In brief: Quipt Home Medical buyout bid, ACO performance, skin substitute spend 

WILDER, Ky. – The tug of war between Quipt Home Medical and Forager Capital Management continues. Quipt has reportedly filed a lawsuit against Forager, one of its largest shareholders, and Forager has released a statement standing by its offer to buy Quipt for $3.10 per share in cash. 

Quipt in late August responded to Forager’s offer, saying it was only the latest in the firm’s “self-serving inferior and declining offers.” Quipt noted that Forager had previously offered to buy the company for $3.90 per share – and that was before the company acquired a DME provider from Ballad Health and entered into a joint venture to acquire a 60% ownership interest in Hart Medical. 

According to Cincinnati Business Insider, Quipt has now filed suit. 

Forager says it reduced its offer to reflect “the material decline in free cash flow and the board’s massively dilutive, self-serving equity grants,” as well as its share price following the news of its recent acquisitions. 

“The clear path to creating shareholder value is to negotiate a transaction with us, or any higher bidder,” Forager stated. “It’s now been 230 days since our initial proposal. Every day the board delays reduces the IRR for shareholders. That is, by definition, destruction of shareholder value.” 

During a recent call to discuss its latest financial results, Quipt said it now services more than 325,000 active patients through 160 locations in 27 states, with respiratory care comprising 75% of its product mix. 

2024 ACO performance surges: Higher savings, better quality, lower utilization 

WASHINGTON – Accountable care organizations (ACOs) in the Medicare Shared Savings Program achieved the highest rates of shared savings since the inception of the program, CMS has announced. 

For performance year 2024, 75% of ACOs out of a total of 476 – representing 80% of the 10.3 million assigned beneficiaries – are earning performance payments totaling $4.1 billion, the agency says. Medicare saved $2.4 billion relative to benchmarks, it says. 

Financial results 

• ACOs had higher savings per capita in PY 2024 compared to PY 2023, $241 vs $207 in net per capita savings and $643 vs $515 in gross per capita savings, respectively. Net per capita savings represent the savings for Medicare, whereas gross per capita savings are the savings shared by ACOs and Medicare. 
• Low revenue ACOs continue to outperform high revenue ACOs, generating $316 vs $175 net per capita savings. Low revenue ACOs are typically physician-led ACOs or are comprised of FQHC/RHCs, while high revenue ACOs are typically hospital-led. ACOs composed predominantly of primary care clinicians performed better compared to ACOs with fewer primary care clinicians, with $401 vs. $219 in net per capita savings. 
• ACOs that achieved shared savings had lower utilization compared to their benchmark across many categories of utilization, including hospital discharges, emergency department visits and skilled nursing facility stays. 
• 16 ACOs owed shared losses totaling $20.3 million. 

Quality results 

• Nearly all ACOs continued to meet quality reporting requirements, and adoption of all-payer digital quality measures increased from PY 2023. CMS continues to encourage ACOs to move toward reporting digital quality measures using electronically stored and transmitted health information, leveraging interoperability, reducing burden and improving efficiency. 
• Shared Savings Program ACOs helped more patients improve markers of good health, such as controlled blood pressure, hemoglobin A1c control (an indicator for diabetes), and depression screening with a follow-up plan, compared to 2023. 
  • Among ACOs that reported quality measures via the CMS Web Interface, the mean percentage of beneficiaries with adequately controlled high blood pressure increased significantly from PY 2023 to PY 2024 (from 77.8% to 79.49%). 
  • Among ACOs that reported CMS Web Interface measures, the mean percentage of beneficiaries with poor hemoglobin A1c control also declined significantly from PY 2023 to PY 2024 (from 9.84% to 9.44%). 
  • Among ACOs that moved toward reporting digital quality measures, and reported all-payer MIPS CQMs, significant improvements were seen from PY 2023 to PY 2024: 
    • The mean percentage of patients with adequately controlled high blood pressure increased (from 69.63% to 73.65%). 
    • The mean percentage of patients with poor hemoglobin A1c control declined (from 35.18% to 23.52%). 
    • The mean percentage of patients screened for depression and for whom a follow-up plan was documented increased (from 43.70% to 55.36%). 
• Nearly all ACOs outperformed similar types of physician groups on quality measures 
  • ACOs performed significantly better than comparable physician groups for screening for depression and follow-up plan (53.53% among ACOs vs. 44.42% among comparable MIPS groups,) and controlling high blood pressure (71.21% among ACOs vs. 67.82% among comparable MIPS groups). 
  • ACOs have performed consistently better than comparable physician groups on the patient experience survey measure, Getting Timely Care, Appointments, and Information, for every year that the survey has been fielded since 2019. 

As part of the CY 2026 Physician Fee Schedule Proposed Rule, CMS has proposed a number of changes to the Shared Savings Program, including reducing the length of time an ACO can participate in a one-sided model of the BASIC track to a maximum of five performance years, the length of the ACO’s first agreement period in the BASIC track’s glide path (if eligible), instead of a maximum of 7 performance years. FMI: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-proposed-rule-cms-1832-p-medicare-shared. 

USAging, BetterAge partner to increase community support for aging Americans 

WASHINGTON and SAN FRANCISCO – USAging, the national association representing Area Agencies on Aging and Title VI Native American Aging Programs, has partnered with BetterAge, a digital health platform, to launch a national effort aimed at transforming the way older adults are supported in communities across the country. The collaboration equips agencies to rapidly capture critical health and well-being data; identify risks early; and deliver personalized, preventive support that connects older adults to the right local services and improves community health outcomes. “Given the nation’s rapidly increasing aging population, our members are being asked to do more than ever – with fewer resources and growing complexity,” said USAging CEO Sandy Markwood. “This partnership is about providing our agencies with the tools they need to deliver more personalized, efficient and effective support to older adults. BetterAge makes it possible to pair local knowledge with powerful digital tools, helping us meet older adults’ needs in the moment and help them prepare for the future.” BetterAge is already in use in pilot programs across several states and will continue to expand nationally in 2026. 

OIG pushes for payment reforms for skin substitutes 

WASHINGTON – Medicare Part B expenditures for skin substitutes have skyrocketed over the last two years, surpassing $10 billion annually by the end of 2024, according to a new report from the Office of Inspector General (OIG). The increase in expenditures was driven by both increased utilization and higher prices, the report says. The OIG also found: 

• Despite Medicare Advantage having more than half of all Medicare enrollees, utilization and expenditures for skin substitutes under Medicare Advantage were just a fraction of utilization and expenditures under original Medicare. 
• Among enrollees with a skin substitute claim, costs for those reportedly treated at home were four times as high as those treated in an office setting. 

The OIG says the factors that may be driving these trends include: 

• The ability of manufacturers to quickly bring new skin substitutes to the market compared to typical products paid using ASP; and 
• Financial incentives such as spread pricing that make certain products more attractive to providers. 

“Action is urgently needed to rein in the massive increases in Medicare Part B spending for skin substitutes,” the OIG stated. “OIG’s findings illustrate the critical need for payment reforms that address fraud, waste, and abuse in Medicare skin substitute billing. As policymakers consider options, any solutions should ensure that Medicare enrollees continue to receive appropriate care while removing incentives for inappropriate and even fraudulent billing. CMS has recently taken steps toward addressing these concerns.” 

FMI: https://oig.hhs.gov/reports/all/2025/medicare-part-b-payment-trends-for-skin-substitutes-raise-major-concerns-about-fraud-waste-and-abuse/ 

NCPA leads 134 groups in pushing for PBM reforms 

WASHINGTON – The National Community Pharmacists Association (NCPA) has sent a letter to the leadership of the House of Representatives and the Senate on behalf 134 organizations representing patient groups, health care providers, employers, business groups and union workers urging them to pass pharmacy benefit manager (PBM) reforms. “The American public is tired of losing access to their local health care providers and of paying too much out-of-pocket for the medicines they need,” said the groups. "Pharmacists are some of the most accessible and trusted health care professionals in America, with patients—particularly in rural and underserved communities—reliant on their training and expertise.” The groups are asking House Speaker Mike Johnson (R-La.), Senate Majority Leader John Thune (R-S.D.), House Minority Leader Hakeem Jeffries (D-N.Y.), and Senate Minority Leader Chuck Schumer (D-N.Y.) to pass the PBM Reform Act (H.R. 4317) and two companion bills in the Senate, the Protecting Pharmacies in Medicaid Act (S. 927) and the Patients Before Middlemen Act (S. 882). The bills would: 

