Industry’s elder statesman offers a wealth of tough love

Later this year, Shelly Prial, a self-described “crabby old man,” plans to check out of the HME industry and into retirement. If there's a grandfather figure in the HME industry, it's the 80-year-old Prial. Since 1950, he's worked as a pharmacist, HME provider, manufacturer's rep, consultant and for the past three years as director of government relations for Graham-Field. He's best known as founder of the Homecare Providers Co-op, which he started in 1987 and sold—following a minor heart attack—to The VGM Group in 1999. He's already begun to wind down his consulting business and expects to leave Graham-Field sometime in early to mid-2008. With the extra time that retirement brings, he'll travel with his wife of 57 years, Thelma, and enjoy his kids and grandchildren. Never short on opinions, Prial had this to say in late November about the current state of the HME industry. HME News: You're leaving or at least cutting back on your industry work—most of us don't believe you'll be able to stay away completely—at a turbulent time. You are very big on cash sales. Do you think providers will be able to reduce their reliance on Medicare and seek out new business opportunities? Prial: They have to. If they don't, they will find themselves working with greatly reduced profits. They'll make a living; that is all. I understand and appreciate that the way HME providers have to do business is going to be different. What upsets me is that rather than thinking about what they can do to make things better or improve their business—looking into cash or over-the-counter sales—they're tearing their hair out, saying ‘What are you going to do for me. What is my senator doing for me?' There are so many markets they can build. HME: For example? Prial: There are still many places that you go to that are not ADA compliant. They don't have a ramp for a wheelchair or an outfitted bathroom. It's a tremendous opportunity. More than that, when you call on them, they may need a first aid kit or something else. I would work with EMTs. They will not buy a cheap stethoscope, and they have to get their oxygen cylinders filled. They spend money. HME: Anything else? Prial: I would run an ad once a week on a specialty product on the page where they list who lives and who dies. Every Sunday I had the upper right hand corner and showed one product. It brought people in. HME: Are you still big on telemedicine as a business opportunity for HME providers? Prial: I think the opportunity is there, but they did not react when they should have. It is a $2.5 billion a year market, and manufacturers are getting a lot of interest from pharmacies. Walgreens is looking into it. HME: Any parting words of wisdom? Prial: Worry about how you run your own business. You cannot depend today on Medicare and Medicaid. You can't walk away from Medicare and Medicaid, but don't look for any more.