A Note From the President: Forecasting 2025—How Did We Do?

Published in Member Communities on December 03, 2025

By Lindy Tentinger, President, VGM & Associates

At the start of this year, we released "VGM Playbook: Forecasting 2025" to help providers anticipate trends and prepare for change. Now, as we close out 2025, it’s time to look back at what we predicted—and how those forecasts shaped the year.

What We Predicted

The playbook highlighted several key themes for 2025:

Competitive Bidding Would Return
CMS was expected to reintroduce competitive bidding, creating pricing pressure and requiring providers to rethink product strategies.
Technology and AI Adoption Would Accelerate
Automation and AI tools were forecasted to become essential for improving efficiency, compliance, and patient engagement.
Cybersecurity as a Top Priority
Rising digital threats meant providers needed to strengthen data protection and invest in robust security measures.
Continued Marketplace Shifts and Consolidation
Ongoing mergers and acquisitions were predicted to reshape the industry, pushing smaller providers toward partnerships and diversification. We anticipated narrowing payer networks and more selective contracting.
Need for Providers to Diversify and Innovate
To remain competitive, providers were encouraged to expand into higher-margin services, retail offerings, and subscription-based models.
Need for Evolving Leadership
Human capital trends pointed toward transparency, adaptability, and prioritizing mental health, with a focus on building resilient, engaged teams and cultures that embrace change.
HME Market Growth
Despite challenges, the market was expected to grow, driven by aging populations, increased demand for home-based care, and innovation in respiratory and sleep therapy.

How It Played Out

Competitive Bidding: CMS announced the next round of national competitive bidding, set to impact providers in 2026 and beyond.
Technology and AI: Providers embraced automation and AI-driven tools to improve efficiency, compliance, and patient engagement. We saw many new technology companies and offerings enter the industry. A couple of the biggest challenges noted throughout the year from providers were implementation and change management.
Cybersecurity: Heightened awareness and investment in data protection became essential as threats evolved. We still have a long way to go here.
Consolidation: M&A activity in HME was robust compared to prior years, driven by the appeal of home-based care, sleep and respiratory growth, and complex rehab technology segments. Private equity and strategic buyers remained active, viewing HME as a growth market fueled by aging populations and demand for home-based care. Many payers tightened networks and, in some cases, canceled contracts to shrink their provider panels.
Growth in Sleep and Respiratory: PAP therapy and compliance programs surged, creating new revenue opportunities without adding headcount.
Leadership and Culture: If there is an area overall that feels lagging, this is it. Organizations in all markets must invest heavily in change management and leadership development to support teams through transformation. Mental health and employee engagement must become central to retention strategies.
HME Market Expansion: Demand for home-based care continued to rise, validating predictions of market growth and creating opportunities for providers to innovate.

If you haven’t revisited the playbook recently, it’s worth another look as you plan for 2026. Log into the portal to access the playbook at www.vgm.com/playbook.

What’s Next: Preparing for 2026

With diabetic and other commodity supplies likely consolidating under competitive bidding, smaller providers must pivot to higher-margin, service-driven models:

Specialization in complex care (CRT, ventilator support, custom mobility)
Sleep therapy & respiratory programs (CPAP resupply, mask fitting)
Home dialysis (Capitalize on existing infrastructure)
Home accessibility & aging-in-place (ramps, stair lifts, bathroom safety)
Retail & wellness diversification (cash-pay mobility and wellness products)
Subscription & service bundles (maintenance plans, concierge support)
Shared services & partnerships (billing, logistics, compliance networks)
Technology-enabled care (remote monitoring, telehealth, AI-driven claims)

Practical moves for the network reality:

Map your payer mix and identify network gaps that materially affect access.
Build and document a payer-ready value proposition: access, speed to service, quality metrics, cost control, and patient satisfaction.
Tighten your unit economics and RCS processes so you can negotiate from facts, not hope.
Where appropriate, evaluate aggregator/platform participation using a disciplined margin and service-level review.
Strengthen referral relationships and patient experience to create pull-through demand across contracts.

Want to Get Real?

If you haven’t yet, check out the latest IM: Unfiltered episode released on November 17, where Ike Isaacson and I dive into the incredible impact one person can make, and that one is you. Join us as we challenge you to turn intention into action and share the stories that move us all. Whether it's going the extra mile for a patient, supporting a family in a moment of need, or perhaps just starting in your own home, your story matters. These are the moments that fuel advocacy, connection, and purpose. Watch here or listen here.

As we look to 2026, our focus is clear: helping you thrive in a rapidly evolving healthcare landscape. Our industry experts are already hard at work on "VGM Playbook: Forecasting 2026," set to launch in early Q1. Stay tuned for their insights on what’s ahead.

Thank you for being part of VGM. From all of us here, we wish you and your loved ones a joyful holiday season and a happy new year!

Lindy Tentinger
President, VGM & Associates

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