MedPAC 2025: Key Takeaways for the HME Industry

Published in Member Communities on July 03, 2025

Tyler CoulanderBy Tyler Coulander, Market Strategy Manager, VGM & Associates

The June 2025 Report to Congress from the Medicare Payment Advisory Commission (MedPAC) offers critical insights into the evolving landscape of Medicare services. While the report does not focus exclusively on home medical equipment (HME) or durable medical equipment (DME), several areas touch on themes that are highly relevant to the industry’s future—particularly around home health care, Medicare Advantage (MA), and supplemental benefits.

Home Health Care Use in Medicare Advantage:

One of the most relevant sections of the report examines home health care use among Medicare Advantage enrollees. MedPAC found that MA beneficiaries receive fewer home health visits compared to those in traditional fee-for-service (FFS) Medicare. This discrepancy raises questions about access, care adequacy, and the role of equipment in supporting home-based services.

For the HME/DME industry, this trend suggests a need to:

  • Align with MA plans to ensure equipment is integrated into care pathways.
  • Demonstrate the value of equipment in reducing hospitalizations and supporting chronic care at home.
  • Advocate for transparency in how MA plans authorize and deliver home-based services.

Supplemental Benefits

The report also delves into supplemental benefits offered by MA plans, many of which are designed to support home-based and preventive care. These benefits may include services like in-home support, transportation, and wellness programs—many of which rely on or are enhanced by durable medical equipment.

However, MedPAC highlights a lack of transparency and standardization in how these benefits are reported and evaluated. For HME providers, this presents both a challenge and an opportunity:

  • Challenge: Difficulty in tracking how and when equipment is used under supplemental benefits.
  • Opportunity: A chance to partner with MA plans to quantify the impact of equipment on patient outcomes and cost savings.

Rural Healthcare Impacts

Another section addresses beneficiary cost sharing at critical access hospitals, recommending that cost sharing be based on Medicare payment amounts rather than hospital charges. While this recommendation is aimed at outpatient services, it indirectly supports greater affordability and access to care in rural areas—where home-based services and equipment are often essential due to geographic barriers. This could lead to increased demand for home-based equipment in rural settings and policy momentum toward reducing financial barriers for patients needing DME.

Industry Implications

The MedPAC report underscores a broader shift in Medicare policy: a move toward value-based, home-centered care. For the HME and DME industry, this means:

  • Greater integration with Medicare Advantage and home health providers.
  • Increased emphasis on data, outcomes, and cost-effectiveness.
  • Strategic positioning as essential infrastructure for aging in place and chronic disease management.

Conclusion

The June 2025 MedPAC Report doesn’t just reflect current Medicare policy—it helps shape its future. For the home medical and durable medical equipment industry, the message from this report is clear: adapt to the growing role of Medicare Advantage, embrace transparency, and articulate the value of effective, home-based care.

References

[1] June 2025 Report to the Congress: Medicare and the Health Care Delivery...


TAGS

  1. hme
  2. medicare
  3. vgm

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