All too often, home medical equipment (HME) becomes an afterthought in conversations around post-acute and long-term care.
But that’s starting to change as silos across the care continuum break down and as the broader health care landscape shifts toward value-based care. In fact, Paul Pino, chief growth and analytics officer for Integrated Home Care Services (IHCS), views HME as a “critical pillar” to improving health outcomes and controlling health care spend.
“We see a lot of people who are chronically living with conditions that require HME,” Pino, who’s also the co-founder of IHCS, said at the HME Business FUTURE conference in August. “If it wasn’t for HME and items such as glucose-oriented items, oxygen- and sleep-oriented items, etc., they wouldn’t be able to [recover] within the home setting. So when you think about the criticality of the category, we think it’s significant.”
“And we reference HME/DME as the unsung hero of the post-acute care space,” he added.
To some extent, HME’s “afterthought” status is tied to the industry’s negative past of fraud, waste and abuse, Pino explained. As HME providers have become more sophisticated and as bad actors have been weeded out from the industry, those perceptions have changed.
In some cases, a company like IHCS can go to bat for HME providers with prospective payer partners, too, highlighting an HME organization’s ability to quickly initiate services and improve quality of care.
IHCS coordinates home-based care services across a dozen states and Puerto Rico, working with health plans and at-risk providers, along with the patients and members those two groups serve. Its network spans more than 2,800 provider locations, according to its website.
In a given month, IHCS coordinates about 3.5 million home care units. About 50% of that total is HME-oriented.
“What we’ve done now is we’ve worked to contract with payers to be able to provide oversight, and understand and determine the medical necessity around the needs for HME,” Pino said at FUTURE.
“What we find across the board is that, from a value standpoint, HME/DME is constantly generating additional value,” he continued.
HME is also finding itself in the spotlight more as the health care system looks to control costs.
In the past, payers didn’t spend too much time thinking about HME because it was only a fraction of their coverage. Now, there’s a greater understanding of how downstream health care services impact costs upstream – and vice versa.
“When people fail to focus on lower-cost-of-care settings, they tend to have inflation and other costs in [higher-cost-of-care] settings,” Pino said.

IHCS executive Paul Pino at FUTURE 2024 in Nashville.
Overall, HME utilization has clearly increased since pre-pandemic times, according to Pino. Utilization per 1,000 members is up by about 20% or 25%. In comparison, home health care utilization is up 35% to 40% compared to the pre-COVID period.
“It’s up significantly,” Pino said. “It’s not trending perfectly with what you’ve seen on the home health space, but utilization is up significantly as a result of multiple factors.”
Looking ahead, Pino believes HME providers can make progress in value-based care conversations by focusing on timely service deliveries and their ability to promptly accept referrals.
“We can come up with alternative models based on providers that are able to meet a certain percentage of what’s referred to them,” he said. “And those models are not necessarily putting the providers at risk, but they are offering incentives with staffing components.”