What's our DC ROI?
By Ike Isaacson & Dan Fedor
Updated 2:41 PM CDT, Mon August 3, 2026
Many businesses rely on the concept of ROI – return on investment – to evaluate whether their resources are being used effectively. The home medical equipment (HME) industry is no different. Over time, this principle has guided decisions on where to invest, whether in conferences, programs, travel, or advocacy. Some investments generate immediate results, while others take longer to pay off, but both are essential to sustaining a strong, stable industry.What sets this industry apart is that it does not operate like a traditional business. It is built on service, compassion, and a commitment to improving lives. That mission is what drives so many of us, even when the challenges are significant.
At the same time, our industry invests heavily in advocacy—engaging with legislators, educating them on the critical role we play, and working to ensure policies support patient access to care. These efforts matter, but they require patience, and the return is often not immediate.
That is why it’s important to look beyond conversations and focus on outcomes—specifically, how legislators vote on issues that impact our industry. Some legislators like to be called “champions of the industry” but do they deserve this title?
It’s easy for policymakers to express support in meetings or conversations. But real support is reflected in voting records. Votes determine funding levels, regulatory direction, and ultimately the ability of providers to serve patients effectively. Bills such H.R. 1 (OBBB), H.R. 8375 (Medicare Advantage Improvement Act of 2026) and many others have real consequences. They impact our businesses and, more importantly, for the people who rely on home-based care.
As an industry, we should be paying closer attention to those voting records. Understanding how elected officials vote on legislation affecting healthcare, Medicaid, Medicare, and home medical services provide a clearer picture of where they truly stand and if they are worthy of being called a champion of the industry. This information is accessible, objective, and far more meaningful than statements alone.Accountability matters. If we want to protect and strengthen the industry, we need to recognize and support those whose actions—through their votes—align with the needs of our patients and providers. Likewise, we should take note when decisions move in a different direction.
At the end of the day, advocacy is not just about being heard, it’s about results. One of the most direct ways to influence those results is through informed civic participation.
Sustaining the industry we care about requires all of us to stay engaged, pay attention to how decisions are made, and participate thoughtfully in the process, including when we cast our own votes.
Because ultimately, what matters most isn’t just what is said, it’s what is done.
Ike Isaacson is senior vice president of government and regulatory relations for VGM & Associates. Dan Fedor is director of reimbursement and education for U.S. Rehab, a division of VGM & Associates.
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