While Part I of the HME Business executive outlook project (scan QR code to access the story on the HME Business website) examined the forces shaping the HME market in 2026 and emerging opportunities, Part II focuses on the challenges executives believe will be hardest to navigate in the year ahead.
Competitive bidding and reimbursement compression remain top concerns, not only for their financial impact but for the operational instability they introduce. In their replies, executives also pointed to payer-mix challenges, including Medicare Advantage and managed care, increased patient cost-sharing, and limited oversight of insurers’ decisions.
Staffing constraints, fragmented technology systems and difficulty modernizing while maintaining day-to-day performance were recurring themes, too.
Read on below to see what several HME leaders said would be the greatest challenges in store for 2026. HME Business edited the responses for style, length and clarity.
Note: Many of the perspectives in this piece were submitted before the U.S. Centers for Medicare & Medicaid Services (CMS) finalized its home health payment rule for 2026, including the expanded role of competitive bidding in DMEPOS categories, and also clarified competitive bidding timelines and product inclusions in subsequent guidance.
Rob Schlissberg, President, Cardinal Health at-Home Solutions
Of course, shifting reimbursement policy is no doubt on all our minds. While it’s a challenge that we are well-positioned to handle as a business, new policy implementations have the potential to really shake up how we’ve been operating as an industry.
We’ll all have to work together to make change and operationalize new ways of working quickly to preserve continuity of care for the patients and customers we serve. I know we have a strong desire to work collaboratively with our customers, the government and industry peers so we can all successfully implement changes in the year ahead.
If there’s one thing I know about all of us in the HME space – it’s that we aren’t afraid to roll up our sleeves and get to work. There’s not usually a challenge we can’t overcome. I remain as confident as ever in the future of home healthcare and HME.
Jay Wendt, CEO, Stance Health Solutions
Specifically for my business, the competitive landscape in California has changed and continues to evolve. Managing through and adapting to that change will be very important for Stance to be successful in 2026.
Jeffrey Baird, Attorney, Brown & Fortunato
The key challenge for DME suppliers will be to diversify their business model to take into account the uncertainty caused by CB and other cost-cutting measures. Ideally, the DME supplier will have multiple sources of income.
Those include traditional Medicare, traditional Medicaid, Medicare Advantage, Medicaid Managed Care, employer-sponsored group health insurance, cash-pay patients, the VA, TRICARE, workers compensation, and special federal and state governmental programs.
David Gelbard, Founder and CEO, Parachute Health
The biggest challenge across the industry is helping providers modernize in a way that is scalable and unified, not fragmented across disconnected point solutions.
Many organizations know they need to become more efficient, but the reality is that implementing change on top of an already stretched workforce is hard. The path to success will be simplifying transformation: connecting referral workflows end-to-end, reducing burden on staff, and giving providers better data to run their business. Demonstrating clear ROI and operational ease will be critical to building confidence and momentum.
Dan Fedor, Director of Reimbursement and Education, VGM & Associates/U.S. Rehab
For-profit private insurance in health care such as the Medicare Part C and MCOs. Their motive is profit for their shareholders – thus limited medically necessary HME, with no oversight of consequences.
We need Medicare for ALL as traditional Medicare, while not perfect, is the best payer for HME because it is not driven by profit. Greed is the main issue with our health care system in the United States. The health insurance companies are the middle man and have no positive impact on health care (outcomes) nor do they care.
Pete Yelkovac, President, Lifestyle DME Group
Nearly all industry providers face increased operational costs alongside economic and governmental policy uncertainties. In addition, patients’ policy deductibles are rising, and patients are also realizing that 20% coinsurance is a reality that will not be going away anytime soon.
Increased health care costs are a real challenge to the vast majority of patients who have to try to juggle expenses as part of their household budgets. Any challenge to patients is inherently a challenge to HME providers.
Regional and local HME providers can maintain patient loyalty and grow operations by establishing a top reputation for individualized service, rather than commoditized service. This approach is a differentiator.
