The June 2025 MedPAC Report to Congress doesn’t explicitly mention durable medical equipment (DME) or home medical equipment (HME) policy, but its insights into Medicare Advantage (MA), home health care and rural service delivery carry potential implications for the HME sector.
For HME stakeholders, several themes in the report signal both emerging opportunities and areas of concern in a shifting Medicare landscape.
MedPAC – the Medicare Payment Advisory Commission – is an independent, nonpartisan federal agency that advises Congress on issues affecting the Medicare program. Congress does not need to act on MedPAC’s insights, but lawmakers will often take the commission’s views into consideration.
The June 2025 MedPAC report came out on June 12.
Focus on Medicare Advantage and supplemental benefits
A large portion of the report evaluates how Medicare Advantage plans are using supplemental benefits, including those that support home-based care and chronic condition management.
While HME is not listed as a standalone benefit category in the report, it is often an essential enabler of these supplemental benefits, such as in-home monitoring, chronic care coordination and functional support for older adults with multiple co-morbidities.
The MedPAC report questions whether these benefits are meaningfully improving access or outcomes. It notes a lack of publicly available data on benefit use and efficacy, highlighting “significant data gaps that impair oversight.”
This scrutiny could lead to a demand for clearer metrics around how MA plans contract with HME suppliers or deploy HME as part of value-based care programs.
“Altogether, our review of numerous data sources pertaining to MA supplemental benefits reveals a fundamental lack of transparency about how often enrollees use the benefits and plans’ spending for the benefits,” MedPAC wrote in the report.
Better information could be used to help beneficiaries navigate the options available to them and could help policymakers identify ways of making the program work more efficiently, the report continued.
Home health use under MA
Another chapter in the report explores the growing dominance of MA in the home health space.
While traditional Medicare spending on home health has been declining, the report explained that MA plans are increasingly filling the gap. However, it also noted that “little is known” about what services are being delivered under MA, and how those compare to traditional home health.
This has possible implications for HME vendors whose products support post-acute recovery and long-term home care. If MA plans are under-delivering or under-documenting services, patients may face equipment delays or limited access.
On the other hand, if MA is simply delivering more targeted care, new partnership models may emerge between plans and HME suppliers.
The report reinforces that CMS lacks comprehensive encounter data from MA plans for services like home health – data that would also reflect DME usage patterns. Transparency in MA plan delivery models could become a regulatory flashpoint in coming years.
“With the information available, it is not possible to draw conclusions on the appropriateness of care based on any reported differences,” MedPAC wrote. “Future, more nuanced work should examine the probability of post-acute or community-admitted home health care use and how that may differ by payer, and the types of home health visits, home health care stays, lengths of stay, and the case-mix groups associated with each home health patient to better understand home health care use under MA.”
Rural access and alternative delivery models
Among its other takeaways, the report touched on challenges facing rural health-care providers, especially critical access hospitals.
Again, while not directly tied to HME, the emphasis on bolstering access and considering alternative models could spill into home medical equipment policy, particularly as Congress looks for ways to improve health care delivery in underserved areas.
Innovative models that deploy equipment with telehealth or remote monitoring capabilities could gain traction as policymakers seek cost-effective care options for rural seniors.
Of note, chronic condition management has already been established as a key priority for the U.S. Department of Health and Human Services (HHS) under the Trump administration.
