ATLANTA--As gas prices continue to soar with no relief in sight, home medical equipment providers across the country are feeling the effects.

The nationwide average at the pump is up to $2.61 per gallon for unleaded, and $2.65 for diesel, according to AAA's daily fuel gauge report. And in some spots, prices have topped the $3 mark. Experts say increased demand and limited supplies are responsible for the rapid climb, and prices aren't expected to fall until after Labor Day when the summer driving season ends.

"It's killing us," said Vince DeStigter, owner of Western Healthcare, Jackson, Calif., noting that $3.19 per gallon is the cheapest diesel fuel he can find within 100 miles. "First we saw a reduction in Medicare pricing [this year], then you increase fuel costs by 24 percent. It's a big-time cost issue."

To make matters worse, the average trip for this rural provider--located between Sacramento and Lake Tahoe--is 15 miles, DeStigter said. "When you have to travel two-and-a-half hours to make a delivery to a patient up on the mountain, you use 14 to 15 gallons of fuel just for one customer. Every other business could pass that cost along, but we can't pass it on to the [Medicare or Medicaid] customer."

To maintain profit, DeStigter said he is working on building up his retail business--and asking customers to come to the store to pick up items whenever possible.

Other providers also are making operational changes--such as converting to alternate fuel sources, switching fleet vehicle types and limiting service areas--to improve efficiency. Last year, owner Cliff Woolard of Home Med-Equip Co., Concord, Calif., converted his company's delivery fleet to vans that run off of compressed natural gas, which yields 160 to 180 miles per tank, and installed GPS (global positioning) to improve routing. (See HomeCareXtra, June 1.)

Last year, Jeff Wills, CEO and CFO of Oklahoma City-based CV Medical, began converting service vehicles to diesel, and the company's drivers are using GPS. "It worked out well for us because we gained 100 percent mileage," he said. Although the cost of diesel fuel also has increased, he noted, "we would be much worse off if we hadn't converted.

"I think along with our other costs, [fuel] costs are certainly going to be a concern long term."