Bill Mixon (left), Tim Wheeler, Dan Bryant and Kyle Berkman discuss M&A issues at the HME Business FUTURE conference.
The home medical equipment (HME) industry awaits the home health final rule that will define the next iteration of Medicare competitive bidding. What impact is that waiting game having on merger and acquisition (M&A) interest for HME companies?
That was one of the top questions during the “M&A in HME” panel at the 2025 HME Business FUTURE conference, hosted at the J.W. Marriott Dallas Arts District, Sept. 15-17, in Dallas, Texas.
“Our panelists bring unique perspectives as owners, operators and dealmakers, with experience in completing several marquee transactions in this space,” said moderator Kyle Berkman, director, Intrepid Investment Bankers. Berkman described Intrepid as “a Goldilocks advisor: the resources of a global bank with the hands-on approach of a 100-banker boutique.”
During the session, Berkman asked panelists about M&A interest in HME, now and into the future.
“If you were to poll 100 investors on whether care is trending toward the home as a lower-cost setting, I think at least 99 would agree,” Berkman suggested. “Yet private equity has leaned in and out of this space over the years. It seems to be on an upswing now, but what drives that pendulum effect, where private equity moves in and out over time?”
An ‘incredibly stable’ market
“Stepping back to your point about the transition to home care — that trend itself drives broad interest in the category,” said panelist Tim Wheeler, partner, BPOC. Wheeler is also a board member for Home Care Delivered, a provider based in Innsbrook, Virginia. “Investors who believe in home-based care see HME and DME [durable medical equipment] as a way to participate in that growth without the heavy labor needs of traditional home care businesses.
“There’s definitely been ebb and flow in private equity interest. Competitive bidding historically has affected that. But over the last five to 10 years, it’s been an incredibly stable market — still highly fragmented — and if you understand the secular and demand tailwinds, it remains a strong area of opportunity.”
Asked how investors can “get comfortable with those risks and perhaps lean in,” as Berkman described, panelist Bill Mixon — the former CEO of Advanced Diabetes Supply and National Seating & Mobility, and now executive partner at Waud Capital Partners — said, “If you can create clinical efficacy, add value, and improve outcomes, there’s a place for you in HME/DME. I tend to be an optimist, and I’m hopeful that over the long term — or even the intermediate term, say 10 years — some of the current noise in the system will settle down.”
Mixon acknowledged significant distractions such as policy uncertainties currently surrounding HME, but added, “I think cooler heads will prevail. The overall value HME/DME brings to care delivery and quality of life — at reasonable cost points — will continue to be recognized.”
But Mixon added a caveat: “The sector also needs to be smart about leveraging technology to drive efficiency. Efficiency will be critical going forward. So while I’m cautious, I’m optimistic that the real overhangs in the system right now won’t be as bad as the pessimists predict.”
Delivering on the ‘thesis’ for home-based care
Dan Bryant, executive director, corporate business development at Henry Schein, was asked what in the company’s “thesis for home-based care” had been proven out so far, and what’s been surprising.
“We definitely didn’t know what we didn’t know when we started,” Bryant said. “We knew we wanted to be in the space and to find the right way to do it, but it’s been a learning journey.
“The long-term thesis is still intact. Care is moving to the home, demographics support it, and the opportunity is real. What we weren’t good at initially was billing. Everything else in our business is B2B; this is the only segment involving direct billing. So finding partners who do that with integrity was critical — we didn’t want to end up in any headlines.”
And overall, Bryant referenced good results thus far.
“I’d love to say we were geniuses, but truthfully, there have been some favorable tailwinds in recent years that helped our portfolio companies,” he said. “Whether those continue remains to be seen, but it’s been a pleasant surprise.”
Winning attributes to look for
Wheeler said a potential investor’s interest in an HME company “starts with the company’s clinical and service reputation. If those are strong, you have a great chance of success; if they’re questionable, your odds drop fast.
“We look closely at retention — of referral sources, patients and employees. Reliable referrals, satisfied patients, and loyal, mission-aligned employees are strong indicators of quality and long-term durability.”
Wheeler added, “This is a tough business — an execution business. Success requires doing a lot of small things right every single day, and that attention to detail is key.”
“I think the future will bring more HME and DME bundling, with deeper service integration,” Mixon said. “For example, I’ve worked on bundling remote patient monitoring with endocrinology practices as part of CGM [continuous glucose monitoring] programs to improve outcomes and device effectiveness.
“It’s not just about shipping boxes — it’s about improving clinical outcomes, capturing data and using that data to have meaningful conversations with payers. That’s where we need to go as an industry.”
“At Home Care Delivered, we talk about that a lot,” Wheeler agreed. “One remarkable thing about this industry is how many touchpoints you have with a patient throughout the year — more than almost anyone else in their care journey.
“You’re interacting with them on refills or new scripts, sometimes more than their primary care physician does. Especially for homebound patients with multiple chronic conditions, leveraging that relationship and access can be incredibly powerful.”
Editor’s note: This story is part of our coverage of 2025 HME Business FUTURE.
Image: Merz Photography
