Viewpoints

Editor's note: Questions about competitive bidding continue to surface throughout the HME industry. As discussions intensify and the program's start nears, AAHomecare's Cadie McGonagill discusses why accurate cost modeling is critical when evaluating bids and payer contracts. DMEPOS suppliers face a common problem, whether they’re preparing for CMS's competitive bidding program (CBP) or negotiating with a managed care payer: many don’t know their true cost to deliver...

Fifteen years of value-based care panels. Walk any trade show floor and you'll hear it a dozen times before lunch. Yet nearly every dollar in HME still moves the way it always has: per unit shipped, per month rented, whether the patient got better, got worse, or ever took the equipment out of the box. I've stopped believing we're doing it wrong. I believe the structure of the payment system itself is the problem. "Value-based" describes how a payment is calculated. "Earned"...

An estimated 1 billion people worldwide are living with obstructive sleep apnea (OSA), yet approximately 85% remain undiagnosed. This matters because undiagnosed OSA can significantly impact patients’ quality of life and increase the risk of other conditions like hypertension, heart disease and stroke. While these figures are staggering, innovations in consumer wearables are creating an opportunity to bridge this gap – not as a replacement for medical-grade diagnosis, but as a catalyst...

A UPIC contractor pulls thirty of your claims for review. Twelve fail documentation. That is a 40 percent error rate. The disallowed dollars on those twelve claims might total twelve or fifteen thousand. Most providers brace for that number, write the check, and move on. Then the demand letter arrives applying that 40 percent rate to the entirety of their billing during the audit window. Twelve months of paid claims. Four hundred thousand dollars. Sometimes more. That is extrapolation. It is...

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...

When Managing Editor Theresa Flaherty and I sat down to brainstorm ideas for the cartoon for the June issue, we made a conscious decision to steer clear of the usual suspects: Medicare, CMS Administrator Dr. Mehmet Oz, and the industry’s ongoing regulatory pressure points – competitive bidding, supplier moratoriums, fraud. Those topics have fueled more than a few recent cartoons, and for good reason. But this month, we wanted to take a step back. Instead, we landed on another...

Going into Medtrade in March, I assumed the biggest topics of conversation would be CMS’s next round of competitive bidding and its new moratorium on new supplier numbers. Those issues were certainly discussed, but by far the most dominant – and most charged – topic on the show floor was the accelerating use of benefits managers and third‑party administrators to manage durable medical equipment products and services. Just prior to Medtrade, we published a story on BlueCross...

The heat outside Medtrade in Phoenix this year – intense, even by local standards – had a certain symmetry with what was happening inside the Convention Center. The industry’s challenges are very real, very present, and yes, very “hot,” but they seemed to thaw under a positive buzz on the show floor.   And let’s be clear: There’s plenty to worry about in DME right now.   • The freeze on new Medicare enrollments. • Benefits...

The HME industry kicked off the new year much like it ended the last – focused on Medicare’s competitive bidding program (CBP). The next round of CBP is officially underway, and its impact will be significant. Although CMS didn’t finalize its plans until a Nov. 28 rule, competitive bidding skyrocketed to the top of our 10 most-read articles of 2025: No. 2 CMS moves forward with national competitive bidding No. 6 Next round of bidding takes shape: CMS proposes new rules,...

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...