Nobody wants you in the hospital. You don't want to be there. Insurers don't want you there. The hospitals, which need the beds, don't want you there. With so many forces pushing you out the door, there should be ample business opportunities for Michael Visnich and his company, Quality Assured Services Inc. (QAS) of Orlando, Fla., who are helping people care for themselves from home.

QAS, founded in 1997, directly markets and distributes home versions of hospital lab tests to consumers, doctors, and home health-care organizations. The company does far more than just ship equipment, though. QAS has developed proprietary software that helps relay information between doctors and patients over the Internet. It offers 24-hour technical support and also has nurses on staff to train customers on the devices. Additionally, QAS helps get the cost of the equipment covered by a patient's insurance carrier by establishing medical necessity.

Visnich, president and founder of QAS, says his business model is meant to capitalize on several trends he watched develop during his more than 20 years in the pharmaceutical and medical distribution industries. First is the escalating cost of health care.

"The most expensive care you can deliver is care administered in a hospital," he says. "We are involved in the shift from hospital care to care at 'alternate sites,' like physician clinics and home health care. Lots of treatments are moving this way. Even surgery is being done in clinics."

While costs are forcing things to be done faster, computerization is allowing things to be done more simply.

"We're focusing on the fact that technology is making things easier to use, and therefore, more accessible to people," says Visnich.

Following in the footsteps of technological advances is the increasing importance of the Internet, which Visnich says allows people to be more involved in their own care, something they've wanted for some time.

"In the early days of the Internet, more than half the people online were looking for health information," he says. "It's probably the same or more now."

Visnich has used these trends to build QAS into a company that's made the Inc. 500 for the past three years (#151 in 2004, #127 in 2003 and #208 in 2002). While diabetes' testing is the largest -- and most competitive -- market, QAS has made a conscious effort to avoid it, focusing on relatively untapped areas like anticoagulation.

"The first thing we got into was helping monitor people who are on blood thinners," says Visnich. "The medication is considered to be dangerous in some ways. In reality, it's not. It just needs close monitoring."

Before point-of-care and home-testing, treatment for such patients would involve a doctor's visit, where blood would be drawn and then shipped off to a lab. The results would find their way back to the doctor's office in a couple of days, by which point the patient's blood condition may have changed, according to Visnich. With home-testing, even the doctor's visit is eliminated.

"There are a lot of things that patients can do themselves and we want to help them do that," says Visnich.