(More) solid middle

The data's starting to trickle in for this year's State of the Industry Report (keep an eye out for it online in December!) and at least one of piece of data isn't looking so bad.

Here is the breakdown of the number of HME companies by how much they billed Medicare for DMEPOS in 2017:

<$300K:                 80,291

$300K to $1M:        3,877

$1M to $3M:           1,093

$3M to $10M:          202

>$10M:                  54

In 2016, the data looked like this:

<$300K:                 81,286

$300K to $1M:        3,679

$1M to $3M:           921

$3M to $10M:         152

>$10M:                  55

As you can see, the number of HME companies that are really small and really big decreased (though only by 1 for the >$10M companies), but the number of companies that are in the middle increased, with the biggest increase for the $300K to $1M companies.

That the biggest increase is in the $300K to $1M companies is a little surprising, considering all the consolidating going on in the HME industry. It's hard to make the current Medicare climate work when you're that small, but maybe these companies are hyper-specialized?

These increases follow a steady decline in the number of HME companies, pretty much across the board, since 2011, when Medicare kicked off its competitive bidding program.

Let's take the $3M to $10M companies as an example:

2011: 209

2012: 229

2013: 184

2014: 173

2015: 172

2016: 152

2017: 202

So for these companies, we actually see a bump in 2012, after Round 1 of competitive bidding, but starting in 2013, when the program spread to substantially more areas, it was downhill from there until 2017.

In fact, when you look at this seven-year spread, $3M to $10M companies are actually nearly back to their 2011 levels.

Stay tuned—there's more where this came from.