How Vital Care Became the Premier Home Infusion Business Franchise

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During the birth of the modern home infusion industry, Vital Care’s founder, Johnny Bell, graduated from pharmacy school. By 1972, he began his ownership and operation of two drugstores near his small hometown in West Alabama, along with a home medical equipment (HME) business. Not shy of working hard, Bell also worked as the consultant pharmacist for the local hospital as well as the local nursing home.

Around 1980, the local hospital administrator approached Bell. This administrator wanted the hospital pharmacy to become Joint Commission accredited with a 24-hour unit dose medication system, an IV admixture program and 365 days a year service. Bell rose to the challenge. Although he had never prepared an IV medication, Bell started watching VCR tapes from Abbott Laboratories and learned everything he needed to know for preparing sterile IV fluids and medications. He got the hospital their Joint Commission accreditation, and word spread to nearby hospitals in Alabama.

Pretty soon, other hospital administrators approached Bell about guiding their hospitals through the accreditation process and starting their Joint Commission accredited pharmacy services. Bell and his business partner began assisting other rural hospitals in the area to better serve their patients with an accredited pharmacy program.

Discovering the Home Infusion Business Franchise Opportunity

After working with local hospitals, Bell gained much experience and knowledge in administering intravenous therapies. While he worked at the hospital, Bell saw firsthand the advantage of patients getting out of the hospital with the IV medications at home. They had a better quality of life and it was less expensive on them and their insurance company. Getting the patient out of the hospital early would help prevent them from getting a hospital-acquired infection.

“If you can get out of the hospital sooner rather than later, that’s always better.“

Johnny Bell, Founder of Vital Care

While Bell continued working in his pharmacies, HME business, and the local hospital and nursing home, a huge opportunity presented itself. Medicare began covering Total Parenteral Nutrition (TPN) as a result of the Prosthetic Device Act. Total Parenteral Nutrition involves the patient meeting all of their nutritional requirement by the administration of intravenous fluids. This was usually a combination of proteins, fats, carbohydrates, and trace elements to meet the needs of the patient.. The therapy required a pump for administration, which is designated as a prosthetic device, making TPN therapy covered by Medicare.

Knowing how to prepare IV solutions from his hospital work and knowing how to bill Medicare from his HME business, Bell began preparing to start his home IV business. He went to TPN presentations given at large Medical Centers around the country. After listening to a presentation by the “Father of TPN” Dr. Stanley Dudrick, M.D., Bell knew he wanted to be in the home TPN business. He and his team read every resource they could find on TPN, preparing IV solutions and getting Medicare and commercial coverage for their patients in the home.

Using their resources wisely, the team converted an old bathroom into their first cleanroom. They installed a hood on the counter, cleaned thoroughly, and painted everything white from top to bottom. These humble beginnings started Bell on the journey to his first TPN patient. Bell remembers vividly going to the patient’s home, delivering the medications himself and talking with the patient. 

“It was a patient that the doctor originally believed would die in a few weeks. Bell said. “We extended the patient’s life for more than a year on TPN services.”

With this first TPN patient came Bell’s first effort at getting TPN services covered by Medicare, who denied the claim saying it was not covered. This started a long process of advocating for the patient, something that remains true to Vital Care’s core today.

“Oh yes, it is covered. It’s covered in the Prosthetic Device Act,” Bell remembered saying when confronted with the denied claim by Medicare.

At the time, they were required to file the Medicare claim with the local carrier, which was Blue Cross Blue Shield of Alabama. When questioned about the coverage, Bell showed them where it was covered and Vital Care set the prevailing rates for getting paid for TPN services by Medicare. While they might not have had the first TPN patient in Alabama, they undoubtedly had the first Medicare-reimbursed home TPN patient in Alabama as well as Mississippi.

The Start of Vital Care Home Infusion Franchising

At the time Vital Care began, commercial insurance companies started covering more home services, like intravenous antibiotics and TPN. Medicare was also covering I.V. medications that required a pump for administration. As this opportunity expanded and others learned of his success with Medicare and commercial insurance coverage and reimbursement, Bell started receiving requests to help his pharmacist peers launch their own home infusion services.

Bell would advise them on exactly what they needed to know and do to start their own home IV business. They would take all this information back to their local community, build a clean room, and try to start their business. But Bell noticed two major problems. The fledgling enterprises either could not get referrals or they could not get paid by insurance for the patients they served.

That’s when Bell realized he had the expertise they needed to solve both problems. He knew how to market infusion services, and he knew the proper documentation needed to get medical claims reimbursed. Other home IV businesses seemed to be failing without an effective program. He considered expanding his business but did not have the capital needed to launch businesses in bigger cities like Birmingham and Mobile in Alabama.

Franchising was an established business model at that time, so Bell decided to pursue the franchise model to expand his home infusion services. He launched Vital Care in 1986 and began providing services to local pharmacists, educating and supporting them in their new home infusion businesses with a complete back office program. Since then, it’s been an upward trend of growth in the decades to follow.

Guiding Vital Care In Growth and Excellence

Originally, Bell’s goal was to sell his Vital Care home infusion business franchises in Alabama and Mississippi. Now, Vital Care expands across the United States with more than 60 locations. As home IV therapies grew, Vital Care grew right along with the industry. From the 80s to 90s, home IV services expanded to include most antibiotics, cardiac therapies, and more. Safely giving medications at home has proven to be possible with proper training, monitoring and patient care.

This growth trend has done nothing but continue in recent years. Most medications that are administered in the hospital can be given at home. More and more patients are becoming aware of the risks and inconveniences of hospital stays, and are opting for home services that are safer and more comfortable.

“At home is better. At home is safer.“

Sue Bell, Wife of Johnny Bell, Vital Care Founder

The key, however, to Vital Care’s success is not only in the expanding home IV industry, but also in its local availability for the patient. Each Vital Care franchise is locally owned and operated, so patients deal with someone they can build a relationship with, and this builds confidence in their IV services. Local doctors know who will be getting their referrals and who is taking care of their patients. The locally-owned, locally-operated Vital Care locations offer the exact same–if not better–home infusion services as a larger, national home infusion business from a major metropolitan city.

The Vital Care Emphasis: Patient Care and Accountability

By focusing on small, rural communities in the early years of corporate expansion, Vital Care grew its network with patient access in mind. Vital Care franchises in rural areas run profitable businesses without the large overhead of a national infusion providers. They have a local presence and local responsibility, while Vital Care’s corporate home office provides comprehensive support services with decades of expertise and experience.

Throughout the years, Bell emphasized patient care as the primary motivation for all his employees. Each person at Vital Care sees themselves as a part of the patient care process, from the person verifying insurance to the person supporting the IV service for the patient. While Vital Care’s corporate office employees do not access veins or visit the patients’ homes, these patients are all part of the patient care responsibility of the Vital Care family.

“We’re not just developing dosages and filing claims. We’re taking care of patients.”

Johnny Bell, Founder of Vital Care

The core motivation of each Vital Care location is patient care. If you are looking for ways to serve patients in your local community with the best home infusion services, reach out to the franchise development team. They provide potential franchise owners with resources needed to discover their own home infusion business opportunities. Set up a time to talk with the team, or keep researching on

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