Balancing Costs and Growth: Williams Bros.' Strategies for Success

Published in Complex Rehab on July 08, 2025

Kim Cuce' By Derek Johnson, Regional Manager, Williams Bros.

Williams Bros., a company known for its continuous innovation and growth and longtime VGM member, has been adept at managing the complexities of business expenses, improving margins, and mitigating lost opportunities. Derek Johnson, Regional Manager at Williams Bros., shares valuable insights into how the company tackles these challenges and maintains its upward trajectory.

Managing Business Expenses

Labor Costs

Labor costs have been a significant factor in Williams Bros.’ business expenses, particularly since the pandemic. Salaries and wages have seen an annual increase of about 8% in 2023 and 2024. However, Williams Bros. strategically outsourced certain functions, such as intake and billing functions. Their contracted professional wages surged by 75% in 2023 due to the outsourcing of intake and billing functions, followed by a further 12.5% increase in 2024.

Product and Supply Chain Costs

The cost of goods for Williams Bros. has been increasing by approximately 5% per year. They manage these costs while maintaining quality by using formularies for many of their supplies, both internal and patient-billed. However, some compromises on quality have been necessary to maintain margins.

Fleet and Site Management

To optimize fleet and site management expenses, Williams Bros. adopted Brightree Mobile delivery two years ago. This technology helps capture patient paperwork and streamline daily routing for branches with extensive routes.

Williams Bros. actively engages with state and federal representatives for assistance.

Regulatory and Insurance Costs

Government regulations and changes in insurance reimbursement rates present significant challenges. Managed Medicare and Medicaid plans seem to be the largest challenge for Williams Bros. by routinely denying clean claims or prior authorizations unnecessarily. Williams Bros. actively engages with state and federal representatives for assistance and has integrated ACU-Serve into their billing department to help with timely appeals of denials.

Technology and Energy Investments

Technology and energy-saving initiatives are crucial in managing business costs. Automating their PAP resupply process has significantly expanded Williams Bros.’ capacity, and investing in Parachute for e-prescribing has expedited their documentation collection process.

Strategies For Improving Margin

Outsourcing and Discontinuing Product Lines

To enhance profitability, Williams Bros. has started discontinuing certain product lines, such as diabetic shoes, due to rising product costs, the outpaced fee schedule, and labor-intensive billing processes. Tariffs may also force the company to exit the bent metal products market entirely.

Automation and Inventory Management

Automation and improved inventory management have played a significant role in enhancing margins, particularly in the CGM category. Williams Bros. has developed templates for this category and dropships all CGMs products, eliminating shipping and receiving costs.

Vendor Negotiations

Williams Bros. seeks long-term partnerships with vendors, allowing for direct conversations about pricing and freight costs, resulting in favorable terms.

Training and Development

Consistency in employee training has been a challenge for Williams Bros. They have refreshed training schedules for all positions in HME, focusing on reducing employee turnover through consistent training programs and regional follow-up.

Mitigating Lost Opportunities

Product Offerings

Williams Bros. continues to provide certain products, like nebulizers, based on the need to dispense inhalation medications by pharmacies. Balancing this strategy with profitability is challenging, requiring tough conversations with referrals about the company’s acute supply capabilities.

Williams Bros. finds profitability in specializing in locations with smaller square footage.

Specialization

While offering a wide range of products in most locations, Williams Bros. finds profitability in specializing in locations with smaller square footage. Specialized locations have relatively low startup costs and headcount, though some customers may be disappointed by the limited product offerings.

Technology Integration

Williams Bros. is exploring AI models to streamline the intake process. Parachute has significantly improved efficiency with respiratory referrals for them, and future plans include utilizing Parachute’s fax wrangling service.

Market Trends and Partnerships

Staying informed about market trends is facilitated by Williams Bros.’ membership with VGM, which presents new ideas and networking opportunities at events such as the VGM Heartland Conference.

Feedback and Improvement

Williams Bros.’ gathers customer feedback through paper surveys and Google reviews. Plans to automate surveys with Survey Monkey are underway, aiming to better identify and address missed opportunities.

Williams Bros. exemplifies how a company can navigate the complexities of business expenses, improve margins, and mitigate lost opportunities through strategic planning and innovation. By leveraging technology, forming strategic partnerships, and continuously refining their processes, Williams Bros. remains a leader in the HME industry, poised for continued growth and success by showcasing the importance of adaptability and forward-thinking strategies in today’s competitive landscape.

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This article was originally featured in the VGM Playbook: Cost Management Trends, Strategies, and Solutions. To read the full article and more like this, download your copy of the playbook today!