Build It Right From the Start: My 11-Step Framework for Healthcare Transportation — Even If You’ve Never Started a Business Before
Build It Right From the Start: My 11-Step Framework for Healthcare Transportation — Even If You’ve Never Started a Business Before
Written By- Coach Willena McGee- RN BSN
You got the van, the insurance, the approval… and now you have no clients. This article introduces my Build It Right From the Start™ framework and explains why preparing the “soil” of your business matters more than rushing to plant the seed.
Imagine this.
You’ve saved, sacrificed, and finally pulled the trigger:
The van is sitting in your driveway.
The commercial insurance bill has already made your stomach drop.
Your state paperwork is approved and your company is officially open.
You post a few “We’re open!” graphics.
You tell friends and family to spread the word.
You wait for the phone to ring.
Silence.
Days turn into weeks. Your savings account is shrinking. Family members are asking how the business is going. You’re wondering if you made a terrible mistake.
This is the moment so many transportation owners reach out to me saying:
“I did everything they told me to do. Why isn’t this working?”
The honest answer?
Because what “they” told you was only the surface-level paperwork, not the true foundation of a business.
Building a business is like preparing soil
I think of a healthcare transportation / NEMT business like a seed.
The vehicle is not the seed.
The paperwork is not the seed.
The broker contract is not the seed.
The seed is your vision to serve a specific type of client with a specific type of care.
Before you plant that seed, you have to prepare the soil:
Clear the rocks — confusion, myths, and bad advice.
Add nutrients — knowledge, strategy, and financial clarity.
Set boundaries — your values, your standards, and what you will or will not do.
If you throw your seed on hard, unprepared ground, you might see a little sprout for a moment… but the first storm will wipe it out.
That’s exactly what happens when people:
Buy a van before they understand their numbers.
Get insurance before they have a real plan to create revenue.
Launch a business before they’ve done any real market research or relationship-building.
It’s not that you’re lazy or not smart.
No one ever showed you what healthy soil looks like.
That’s why I created my Build It Right From the Start™ 11-step framework.
The 4 phases behind the 11 steps
To keep things simple, I organize the 11 steps into four phases:
Foundation – Your legal structure, business plan, and financial clarity.
Identity & Visibility – Your brand, niche, and message.
Compliance & Operations – Your paperwork, policies, and daily systems.
Revenue & Growth – Your offers, pricing, marketing, and relationships.
Most struggling owners have one thing in common:
They skipped straight to the tail end of Phase 3 (vehicles + insurance) and tried to jump into Phase 4 without ever truly building Phases 1 and 2.
In other words, they planted a seed without preparing the ground.
What happens when you skip the early steps
When you plant in hard soil:
Roots can’t go deep.
The plant fights for every drop of water.
The smallest storm can pull it out of the ground.
In business, skipping the early steps looks like:
Saying “yes” to any and every trip because you don’t know your actual cost per mile.
Running rides that barely cover fuel because you never calculated your real expenses.
Calling every facility in town but not having a clear niche or value proposition.
Feeling stuck in survival mode, hoping a broker or one “big contract” will magically fix everything.
It’s not that your dream is wrong.
It’s that your sequence is off.
You tried to harvest before you built roots.
What Build It Right From the Start™ actually covers
Without listing all 11 steps in detail, here’s what the framework is designed to help you do:
1. Clarify your vision and niche
Who are you called to serve?
Dialysis, oncology, rehab, neuro, complex care, mental health day programs, seniors, post-op, etc.
What problems are you solving for them and their families?
How does your service feel different from “just a ride”?
2. Choose the right structure and strategy
This includes things like:
Selecting the best business structure with your professional team (LLC, etc.).
Clarifying your roles if you have a partner or spouse involved.
Understanding the true cost of startup and setting realistic financial goals.
3. Build a business plan you actually understand
Not a 40-page document you never read again, but a roadmap that:
Explains your model, market, services, and pricing.
Helps you talk to lenders, partners, and regulators with confidence.
Keeps you from chasing every random idea on social media.
4. Map your numbers and funding options
We look at:
Startup capital (vehicle, insurance, operations, reserves).
Realistic revenue projections over 12–36 months.
Funding pathways like savings, lending, or partnerships that fit your situation.
This is where your dream meets math—so you’re not operating on “hope” alone.
5. Establish your brand and visibility
Before you worry about fancy ads:
Clear name, message, and visual identity.
A simple website or landing page that explains who you serve and how you help.
Basic online presence (Google, social, etc.) so people can actually find you.
6. Build compliance and operations the right way
This includes:
Understanding your state’s requirements and applications.
Creating basic policies, procedures, and documentation.
Setting up simple systems for scheduling, communication, and record-keeping.
It’s not about being perfect. It’s about being organized enough to grow.
7. Prepare for revenue and relationships
This is where we shift from “setup” to “serve”:
Designing service packages that make sense for your niche.
Pricing that covers your costs and pays you, not just the vehicle.
A basic relationship and networking strategy so you’re not just dropping off brochures and praying.
Those are the big rocks the 11 steps move you through—in order—so you’re not trying to build everything at once.
Healthcare transportation is a slow grower
One of the biggest myths I will fight every day of my coaching life is this:
“Once I get my approvals, the trips will just start rolling in.”
Healthcare transportation / NEMT is not a quick-growing crop.
It’s a slow grower with deep roots.
You’re building trust with:
Patients and families
Providers and facilities
Case managers and social workers
Payors and partners
Trust takes time.
You don’t just:
Hand a brochure to a dialysis clinic and magically become their preferred provider.
Drop business cards at a rehab center and instantly fill your schedule.
You:
Show up.
Follow up.
Demonstrate reliability over and over again.
Communicate like a professional, not a desperate vendor.
The relationships you build—through networking, community presence, and consistent service—are the root system of your business.
Networking is more than dropping brochures
Let’s be clear about this:
“Networking” is not driving around town tossing your cards at front desks.
Real networking looks like:
Attending local healthcare and business events and actually talking to people.
Asking intelligent questions about their needs, gaps, and frustrations.
Following up with a clear explanation of how your services help solve those problems.
Showing up consistently enough that when transportation is mentioned, your name comes up.
This is the part that separates:
Those who quietly close their LLCs in a year, from
Those who build names that carry weight in their city.
Even if you’ve never started a business before
Some of my favorite clients come to me saying:
“I know healthcare. I’ve never run a business. I just don’t want to mess this up.”
If that’s you, hear this:
You do not have to know everything today.
You do need a framework so you’re not reinventing the wheel.
You do need to be willing to grow into the CEO your business requires.
Build It Right From the Start™ is not a magic wand.
It won’t exempt you from hard days, learning curves, or tough decisions.
What it will do is:
Keep you from skipping the most important steps.
Help you understand what’s supposed to happen first, second, and third.
Protect you from the “I bought a van and now I’m stuck” story.
Healthcare transportation is not a fast grower.
But with the right soil, the right seed, and the right care, it can become a strong, steady tree that supports your family, your community, and your legacy for years to come.
If you’re ready to move beyond guesswork and start building a business that was designed to last, your next step is simple:
Start with the foundation. Build it right from the start.
