Saturday, August 31, 2002

CHATTANOOGA, Tenn. — In 1992, Mike Ballard, then an investment banker, witnessed the wizardry of a rehab technology specialist (RTS) for the first time. Ballard had been hired as a consultant by an HME business having cash flow problems. He visited the business and saw an RTS fit a child who had mild cerebral palsy with a wheelchair.

"It was like 100 Christmas mornings wrapped up in one moment," he said. "It was one of the most emotional experiences I've ever seen."

Spellbound, Ballard began befriending RTSs. "When they talked about what they did, there was definitely a sparkle factor in their eye," he said. But Ballard learned that many RTSs felt their clinical abilities were being choked by the profit expectations of their employers. They also resented being painted with the same brush as HMEs when it came to regulations and reimbursement.

"Right then, I decided to lead the charge to separate rehab from HME," Ballard said. "I had the arrogance to name my first branch National Seating & Mobility (NSM) before I even knew if there'd ever be another branch."

Today, NSM has more than 50 branches across the country where RTSs reign. This year, the business is celebrating its 10-year anniversary. HME News talked with Ballard recently about how he branded custom rehab on a national scale, something no other business has been able to do. Here's what he had to say.

HME News: What's the secret to NSM's success?

Mike Ballard: It's the culture we've established. We believe RTSs need to be treated like medical practitioners. They need to be put in a position where they are the king or queen. We don't have a business manager that our RTSs report to. They are the ultimate authority. There are some management challenges with this model, but in the end, you're taking better care of end-users and your referral sources. Too many things get compromised if decisions are based on purchasing.

HME News: NSM isn't profit driven?

Ballard: I'm not in this business to make money. If I wanted to just make money, I would have stuck with investment banking. I never said, "I want to get into health care. What's the most profitable segment to get into?" I was going to be in the rehab business. The question was, "Could I make enough money to stay in business?" My goal is to be the very best and make a profit. You have to have profits. Profits are like breathing. You have to breathe to live.

HME News: Why is it so important that rehab stand-alone?

Ballard: The functionality of custom rehab is a direct result of not the products but of the expertise of which products are purchased and how they're set up. A manual custom wheelchair can have 10,000 variations. Every week, I'm cutting checks to 200 different suppliers; that's how involved a field it is. HME is a sales driven model. The only difference in the functionality between two pairs of crutches is price. Rehab is about who's doing the work and how they're trained. It's not a one-size-fits-all business.

HME News: How has NSM grown from one to over 50 branches in 10 years?

Ballard: RTSs want to join our team. We'll hear of an RTS who wants to join us, and if we have the time to set up a branch there, we do it. We don't have a strategic plan. We don't have personnel allocated toward business development so to speak. We just want to be the best place for the passionate RTSs to work. When we get them all, and there's no more out there, we'll stick to our business. If there's more, we'll keep going. We don't necessarily want to get bigger, bigger, bigger. We just want to be the best. If that means someday that we're not the biggest, that's OK.

HME News: Where's the high-end rehab industry going?

Ballard: The market for low-end power wheelchairs and scooters is growing very rapidly because of the aging of America. The manufacturers are all in a tizzy about that, because it's going to be such a big market. They've got a game of capture the flag going. In high-end rehab, you're not going to see a lot of growth. What I'm concerned about is the baby getting thrown away with the bath water. I don't want high-end rehab to get stepped on in the stampede. If the low-end power wheelchair and scooter providers get into high-end rehab, we're going to go back 10 years. HME