Episode #15: A Conversation with Zach Gantt of Encore Healthcare

In this episode of the Claim to Fame podcast, we speak with Zach Gantt of Encore Healthcare, who shares his journey from a family-rooted career in DME to pioneering data-driven respiratory care.

What’s Covered?

Zach delves into the creation of Encore and its Nexus platform, highlighting the transition from traditional DME services to a focus on outcomes and data, and the unique business models offered by Encore. The discussion also touches upon the trends and future of respiratory care, including the impact of AI and telehealth. Zach shares his personal insights on bootstrapping his business, leveraging technology, and the importance of maintaining a people-first approach, influenced by his background as a pastor. The episode wraps up with details on the Smoky Mountain Symposium, an educational conference for DME providers organized by Encore Health.

Podcast Transcription

Podcast Episode: Faith, Data, and the Future of Respiratory Care
Guest: Zach Gantt, CEO & Founder, Encore Healthcare
Hosts: Alex and Wayne (NikoHealth)

[00:00] Opening — Outcomes, Data, and the Future of DME

Zach:
The future of healthcare is outcomes. Everyone around DME is already being paid for outcomes and data — except DME providers, who are still reimbursed on a fee-for-service model. But I knew that would eventually change.

Today, Encore has 150,000 patients on our platform. We’ve reduced hospitalizations by 60%+, and avoided between 80,000–100,000 hospital admissions through structured respiratory management.

[00:01:00] Meet Zach Gantt — From Childhood in DME to Encore Healthcare

Alex:
Welcome to the Claim to Fame podcast. We’re excited to have Zach Gantt with us today.

Zach:
Thanks for having me.

I’m a respiratory therapist by training and have been in DME my whole life. My dad and uncle were respiratory therapists who opened their first DME when I was born — so I grew up in the business.
Where most kids rode bikes, I was fixing concentrators at age 10, delivering oxygen at 12, and doing DME deliveries at 16.

Ten years ago, we founded Encore Healthcare. At the time, I was working on the DME side and built an outcomes program that helped us expand from 10 counties in Tennessee to 26 states in under three years — going from 30 ventilator patients to over 5,000.

We proved DMEs could get paid for services and outcomes, not just equipment.

[00:03:00] Why Encore Was Created — Giving DME a Way to Prove Their Value

Most DME providers take great care of patients, but they can’t prove it. There were no systems designed to measure outcomes, track clinical impact, or show reductions in hospitalizations.

So we built Nexus, a platform that allows DME providers to:

• Manage respiratory patients
• Track outcomes in real time
• Show measurable reductions in cost and utilization
• Present that data to payers and health systems

For years we were early — probably five years too early. But now the industry has caught up.
Data and outcomes have become the focus everywhere.

Today, Encore likely has more respiratory outcomes data than any organization in the U.S.

[00:05:00] Is Encore a Tech Company or a Services Company? (Both.)

Zach:
Encore offers two models:

1. SaaS Model (Do-It-Yourself)

DMEs license Nexus and run their own respiratory program with their own clinicians.

2. Tele-Respiratory Model (Done-With-You)

We staff respiratory therapists and run the outcomes program for the DME under their brand — collecting the data, running the visits, and producing the outcomes.

Some of the largest players in the industry run on Nexus behind the scenes without anyone knowing. Others use it visibly to differentiate with physicians.

Not white-labeling Nexus allows DMEs to leverage our national data, peer-reviewed publications, and proven ROI.

[00:08:00] How Big Is Encore Today?

We’re now operating in all 50 states, serving 150,000+ patients, and working with:

• 2 of the top 4 national DMEs

• Many dominant regional providers

• A growing number of payers

Demand has exploded with the new NCD for ventilation, which requires a level of clinical oversight many DMEs aren’t prepared for.

Encore also just secured a COPD disease-management pilot with the state of Florida, funded directly by Medicaid — the result of years of outcomes data.

