SEO. GEO. ASO. Three Disciplines. Most health systems lag.
AEO STRATEGY | AI HEALTH STRATEGIST LLC
Adobe Just Spent $1.9 Billion to Tell You SEO Is Not Enough. Healthcare Still Hasn't Gotten the Message.
Published May 6, 2026 | 6-minute read | AI Health Strategist LLC
On April 28, Adobe closed its $1.9 billion acquisition of Semrush. The press release did not bury the lead.
Adobe explicitly named three distinct disciplines that marketers now need to compete on: SEO, GEO (Generative Engine Optimization), and ASO (Agentic Search Optimization). Not SEO and "AI stuff." Three separate, named disciplines. From the company that just paid nearly $2 billion to own the infrastructure for all three.
Healthcare marketing has not caught up to the second one yet. The third one is already here.
What ASO Actually Means
Most healthcare marketers have heard of SEO. A growing number have heard GEO explained, usually as "optimizing for AI search" or "getting cited in ChatGPT." That framing is roughly correct.
ASO is different. It is not about getting cited in a conversational AI response. It is about getting recommended by an AI agent that is taking action on behalf of a user.
A patient uses an AI assistant to find a cardiologist, check insurance coverage, compare hospitals, and book an appointment, all in a single conversation. The agent is not just answering a question. It is making decisions and executing tasks. The brands it recommends, the providers it surfaces, and the systems it routes to are determined by how well each organization has optimized for agentic discovery.
Adobe put it directly in its acquisition announcement: AI agents are becoming a primary way for customers to discover, evaluate, and engage brands. That is not a prediction. That is a description of what is already happening.
The Signal Health Systems Are Missing
Here is why this matters specifically for healthcare.
The shift from Google search to generative AI was already a structural problem for health systems. Our national benchmark found a mean AI visibility score of 6.21 out of 10 across 50 programs and five service lines. Most health systems are invisible or generic in conversational AI today, before ASO even enters the equation.
Now add a second layer. As AI agents become the interface patients use to navigate their healthcare decisions, the optimization requirements get more complex. It is not enough to appear in a ChatGPT answer. Your system needs to be discoverable, trustworthy, and actionable within agentic environments where the AI is doing the searching, comparing, and routing for the patient.
Adobe's data quantifies the gap: AI traffic to U.S. retail sites increased 269% year over year as of March 2026, while businesses still face significant gaps in AI-led brand visibility. Healthcare is not retail, but the behavioral shift is identical. Patients are discovering providers through AI-mediated channels at an accelerating rate. The infrastructure most health systems have built was designed for a world where patients went to Google first.
Three Disciplines, Three Different Gaps
The Adobe/Semrush framework maps cleanly onto what we see in the field.
- SEO is the foundation most health systems have invested in, with variable quality. Website content, local listings, technical structure. Necessary but no longer sufficient.
- GEO / AEO is where most health systems are failing right now. This is the ability to appear credibly in AI-generated answers across ChatGPT, Perplexity, Google AI Overviews, Microsoft Copilot, and Claude. The gap is structural: most health system content was built for search engines, not language models.
- ASO is what comes next. Optimizing for AI agents means your digital presence needs to function as a reliable data source that agentic systems can query, verify, and act on. Schema markup, structured service data, and content architecture that support machine decision-making.
Most health systems are behind on the middle layer. The third layer is already arriving.
What the $1.9 Billion Signals
Corporate acquisitions are a useful proxy for where the market is heading. Adobe did not spend $1.9 billion on a search engine optimization tool. It spent $1.9 billion on an agentic brand visibility platform, one that covers all three disciplines and connects discoverability intelligence to content creation and customer experience.
The marketing industry's largest technology players have now formally declared that brand visibility in AI-mediated environments is a distinct, investable discipline. Not a feature update. A platform.
Healthcare CMOs who are waiting for this to stabilize before investing are viewing from the wrong vantage point. The discipline is being codified now. The tools are being built now. The health systems that start building content architecture for agentic environments in the next 12 months will have a structural advantage that will be difficult to close in 2028.
The Practical Question
You probably cannot fix all three layers at once. You do not need to.
The question worth answering this quarter is: do you know which layer is your biggest gap?
For most health systems, the answer is GEO/AEO. The conversational AI gap is real, measurable, and directly connected to patient volume today. That is where investment has the fastest return.
But understanding where ASO is heading, and beginning to build the content infrastructure that will support it, is not a 2027 problem. The organizations that wait for agentic search to become mainstream before they address it will be three years behind when it does.
Adobe just spent $1.9 billion to tell you where the market is going. The health systems that listen will be ready. The ones that do not will be invisible in a channel they never saw coming.
Run a Complimentary AI Readiness Scan
If you want to know where your organization stands across SEO, AEO, and the emerging ASO layer, start with a complimentary AI Readiness Scan. We will show you what AI says about your top service lines today, where the gaps are, and what the path forward looks like.
Contact us: jeff.montgomery@aihealthstrategist.com
