and retention around cohort LTV instead of last-click ROAS.
+663%
+40%
$16.1M
−92%
Twist plugged in as our growth leadership and within a quarter we had a creative engine that didn't rely on an agency, a measurement model the CFO trusted, and a +663% sessions chart we could defend line by line.
The hurdle
Healthwords.ai had product–market fit and a fast-growing user base, but acquisition was running ahead of the team's ability to plan, measure and govern it. Spend was scaling faster than the data infrastructure underneath it — and creative production was the single biggest bottleneck on every paid channel.
They needed a senior operator who could own 2025/26 growth strategy end-to-end — acquisition, lifecycle, retention, and the marketing data product itself — without adding a full-time CMO or Head of Growth to the cap table.
What we changed
We took on the Fractional Head of Growth role and rebuilt the planning stack from the channel mix up. New acquisition model, unified analytics layer across paid and product data, and a retention framework anchored on cohort LTV and CAC payback instead of last-click ROAS. The reporting layer compressed three siloed dashboards into one weekly leadership view.
In parallel we shipped the AI Creative Studio — a generative production pipeline that took concepting, iteration and localisation in-house, removed the agency dependency, and gave the team a 24-hour test-to-learn loop on paid social. Inside ninety days, creative was no longer the limiting factor on spend.
How it runs now
Twist runs growth as an embedded function: weekly leadership reviews, monthly cohort and LTV readouts, and a creative pipeline producing iteration sets on demand. The internal team owns execution; we own the strategy, the data product, the AI tooling and the spend governance model.
Decisions that used to take a planning cycle now take a Slack thread. The marketing team ships more, with less rework, against a metric the CFO actually believes.
What's next
The next phase moves the AI Creative Studio from a paid-social tool to a full-funnel asset engine — lifecycle, on-site, and in-product creative all flowing through the same pipeline. We're also scoping international launch into two new markets without expanding the agency roster.
AI creative as an operating layer —
The biggest single lever wasn't a channel — it was removing the wait time between insight and creative. A generative studio inside the marketing function compressed a 3-week cycle to under 24 hours, and that's what unlocked the +663%.
Cohort-first, not click-first —
Re-anchoring measurement on cohort LTV and CAC payback (not last-click ROAS) changed which channels we leaned into, and unlocked spend in places ROAS dashboards had quietly been killing.
Fractional senior, full-time outcome —
A Fractional Head of Growth at a senior level can drive a full-time-equivalent outcome — provided they own the data product as well as the channel mix. Treat the two as one job.
Want results like this?
30 minute fit call. We'll come back within a week with a ready to go plan built around your numbers.