08/18/2025
How the Proposed Medicare Competitive Bidding Program Affects End Users of Home Medical Equipment(DME companies)
Proposed Cuts to DME Providers Threaten Older Adults and Rural Health Access!!
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Executive Summary
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules for 2025–2026 that could reduce the number of Durable Medical Equipment (DME) providers by up to 50%. While the plan aims to cut costs through nationwide competitive bidding, it may have severe unintended consequences, particularly for older adults, rural communities, and underserved populations. These changes could undermine access, delay essential care, increase caregiver burden, and deepen healthcare disparities.
• CMS aims to cut DME providers by up to 50%, moving to fewer, nationwide contracts.
• This favors large national suppliers over local businesses.
• Smaller providers—often the only ones serving rural/underserved areas—may be squeezed out.
Impacts on Older Adults and Underserved Communities
🔴 Access & Wait Times
• Equipment delays can result in hospital readmissions, falls, and health deterioration.
• Past data shows that only 2.9% of high-risk diabetic seniors used therapeutic footwear, highlighting current underuse and gaps
🔴 Service Quality Decline
• Local providers offer personalized fittings, training, and on-site service—largely absent in national models.
• Familiarity with equipment brands and caregivers is critical for older adults’ comfort and safety.
🔴 Financial & Emotional Strain
• Families face increased out-of-pocket expenses, travel, or long waitlists.
• Damaged or unusable equipment exacerbates distress and caregiving challenges.
🔴 Disproportionate Harm to Rural & Low-Income Areas
• Many rural counties rely on just 1–2 DME providers.
• CMS cuts could create “DME deserts,” especially where transportation or broadband access is limited.
• Competitive bidding discourages suppliers from serving low-reimbursement zones.
Major Risks to Older Adults from DME Cuts...
1. 🚚 Delayed Access to Vital Equipment
2. 📉 Lower Quality of Care
3. 💸 Financial + Emotional Stress
4. 🏥 Higher System Costs
5. 🌄 Rural and Underserved Communities Hit Hardest
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🔍 Bottom Line
The CMS plan to reduce DME providers could save money, but it will likely:
• Increase delays, reduce access, and lower care quality
• Harm the very populations Medicare serves most: older adults, rural residents, and low-income individuals
• Exacerbate healthcare disparities without clear evidence of improving care outcomes
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Cost vs. Care Trade-Offs
Budget savings from the CMS proposal risk being outweighed by higher healthcare system costs:
• Increased hospitalizations due to preventable complications.
• More emergency care use.
• Greater caregiver burden and burnout.
• Infrastructure strain from limited DME logistics.
Medicare wants to restart a flawed program called “Competitive Bidding” that sets rates for home medical equipment (HME) & supplies by awarding a few contracts to the HME suppliers who bid the lowest – regardless of the true costs of providing quality care. In the past, this excluded 75% of suppliers from being able to provide care for end users & resulted in 37% HME locations closing across the country, leaving end users with fewer choices, longer wait times, or no access at all. After pausing the program due to problems, Medicare wants to restart it with changes that would make access even worse. If you or a loved one use HME & supplies, submit comments to voice concerns on the proposed rule for the new round of the bid program by the 8/29/25 deadline.
Recommendations (if you're advocating or writing a brief)
1. Pause or revise the competitive bidding overhaul.
o Conduct full impact studies, especially on rural access.
2. Protect local and community-based providers.
o Carve out rural exemptions or create minimum geographic coverage standards.
3. Prioritize patient-centered metrics.
o CMS should consider access, quality, and patient experience—not just cost.
4. Invest in rural DME infrastructure.
o Grants, incentives, or reimbursements to support service continuity in underserved regions.
5. Bridge the digital divide.
o Ensure that technology-enabled care doesn’t leave older or low-income patients behind.
SUBMIT COMMENTS BY 8/29
1)click link: https://www.federalregister.gov/documents/2025/07/02/2025-12347/medicare-and-medicaid-programs-calendar-year-2026-home-health-prospective-payment-system-hh-pps-rate
2) Click the green box that says “Submit a Public Comment”.
3) Enter your comment in the text box – or upload a file in the “+ Add a File” green box. Do not include personally identifiable information.
4) Under “Tell Us About Yourself”, choose either “An Individual” or “Anonymous”.
5) Check the box that you’ve read & understand the statement.
6) Click “SUBMIT COMMENT”.
This proposed rule would set forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this proposed rule proposes permanent and temporary behavior adjustments and proposes to recalibrate the case-mix weights...
