AAHomecare Survey Finds Significant HME Business Risks From Competitive Bidding

WASHINGTON—A new survey from the American Association for Homecare (AAHomecare) captured the real-world impact of the 2021 remote item delivery competitive bidding program round. The findings showed that the planned 2028 round would threaten patient access to care and products on a national scale, lead to large layoffs and pose a serious threat to business survival.

Based on Medicare claims data, AAHomecare estimates approximately 3,650 suppliers would be impacted by the 2028 remote item delivery (RID) competitive bidding program (CBP). A total of 306 companies, representing more than 1,500 locations, participated in the AAHomecare survey, providing a broad view of projected business responses. 

Key findings and the full survey results were released and include:

• Workforce reductions: 50% would lay off employees; more than one in three said they would eliminate at least half of their current workforce.
• Business viability risk: 47% anticipate significant risk to business viability, closing one or more locations, facing a high risk of going out of business, and/or closing entirely. Extrapolated across the 3,650 impacted suppliers, more than 1,700 durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) companies would face significant viability risk.
• Product category exits: 53% would exit one or more affected product categories, reducing supplier availability nationwide.
• Reduced service areas: 45% would reduce operations or shrink their service area, limiting geographic access to products and services, particularly in rural and underserved communities.
• Impact beyond Medicare: 71% report that the loss of Medicare revenue would also affect their ability to sustainably serve patients covered by other payers, showing the impact would extend well beyond Medicare Fee-for-Service (FFS).

These findings contrast with CMS’ Regulatory Impact Analysis for the CY 2025 Rule, which stated there would be “no economic impact” from the RID CBP.

This data makes clear the need to pause the competitive bidding program for further evaluation.

AAHomecare shared the data with the White House and Vice President’s office following a request for more information and said it appreciates the Administration’s continued engagement on this issue and welcomes the opportunity to discuss these findings further.

“We also want to thank the DMEPOS suppliers who participated in this survey,” AAHomecare said. “Your willingness to share data on your operations made this a credible, industry-wide picture of the RID CBP’s impact and gives AAHomecare the evidence we need to advocate on your behalf. Members should continue to reach out to your members of Congress to let them know how this program will impact you and share the survey results.”

To see the full results of the survey, visit here.