Philip Parks (left), Yelena Brusilovsky and Todd Squilanti at HME Business FUTURE in Dallas.
What is the future for home-based health care, and how will the home medical equipment (HME) industry shape it?
That was the heart of the matter at the 2025 HME Business FUTURE conference, as HME providers, service vendors and other industry stakeholders came together at the J.W. Marriott Dallas Arts District, Sept. 15-17, in Dallas, Texas.
The industry, of course, awaits a final rule that will redefine Medicare competitive bidding for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) — a stark reminder that HME professionals face many influences outside their control.
But attendees also talked about actions the industry can take now to improve outcomes for themselves and the patients they serve.
In the conference’s first featured panel, Yelena Brusilovsky (Cardinal Health), Philip Parks (AdaptHealth) and Todd Squilanti (Performance Home Medical) joined HME Business Editor in Chief Laurie Watanabe to discuss “How HME Is Defining the Future of Home Care.”
A ‘transformative shift’ in health care
Asked what the home medical equipment industry could be like at its very best, Brusilovsky, Cardinal Health’s national vice president of commercial sales, said, “We are certainly seeing a really transformative shift in health care, which is the increased prevalence of individuals wanting to age in place, to age in the comfort and familiarity of their homes. And because of this transformative shift, we are seeing an increased spotlight on home care and on HME providers, and the role that we play in facilitating that journey in evolution. That’s driven by a couple of really critical factors.”
Among those, Brusilovsky said, is the rise of chronic conditions: “93% of those age 65-plus in the U.S. live and manage at least one chronic condition; 80% manage and live with at least two chronic conditions.”
Simultaneously, the overall American population is aging. By 2050, 23% of the population — more than 90 million people — will be 65 or older, Brusilovsky added. Simultaneously, “hospital-at-home programs have been shown to deliver savings of upwards of 32% compared to traditional in-hospital utilization.”
HME and home care at its best, Brusilovsky said, “truly look like a connected hub of health care in the home. It means moving beyond an HME provider being a transactional part, potentially, of a patient’s care journey to truly being the primary mode of care delivery in the United States for a significant portion of the population.
“So I envision an individual’s home not just being their primary residence, but a smart, connected care hub, where those that are involved in a patient’s care journey — like HME, providers, health-care professionals — can partner together, leveraging innovative technology to drive interventions that turn an illness or a condition, that prevent an illness right from becoming exacerbated, from preventing hospitalizations to truly driving health and wellness for patients.
“It’s also us working together, leveraging the technology, different solutions, tools and resources, to curate an individualized, personalized experience that meets patients where they are.”
Brusilovsky envisions home-based health care evolving from reactive to proactive. “We see HME providers investing in technologies and solutions like remote patient monitoring, condition management programs, hiring specialized individuals to augment the services that perhaps a health-care professional might provide a patient. We are really trying to evolve a patient’s care from just managing illness to truly promoting wellness. I think that’s a really powerful outcome that HME providers can drive.”
Getting tactical with service excellence
Parks, AdaptHealth’s chief innovation and strategy officer, then zeroed in on what providers will need to do to achieve those goals.
“I think that sometimes it’s odd to hear strategy and innovation folks talking about getting tactical,” he said. “But I think there are areas that end up being strategic. The key thing that we think about at scale and even day by day, patient by patient, is service excellence.”
Parks acknowledged that focusing on service excellence can sound a bit like a business cliché, but added, “We really think about how that looks from the morning to the evening, from when our teams are waking up, setting the table for what they’ll do in the day with deliveries, sometimes 20 stops per delivery driver, right? How do you make sure that person’s set up for success — their route planning, the truck is loaded properly, and when they cross that threshold, there’s trust and empathy and the embracing of home care?”
He also compared being an HME provider to being “in the hospitality industry in some ways,” because “you have one chance to not get it right, and that trust can be erased in a second with an individual or even a community overall.
“Do we have people that are crossing thresholds with supplies that are the right size, the right personalization, the right information is there for someone to understand and use that? Because at the end of the day, everything we’re talking about — from the use of the actual product or supply or device or therapy, to onboarding that therapy, and then the continuation of that therapy — is what adds value. I strongly believe in that service excellence, taking that down to the tactical level, and having it be reliable and repeatable every single day.”
That strategy, Parks said, then dovetails into operational excellence. “So for that service excellence to happen, what are the top three to five things that the teams are focused on operationally every day? And then, if we have operational excellence, it almost mandates standardization of what we do — of training, of the ability to do things, the skills and the competencies, and then also how we actually source employees. Where do they come from? What backgrounds? What do we do to set them up for success?
“That operational excellence sets the standard for what happens every day at the tip of the spear. Then there are advanced technologies, automation and AI [artificial intelligence] we know are coming.”
Reducing costs while maintaining successful outcomes
Squilanti, Performance Home Medical’s chief development officer, debated the “real balance” of service excellence relative to cost.
“We can’t just keep adding cost in the name of service excellence,” he said. “I think all HME providers, like every other stakeholder in health care, need to acknowledge that our system is just too expensive.”
The challenge, Squilanti said, is to figure out how to reduce costs while safeguarding patient outcomes. “So we have to look at the cost structures today and say, ‘Where can we find more money for patient care and take money out of commodities or back office infrastructure?”
Attendees chuckled when Squilanti asked why faxes are still commonplace in providers’ offices.
“Claims processing is archaic in this industry,” he said. “I’m new to HME, but I’m not new to health-care services, and I’m not new to the post-acute spectrum. It’s always instructive to say, ‘How are other sectors addressing the same challenges?’ When you think about pharmacy, how have they addressed claims processing? Well, they’ve invested. Now you go to the point of sale, and you’re auto-adjudicating a claim.
“If we’re providing a sleep apnea device, why is that so complicated? Why is it any more complicated than getting your statin at CVS? We need to find ways to use technology to auto adjudicate claims.”
Squilanti also suggested that providers and manufacturers consider product options.
“With every device I’m sending into a home — can I find a lower-cost device with the same clinical efficacy, sort of like a generic drug?” he asked. “Is there a generic humidifier or is there a generic POC [portable oxygen concentrator]? Identify alternative potential sources for your supplies and your equipment and say, ‘Is anybody out there with the same clinical efficacy as the market leaders?’ I don’t mean to dismiss them, because they’re doing a great job. But it is incumbent on us to take cost out of the system tactically, if we can find ways.
“Suppliers have to ask themselves what patients care about,” Squilanti added. “Do they care how hard your team worked and how many items you stocked in a warehouse? What if you can use somebody else’s warehouse and still get it delivered, and you took cost out of the system? That’s the way people have to continue to modernize their supply chains and get out of the past. Small players can still compete on service in particular, but they have to be able to adapt back office technologies that don’t impact patient care.”
Editor’s note: This is the first in our series of stories covering 2025 HME Business FUTURE.
Image: Merz Photography
