Penny-wise, pound-foolish mentality threatens home-based care 

CMS’s latest proposal to expand the competitive bidding program (CBP) to include ostomy, tracheostomy and urological supplies has sparked concern across the HME industry. But the issue goes far beyond these categories. As VGM’s Ike Isaacson put it: 

“To save pennies and turn around and spend multitudes of dollars is bad policy and irresponsible.” 

That sentiment applies to the entire CBP framework. The cartoon for our November issue captures the irony: a toddler in an “I ❤️ CBP” onesie gleefully counting pennies – a visual metaphor for CMS’s short-sighted cost-cutting. (If there had been room for it, we envisioned a second panel with the same toddler crying as dollars fly out the window behind them.) 

We considered another cartoon: a circus performer juggling multiple balls. Because that’s the current vibe in the HME industry. 

Providers are navigating a dizzying array of developments: 

• Policy pressures: CMS is expected to finalize a rule that not only expands CBP but also increases re-accreditation frequency from every three years to every year. 
• Legislative efforts: A Senate bill was recently introduced to extend the 75/25 blended Medicare reimbursement rate in non-bid, non-rural areas. 
• Trade uncertainty: A new national security investigation into medical imports could lead to tariffs, quotas or other restrictions by 2026, with the goal of reducing reliance on foreign supply chains. 
• Market shifts: M&A activity, joint ventures and preferred provider agreements are gaining momentum, as reflected in this month’s HME Newspoll. 

And that’s just the beginning. 

The HME industry has always juggled—new policies, shifting regulations, macroeconomic trends like labor shortages and supply chain disruptions—but under the current administration, the number of balls in the air feels unprecedented. 

What’s more, the long-standing message that, like Isaacson says, HME saves Medicare money by keeping patients at home, where care is less expensive, isn’t landing like it used to. This administration seems more focused on optics than outcomes. 

To their credit, stakeholders are adapting. They’re exploring new lobbying tactics, including polling, to reshape the narrative and make the value of HME resonate in different ways. 

So now, more than ever, in more ways than ever, the industry needs to evolve. It must.