• Ban spread pricing in Medicaid, a practice that allows PBMs to overcharge state prescription programs billions of dollars 
• Require PBM contracts with pharmacies in Medicare Part D to include reasonable and relevant terms 
• Delink drug prices in Medicare Part D from PBM revenues 
• Mandate that negotiated savings between insurance plans and drug makers be passed on directly to employers, workers and their families 
• Promote price transparency for employer health plans, with regular detailed data reporting on prescription drug plan spending 

“We urge you to prioritize PBM reform this fall and ensure these bipartisan efforts are enacted into law without delay,” said the groups. “Immediate action is needed to address these harmful practices. Americans deserve and expect protection from inflated prescription drug costs, from forced pharmacy closures, and from barriers to their pharmacy of choice that result from PBM tactics.”   

• Related: American Medical Associations says PBM markets are at risk of harming patients. 

Numotion launches updated website with customer in mind 

BRENTWOOD, Tenn. – Numotion has launched an updated website, www.numotion.com, to make connecting with the company faster, easier and more intuitive. The company says the redesigned website reflects its commitment to customer experience, accessibility and innovation in serving the mobility and independence community. “At Numotion, everything we do starts with the customer in mind,” said Bret Barczak, chief marketing officer of Numotion. “This new website is more than just a facelift, it’s about ensuring that anyone who engages with us online has a simple, accessible and meaningful experience. It gives us a powerful platform to keep our customers informed on the latest ways Numotion is working to better serve them, as well as better share our mission, our services and the incredible impact of our employees and customers in the communities we serve.” Key enhancements of the website include: 

• Accessibility first: Designed to be inclusive and user-friendly for all visitors 
• Modern, mobile-friendly design: Improved navigation and faster load times across devices, creating a seamless experience whether on desktop, tablet or phone 
• Improved connections: Highlights how Numotion supports customers, health care partners and both current and future employees by making information and resources 

Numotion has more than 150 locations and serves more than 500,000 people annually through its family of brands. 

Cardinal Health invests in ‘must have’ distribution centers in Texas, California 

DUBLIN, Ohio – Cardinal Health has announced the opening of its newest distribution center in Fort Worth, Texas – a facility solely dedicated to its at-Home Solutions business, which provides medical supplies to more than 6 million people annually in the United States. The company has also announced that it will break ground on a new distribution center in Sacramento, Calif., this fiscal year that will also be dedicated to the at-Home Solutions business. “Investing in our supply chain is not a ‘nice to have’ – it is a must-have,” said Jamie Deist, senior vice president of Supply Chain for at-Home Solutions. “We will always prioritize what is needed to ensure that our distribution network is built with our customers’ needs in mind. We’ve been intentional as we design our supply chain of the future, being extremely selective of the robotics and automation technologies that enhance our ability to get supplies shipped to patients more quickly and efficiently. No doubt this focus led to what has been the best year on record in at-Home Solutions’ history for warehouse service levels, quality and safety.” The new 340,000-square-foot distribution center in Fort Worth will ship about 10,000 packages per day directly to people’s homes across the country. In just three years, at-Home Solutions has added more than 750,000 square feet to its nationwide distribution network with three new buildings in Ohio, South Carolina and now, Texas – all equipped with the latest robotics and automation technology. Cardinal anticipates the new distribution center in Sacramento to be fully operational in the summer of 2027. 

