The number of providers who bill Medicare $10 million or more is up. So what?


The data is starting to trickle in for our annual State of the Industry report.

One of the pieces of data we feature in the report each year is the number of DMEPOS suppliers that bill Medicare in four different categories: less than $300,000; $300,000 to $1 million; $1 million to $3 million; $3 million to $10 million; and more than $10 million.

With competitive bidding driving consolidation and other changes to the HME industry, this is always interesting data to analyze, especially compared to years past.

It looks like for 2011 compared to 2010 the number of providers that bill Medicare in all categories but one decreased:

Less than $300,000:  -0.04%

$300,000 to $1 million: -4.2%

$1 million to $3 million: -1.9%

$3 million to $10 million: -8.3%

More than $10 million: 9.5%

At first blush, this is a little disappointing. Last year, when we compared 2009 to 2010, we saw a nice little increase in the number of providers in two categories: $1 million to $3 million and $3 million to $10 million. I thought this was a good sign. While the number of providers billing Medicare less than $1 million has been declining steadily for the past few years, I’ve always thought that those were companies that were providing HME as an aside. But $1 million to $10 million? Those are probably some good-sized mom-and-pop companies and maybe even some smaller regional companies.

I’m not quite sure that my theory extends into 2011. Providers in the $1 million to $3 million category saw a small decrease and those in the $3 million to $10 million category saw a more significant decrease.

But wait a minute, the number of providers in the $10 million and up category was the one and only gainer in 2011. What's more: The providers in this category grew from 46 in 2008 to 69 in 2011, a 50% increase. When you consider that national companies like Apria bill Medicare for more than $1 billion in one year, the fact that the number of providers in this category continues to increase may be the strongest sign yet that regional companies are on the rise.

Anecdotally, based on some of the recent stories we’ve run in HME News, that certainly holds true.