Bad Economy, Good Franchise: Interim Healthcare Franchisee Oversees 45 Locations In 5 States

Tom DiMarco knows his numbers--and they're getting bigger every year.

When he was recruited 27 years ago as controller for Salo Inc., a franchisee of Interim HealthCare, the company had only four locations. As Salo has grown, so has DiMarco's career. Seven years ago he was tapped to become the president of the organization, and today the fast-growing business has 45 Interim HealthCare locations in 5 states.

Salo, based in Columbus, Ohio, offers full- and part-time work to 8,300 employees, up from 6,600 people just a few years ago. The company is still growing steadily--along with a healthcare industry that continues to expand even as the economy languishes--and has become the largest provider of home healthcare Medicaid services in Ohio, providing everything from pediatric to geriatric and skilled nursing services.

In fact, says DiMarco, a bad economy has been a boon to Salo and other Interim franchisees. "There are a lot of skilled RNs and licensed practitioners who stayed at home, taking care of their kids," he says. "With the downturn, there was a huge influx of these professionals. They were brought back into the workforce, looking for work."

Interim HealthCare, a 40-year-old brand with 325 home healthcare franchise locations in the U.S., brings plenty of name recognition--and a crucial national contract to provide Medicare and Medicaid services to the elderly and families getting by on low incomes.

Despite all the uncertainty about healthcare reform at a time financially strapped states are cutting back on hours for home healthcare providers (one of their healthcare professionals who may have needed six hours to provide a service may now be lucky to be approved for four), DiMarco has no plans to slow down.

"We've set a goal next year of $200 million in revenue," he says following a goal of $174 million for 2011. And the company, which billed for 5.5 million hours in 2010, has its sights set on 6 million hours in 2011.

Given the budget cuts he's seeing in the five states he operates, those figures may be ambitious, says DiMarco. But he would rather set a goal and fall short than be too conservative and fail to expand as quickly as the organization is capable of doing. He also knows that the stronger Salo becomes, the better his chances are of navigating the turbulent changes ahead for the nation's home healthcare agencies.

"The upside is the strong will survive," he says. With some 13,000 home health agencies scattered across the country, government officials have made it clear that they want that number reduced to a more manageable level.

At the same time, anyone familiar with the country's demographics can see a tidal wave on the horizon of people to care for on the Medicare side of the business, while healthcare reform has promised to boost the numbers of people in Medicaid with millions of new beneficiaries.

There's another side to the healthcare reform initiative, one that worries DiMarco. In a large service company like his, he has quite a few people on the payroll who don't receive insurance coverage. Under the reform act, companies will either have to pay for those benefits, or face a stiff fee from the government. That can hit the bottom line in a big way.

Still, DiMarco says that his seven years at the helm of the company have been a lot of fun--and he plans to keep on doing it as long as it remains that way. In the meantime, he has a vacation home at Lake Las Vegas and a team of managers he's confident can handle the challenges and opportunities ahead.