Indie pharmacy owners are wary of drug program 

ALEXANDRIA, Va. – Nearly 20% of independent pharmacists won’t stock drugs in the Medicare Drug Price Negotiation Program and another 67% might not participate, according to a new survey from the National Community Pharmacists Association (NCPA). “Independent pharmacists want this program to work, and they want to participate,” says NCPA CEO B. Douglas Hoey. “But the program must be implemented in a way that makes business sense or independent pharmacies won’t be able to participate to help make the program successful.” The survey was conducted from Aug. 15-21 and was sent to about 10,450 independent pharmacy owners, with 405 responding. Additional results from the survey: 

• When asked if they have enrolled in the Medicare Transaction Facilitator (MTF), 39% stated yes, their pharmacy/all their pharmacies were enrolled, 31% stated no they have not begun the enrollment process, and 22% stated no but they have begun the enrollment process. The remainder of respondents stated that they began but gave up (4%), they haven’t and do not know what MTF is (4%) or that they do not participate in any Medicare Part D network (0.2%). 
• When asked if they have declined one or more PBM contracts for 2026, 47% stated yes, with the majority of those (62%) being from Express Scripts. 
• 87% stated that they have not finalized all their contract year 2026 Part D contracts and do not know which plans they will be participating in. 

NCPA shared the survey results in a letter to Mehmet Oz, head of the Centers for Medicare & Medicaid Services (CMS). 

OPGA names Fanny Schultea 2025 O&P Woman of the Year 

WATERLOO, Iowa – The Orthotic and Prosthetic Group of America (OPGA) has announced that Fanny Schultea, MS, MSed, CPO, LP, FAAOP, executive director of the Orthotics and Prosthetics Foundation for Education and Research, has been selected as the 2025 O&P Woman of the Year. The award was presented to Schultea during the AOPA National Assembly on Sept. 4. “Thank you to VGM Group, OPGA and Össur for this platform and the extraordinary opportunity to share with the O&P community the vision behind my work with the O&P Foundation,” Schultea said. “To empower our community to reimagine not just how we deliver care and how we train the next generation, but how we use data to drive better outcomes, and how we elevate voices that have long been underrepresented in research, education and clinical practice.” Schultea is a certified ABC Orthotist/Prosthetist and a Fellow with Distinction of the American Academy of Orthotists and Prosthetists (AAOP). Prior to her current role, she served as an assistant professor in the Baylor College of Medicine program in Houston, Texas, and as director of AAOP’s O&PiQ. She continues her service to the profession with the Limb Loss and Preservation Registry (LLPR) on the Scientific Committee. She is passionate about knowledge translation, health care quality, access and innovation in O&P clinical care. 

Rhythm Healthcare opens Atlanta facility for coast-to-coast distribution 

NEW YORK – Rhythm Healthcare has officially opened the doors to its new 60,000-square-foot distribution center in Atlanta, in a move that the company says accelerates delivery, streamlines operations and supports sustainable growth for its HME provider partners. The new center complements Rhythm’s existing 50,000-square-foot center in Corona, Calif., strengthening its national distribution network and reinforcing a coast-to-coast commitment to timely, reliable services. “This is a huge step forward for Rhythm,” said COO Mitch Yoel. “We are expanding rapidly, and this facility allows us to scale with purpose – staying laser-focused on what matters most: our customers. It is about meeting needs, exceeding expectations and doing it all with speed and heart.” Rhythm says the center in Atlanta, which is strategically located to enhance service across the Southeast and beyond, boasts optimized logistics. The company moved into the center in June and implemented a new warehouse management system there on Sept. 1. 

• Related: Rhythm Healthcare launches in Europe, Canada 

sovaSage unifies solutions as part of new rebrand 

PITTSBURGH – sovaSage has announced a rebrand that it says underscores its evolution as a SaaS innovator. The rebrand includes a new tagline – “Guided by Data. Driven by Care.” – along with renamed product offerings that the company says align with its mission to optimize patient outcomes and streamline provider workflows. “Our brand refresh communicates who we are today: A company that harnesses advanced data science and clinical insight to drive extraordinary outcomes in sleep health,” said William Kaigler, founder and CEO of sovaSage. “We are proud to now clearly present our solutions under a unified, modern identity that emphasizes not only our purpose but the mission we share with our customers.” sovaSage says it offers a fully integrated, AI-powered platform that guides patients from mask selection to long-term therapy success. All products now carry the “sova” prefix: 

• sovaFit: AI-powered mask fitting solution for precise, patient mask selection 
• sovaStart: Workflow automation that accelerates onboarding via telehealth support, AI, education and live intervention 
• sovaGuide featuring Jeanie: AI PAP coach, real-time patient communication, encouragement and escalation pathway to live coaching when needed