Savvy Survivors

If there is one constant in the home medical equipment industry, it is change. Product lines, reimbursement rates, governmental regulations, even the players themselves seem to shift daily.

This is not your parents' industry anymore — or, for that matter, even the one you first got into.

Welcome to the new version of HomeCare's annual celebration of top companies. New, you say? Why new? Well, chalk it up to change.

HomeCare first published the 100 top HME performers — both public and private — in 1991. Back then, the industry boasted a handful of national companies and an abundance of small mom-and-pop shops eager to share their success stories.

But times have changed. The industry has been buffeted by continuous declining reimbursement, rising costs, tightened regulations and intense governmental scrutiny. For many, the changes have been too many too fast. They've closed up shop or sold out.

As they did so, the list changed. By 1998, it had tightened up to include 58 companies. Last year, it was 24. And this year, some of those who had long been a part of the roll call were absorbed by larger companies. Praxair Healthcare Services acquired Home Care Supply of Beaumont, Texas, which had held the top spot among private companies for three years running.

Air Products Healthcare added Ultra Care of Melrose Park, Ill., and Rx Healthcare Group of Monroeville, Pa., from last year's list. Still others appeared on the brink of being sold.

Most prognosticators predict the trend toward provider consolidation will continue. Wallace Weeks of Weeks Group, Melbourne, Fla., estimates 4,300 fewer DME providers in the next five years.

So in 2005, we celebrate a selection of standout companies that are savvy survivors, and, we even turn the spotlight on an up-and-comer.

The private home care companies on the list this year (see page 29) may not all be tops in terms of revenue, but they all have hearty bottom lines — and increasing business. And in these ever-changing times, that is the mark of an innovative provider. Indeed, these providers see a strong future for HME, albeit a volatile one, and they are eager to embrace it.

Take a look at what some of these companies are doing right: