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Forced Consolidation Damaging Healthcare

Forced Consolidation Damaging Healthcare

Image of Elderly person's hands on cane Flawed federal government policies are forcing a dramatic consolidation of healthcare providers across the nation. This consolidation is greatly reducing competition among providers, reducing patient choice and severely limiting patient access to needed healthcare. The most significant consolidation is occurring in homecare 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%. 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 which rely upon home medical equipment suppliers to maintain quality of life. Consolidation is occurring across the healthcare continuum. Over the past five years, hospital system consolidation has occurred at higher rate than in any other five year period in history. Over the three year period from 2012 to 2015, 12% of all physicians in the US 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% reduction in the number of HME suppliers over three and a half years. In the fifteen lowest population states, where competitive bidding was largely absent, there was an 18% 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%, in home medical equipment suppliers. But further, competitive bidding alone, the most deeply flawed of policies, caused a consolidation of nearly 30% of supplier 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 which force consolidation and harm providers and patients.

Store locations LOST in just 42 months

Large States California 734 New York 656 Texas 493 Florida 387 New Jersey 288 Illinois 392 South Tennessee 169 Alabama 58 Mississippi 54 Arkansas 55 Georgia 291 South Carolina 84 North Carolina 29 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


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