[00:10:30] Bootstrapped vs. Venture-Backed — Why Zach Chose Control

Zach:
I grew up in a family business that never took outside investment. Later, I worked in a VC-backed environment — fast-paced, high pressure, decisions driven by money rather than people.

As a pastor as well as a CEO, my philosophy is simple:

Do the right thing, and the money follows.

Bootstrapping allowed me to maintain control, prioritize people, and stay true to the mission — not chase investor timelines.

We’ve built deep, trusted relationships in DME by partnering with providers rather than forcing their hand through payer contracts.

[00:13:00] How Zach’s Faith Influences His Leadership

Wayne:
You might be the first CEO/pastor I’ve met. How does being a pastor shape your role as CEO?

Zach:
My faith influences everything I do. I’m a follower of Jesus — that’s who I am, not just something I do on Sundays.
Business is part of my ministry. I believe in leading with love, integrity, patience, and service.

What’s interesting is how many people in the industry tell me privately they share the same faith — they just never talk about it.

[00:15:00] Recognizing the Problem & Pioneering New Care Models

Encore’s roots go back to Zach watching his father and uncle pioneer the first ventilator programs in Tennessee nursing homes.

They didn’t wait for rules or billing codes — they wrote the rules.

That mindset shaped Encore:

• Keep going when others say no
• Create solutions even when reimbursement doesn’t exist yet
• Build models that show value and force the system to adapt

Zach pitched 90 payers before the first one said yes.
After that, momentum took off.

Consistency of vision made Encore possible.

[00:19:00] What People Get Wrong About Complex Respiratory Patients

Many assume:

• These patients are “too complex”
• Care is too hard to scale
• DMEs lack the resources to manage them

But when you standardize the workflow and use technology, the care becomes:

• Predictable
• Repeatable
• Scalable
• Measurable

The new ventilation NCD is revealing the divide:
Some DMEs see opportunity and expansion; others are pulling back in fear.

[00:21:00] The Future of Respiratory Care — AI, Telehealth, and Workforce Shortages

The biggest issue ahead: not enough respiratory therapists.

COVID accelerated retirements, and schools aren’t producing enough replacements.

If we continue doing care the traditional way, the system will collapse.

That’s why Encore has championed:

• Tele-respiratory care
• Technology-enabled workflows
• AI-supported clinical evaluation
• Standardized clinical paths
• Remote monitoring
• Automated reporting

Technology doesn’t cheapen care — it elevates it by making it consistent and scalable.

Care is moving home. Demand is rising. The workforce is shrinking.

Without tech, the math doesn’t work.

[00:25:00] The Industry Must Think Beyond Today’s Problems

DMEs often focus only on what’s directly in front of them — the next rule change, the next billing code, the next prior authorization headache.

But the winners will be those who:

• Make decisions based on 5–10 years out
• Invest in adaptable software
• Build automation into their workflows
• Stop solving problems by “throwing bodies at it”

Old software and manual processes aren’t sustainable.

Zach praises NikoHealth for being one of the easiest and most modern platforms to integrate with — exactly the type of foundation providers need to grow in the future.

[00:30:00] Smoky Mountain Symposium — A Conference Built for Post-Acute Care

Encore hosts the Smoky Mountain Symposium, now in its 16th year. It’s a 2.5-day event focused on:

• Respiratory care
• Sleep medicine
• Post-acute care transitions
• DME leadership and innovation
• It includes:
• 300–350 in-person attendees
• 150+ virtual attendees
• 30–40 vendors
• Collaboration with the Sleep Tech Podcast
• Beautiful Smoky Mountain backdrop

Dates: October 22–24
Website: encorehc.com

[00:34:00] Rapid-Fire Round

Live without coffee or Wi-Fi? – Coffee
Teleport or read minds? – Read minds
Sing instead of talk or dance instead of walk? – Dance instead of walk
Vegas or Redneck Vegas? – Redneck Vegas
Famous for a day or anonymous forever? – Anonymous
4×10-hour days or 5×8-hour days? – 4×10
Free sporting events or free concerts? – Concerts