The DME industry has changed a lot over the last decade (a huge understatement if you’re talking to providers who’ve experienced it).
Between reimbursement pressure, competitive bidding, rising equipment costs, and increasingly complex documentation requirements, many owners have been forced to choose between scale and service.
And then there are owners like Dwayne Weitzel, who managed to acquire a business in debt (Respicare) and build it to steady growth. How? Dwayne sought outside perspective to pressure-test decisions, understand billing risk, and bring clarity to the operational realities of running a DME business.
Respicare’s story reflects the evolution of the DME industry while also standing in contrast to it. Dwayne, a registered respiratory therapist, has always maintained his clinician-first mindset. And as it turns out, that’s a great strategy for getting referrals.
The Industry Dwayne Entered Was Already Changing
When Dwayne entered the DME space, family-owned providers dominated local markets, and patient relationships were often the differentiator. “I always worked for family companies until they would sell out,” Dwayne said.
“Larger corporations did not take care of patients. They were just more worried about the equipment itself.”
By the mid-2010s, the landscape had changed. CMS competitive bidding programs compressed margins, Medicare reimbursement declined year over year, and small businesses that failed to adapt their billing infrastructure or resupply programs struggled to survive.
Buying a Business on the Brink
When Dwayne purchased Respicare in 2016, the business was nearly underwater.
“The previous owners were about a half a million dollars in debt,” he said. “When I purchased it, I assumed that debt.”
Competitive bidding had wiped out their Medicare business. Referrals had slowed to a trickle. Resupply processes were inconsistent, and financial discipline had eroded.
For the first six months, Dwayne didn’t pay himself.
“I worked without a paycheck… to the point where I got it stabilized and we were making just enough money to pay off the debt.”
But within a year, Respicare was solvent. And within three years, it was growing—driven largely by referrals and word of mouth.
A Clinician’s Approach to Growth
Dwayne didn’t rebuild Respicare using traditional DME sales tactics. Instead, he leaned into his clinical background.
“When I went in and marketed to doctors, I talked to them as a clinician,” he explained. “I didn’t talk to them as a salesperson.”
His pitch wasn’t about products. In DME, the equipment is largely the same across providers.
“Your CPAP is identical. I’m selling the same CPAP you are,” he said. “What I have to sell is how I can take care of you better than somebody else.”
That philosophy extended directly to patients. Instead of group setups or rushed handoffs, Respicare built a one-on-one, education-first onboarding model.
“We do one-on-one setups,” Dwayne said. “When that patient walks out the door, they’ve put the mask on themselves, taken it off, turned the machine on and off. They understand all of it.”
Physicians noticed, and the referrals kept coming.
How Compliance Became a Business Strategy
Nationally, PAP therapy compliance averages around 50%. Respicare consistently operates in the high 80s to low 90s.
“Last month we were at 92% compliant,” Dwayne said. “Doctors are happy with that, so they keep sending us business.”
That level of compliance is good for the patient and the business.
“If that patient’s compliant, they’re going to keep getting supplies,” he explained.
Education plus proactive resupply became a growth engine, not an afterthought.
A Different Way to Think About Billing
As Respicare stabilized, Dwayne began examining billing risk more closely.
“With me being a clinician, I know that if I have a script, I’m allowed to set equipment up,” he said. “But I didn’t know all the other things that came behind it.”
That understanding developed through ongoing conversations with Medbill founder Keith Kuhn.
“What made me switch was knowing Medbill was going to look at our orders and say, ‘Yes, this is a good order—or no, it’s not,’” Dwayne said. “If I got audited, everything would be there and perfect.”
For a provider operating in an increasingly regulated environment, that confidence mattered.
Growing Alongside TrueSight
When Respicare transitioned its DME billing to Medbill, it also became an early adopter (and beta tester) of what would eventually become TrueSight.
“When Dwayne’s previous billing provider pulled the rug out from under him, we focused on getting him what he needed to keep serving patients,” says Keith. “Our development team worked nights and weekends to build an early version of what became TrueSight.”
“I told them, ‘I’m losing my EMR system,’” says Dwayne. “They said they had a platform, so I said, ‘I’ll take it!’”
Today, TrueSight is a part of nearly every aspect of Respicare’s operation. Clinical documentation, intake, billing workflows, and resupply automation all live in TrueSight.
“All of our charting’s done in it. All of our supplies are sent out through it. We use the resupply forecast,” Dwayne said. “Being the business owner, I’m in it every day.”
The Challenges of the Industry aren’t Going Away
Like most DME providers, Respicare faces ongoing headwinds: staffing shortages, insurance volatility, rising equipment costs, and uncertainty tied to coverage changes.
“Our insurance is going up 19%,” Dwayne said. “Right now, I’m trying to figure that out.”
Patients feel that pressure too.
“We’re seeing patients wait [to get equipment] because they don’t know what’s going to happen with insurance,” he said. “We’re trying to figure out out-of-pocket pricing that works for them and for us.”
Despite the challenges, Dwayne remains committed to the work.
“I get to work for myself,” he said. “And I get to run my business the way I want it run. We’re taking care of people the way I want them taken care of.”
Dwayne says he trains his staff to treat every patient like a family member, and in an industry shaped by consolidation and automation, this is what sets Respicare apart.
Here’s the point of Dwayne and Respicare’s story: You don’t have to choose between a sustainable business model and high-quality care.
Need help finding a balance between the two? Get in touch with Medbill’s team.