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What would you do if a loved one was unable to have access to much needed oxygen, mobility equipment, or other home medical devices that allow for independent living? For thousands, the extreme reduction of health care providers puts many beneficiaries and care givers at a loss for answers. Unfortunately, care givers are being forced to take loved ones to hospitals and long-term facilities much sooner than what was planned.

The following article, written by home health care industry expert Mike Mallaro, outlines how flawed federal health care policies are forcing home care and home medical equipment providers to consolidate or close their doors, severely reducing patient choice and access to much needed care.   



By Mike Mallaro, CEO, VGM Group, Inc.

Flawed federal government policies are forcing a dramatic consolidation of health care providers across the nation. This consolidation is greatly reducing competition among providers, reducing patient choice, and severely limiting patient access to needed health care. The most significant consolidation is occurring in home care and home medical equipment, where government policies have been particularly aggressive in forcing consolidation.


In the past three and a half years, the number of home medical equipment suppliers and the number of locations has declined by 38 percent. This is a staggering downsizing of suppliers in any environment. This consolidation is even more egregious when considered in the context of a growing population of seniors brought on by the aging of the baby boom generation. The frail elderly and the disabled are the populations that rely upon home medical equipment suppliers to maintain quality of life. Consolidation is occurring across the health care continuum. Over the past five years, hospital system consolidation has occurred at a higher rate than in any other five-year period in history. Over the three-year period from 2012 to 2015, 12 percent of all physicians in the U.S. went from an independent practice to being employed by a health system. That’s 46,000 docs consolidating into health systems in just three years.

Drilling deeper into the home medical equipment consolidation provides a clear correlation between federal policy on the inaccurately named competitive bidding and consolidation. In the 10 most populous states, where competitive bidding is focused, there was a 47 percent reduction in the number of HME suppliers over three and a half years. In the 15 lowest populated states, where competitive bidding was largely absent, there was an 18 percent reduction in suppliers over the same period. That tells us that a combination of federal policy changes and economic realities caused a significant consolidation, 18 percent, in home medical equipment suppliers. But further, competitive bidding alone, the most deeply flawed of policies, caused a consolidation of nearly 30 percent of suppliers in impacted areas. And, to be clear, that’s a consolidation over a very short window of 42 months.

Consider this: New Jersey, California, New York, Illinois, and Connecticut each lost over half of their HME locations in just 42 months. In the 15 least populated states, more than 200 HME business locations have shuttered in this same short period. That means over 200 rural communities lost their access to a medical equipment supplier.

Competition is good for the consumer, it gives them choice, and it forces competitors to provide exactly the things consumers want in order to win their trust and their business. Consolidation eliminates competition and eliminates patient choice. It has robbed patients of local access as many communities that once had access to providers no longer have that local access. We must all advocate for reversal of federal and state policies that force consolidation and harm providers and patients.

Lost Store locations in just 42 months

Large States

California                   734
New York                   656
Texas                          493
Florida                        387
New Jersey                 288
Illinois                         392


Tennessee                 169
Alabama                     58
Mississippi                 54
Arkansas                    55
Georgia                      291
South Carolina          84
North Carolina          294
Virginia                       115

Industrial Midwest

Michigan                    236
Ohio                            262
Wisconsin                  76
Indiana                       95
Minnesota                  76
Iowa                            45

Great Plains

Nebraska                    28
Kansas                        59
South Dakota             9
North Dakota             3

Pacific Northwest

Washington                69
Oregon                        56
Idaho                           24
Montana                     15

What can you do to help?

Send us your stories about issues you’ve had getting or helping someone get needed home medical equipment and supplies. Everyone deserves access to the equipment and supplies needed to live a healthy, independent life. At People for Quality Care, we can connect you with the resources you need to help protect patient access. Let’s work together to contact Congress and share how critical it is to ensure our loved ones receive the services they very much deserve. Click here to join the fight.     


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