Anyone who has spent a Sunday afternoon struggling to decipher The New York Times' crossword puzzle understands the challenges that HomeCare's editors face each year as we compile the home medical equipment industry's latest statistics. Like crossword aficionados everywhere, we know that the answer to No. 2003 Across — “The HME industry is _____” — exists. We read the clues all around us in news stories, market reports and health care studies. We hear the clues when we interview HME experts, attend trade show conferences and receive letters from our readers.
To crack The New York Times' puzzle, one must have a breadth of knowledge. No individual can be an expert in every field, but if he wants to solve the puzzle, then he had better know a few experts — or at least be on a first-name basis with the local librarian. The same is true for HomeCare's annual Facts & Figures feature. In a market that covers everything from sleep-disordered breathing to pressure ulcers, oxygen conservers to compression hosiery, no individual can have all the answers. And of the firms that track general health care trends, only a few attempt to keep up with HME. Even then, the industry's defining statistics often are fragmented or lumped into more general reports.
So to solve No. 2003 Across, this year we tapped all our resources. Pulled from the federal government, industry associations, private research firms, company financial records and our own extensive files, the hard numbers in this HME snapshot offer providers the baseline they need to determine business goals, set strategies and measure performance.
In compiling the following pages, HomeCare's staff found many answers to this year's puzzle. Our research confirms that the HME industry is …
growing
vital
resilient
creative
tenacious.
In 2002, CMS spent a total of $7.7 billion on durable medical equipment, prosthetics, orthotics and supplies.
Source: Centers for Medicare and Medicaid Services
The HME industry generates approximately $19.74 billion annually.*
*Estimate based on the total amount that the Centers for Medicare and Medicaid Services spent on durable medical equipment, prosthetics, orthotics and supplies in 2002; and on information from the American Association for Homecare's 2002 Financial Survey Report, published in 2002. Statistics from the latter are reprinted by permission of the American Association for Homecare (AAHomecare), and are based on fiscal year 2001 information provided by 119 firms of varying sizes and home care services. Visit www.aahomecare.org for more details.
Durable Medical Equipment made up 1.3% of public health care expenditures in 2001.
Source: Centers for Medicare and Medicaid Services
NUMBER OF DURABLE MEDICAL EQUIPMENT SUPPLIER NUMBERS ISSUED
| Year | Total |
|---|---|
| 1999 | 11,400 |
| 2000 | 10,706 |
| 2001 | 11,450 |
| 2002 | 14,334 |
| Source: Pametto GBA, Columbia, S.C., National Supplier Clearinghouse | |
NUMBER OF MEDICARE BENEFICIARIES IN 2003
| Category | Total | |
|---|---|---|
| Aged Persons | 34,457,024 | |
| 65 to 74 | 17,764,379 | |
| 75 to 84 | 12,303,987 | |
| 85 and over | 4,388,658 | |
| Disabled Persons | 5,568,693 | |
| Under 45 | 1,658,257 | |
| 45 to 54 | 1,727,547 | |
| 55 to 64 | 2,182,889 | |
| All Persons | 40,025,717 | |
| Source: Centers for Medicare and Medicaid Services | ||
ACCREDITATION BY JCAHO, CHAP OR ACHC
72% of respondents to AAHomecare's 2002 Financial Performance Survey are accredited by JCAHO, CHAP or ACHC. Accreditation is related to company size, with all firms above $10 million in revenue being accredited.
| Size of Firm | Percent of Firms in Survey |
|---|---|
| Less Than $1,000,000 | 41% |
| $1,000,000 - $2,999,999 | 50% |
| $3,000,000 - $10,000,000 | 81% |
| More Than $10,000,000 | 100% |
| Reprinted by permission of the American Association for Homecare (AAHomecare). Based on fiscal year 2001 information provided by 119 firms of varying sizes and home care services. Visit www.aahomecare.org for more details. | |
HOSPITAL OWNERSHIP OF FIRMS*
| By Size of Firm | |
|---|---|
| Less than $1 million | 29% |
| $1 million - $2.9 million | 35% |
| $3 million - $10 million | 21% |
| More than $10 million | 21% |
| By Type of Firm | |
| Respiratory | 25%** |
| Home Infusion | 40%** |
| HME | 0%** |
| Rehab | 0%** |
| Mixed-Market | 33%*** |
| *Based on firms participating in
AAHomecare's 2002 Financial Performance Survey. **More than 50% of firms' revenue was from respiratory, home infusion, HME or rehab. ***No one business segment represented at least 50% of firms' total revenue. |
|
| Reprinted by permission of the American Association for Homecare (AAHomecare). Based on fiscal year 2001 information provided by 119 firms of varying sizes and home care services. Visit www.aahomecare.org for more details. | |
| Year | Revenue ($ Millions) | Revenue Growth Rate (%) |
|---|---|---|
| 1999 | 1,720 | 14.0 |
| 2000 | 1,961 | 14.0 |
| 2001 | 2,235 | 14.0 |
| 2002 | 2,555 | 14.3 |
| 2003 | 2,923 | 14.4 |
| 2004 | 3,311 | 13.3 |
| 2005 | 3,698 | 11.7 |
| 2006 | 4,095 | 10.7 |
| 2007 | 4,497 | 9.8 |
| 2008 | 4,918 | 9.4 |
| 2009 | 5,379 | 9.4 |
| All figures are rounded; the base
year is 2002. Source: Frost & Sullivan |
||
| Company Name | NYSE/Nasdaq Symbol | Fiscal Year-End | 2002 Net Income in Millions | 1-Year Net Income Growth | 2002 Net Revenue in Millions | 1-Year Net Revenue Growth | No. of Employees | 1-Year Employee Growth |
|---|---|---|---|---|---|---|---|---|
| Abbott Laboratories | ABT | December | $2,794 | 80.2% | $17,685 | 8.6% | 71,819 | 0.6% |
| AmerisourceBergen | ABC | September | $345 | 175.7% | $45,235 | 179.4% | 13,700 | 0% |
| Apria Healthcare | AHG | December | $115.6 | 60.8% | $1,252.2 | 10.6% | 10,553 | 8.8% |
| Cardinal Health | CAH | June | $1,056 | 23.2% | $51,136 | 6.6% | 50,000 | 2.2% |
| CareCentric | CURA | December | $.3 | N/A | $22 | 7.9% | 158 | 20.6% |
| Chad Therapeutics | CTU | March | $1.2 | N/A | $18.7 | 53.3% | 107 | 16.3% |
| Gentiva Health Services | GTIV | December | ($49) | N/A | $768.5 | (44.2%) | 16,400 | (3%) |
| Invacare | IVC | December | $64.8 | 84.1% | $1,089.2 | 3.4% | 5,300 | 1.9% |
| Johnson & Johnson | JNJ | December | $6,597 | 16.4% | $36,298 | 10% | 108,300 | 6.4% |
| Lincare Holdings | LNCR | December | $190.4 | 41.1% | $960.9 | 18.3% | 6,700 | 9.8% |
| Matria Healthcare | MATR | December | ($16.3) | N/A | $277.6 | 5.2% | 2,213 | 16.4% |
| National Home Healthcare Corp. | NHHC | July | $5.3 | 26.2% | $82.2 | 10.3% | 3,500 | 25% |
| Option Care | OPTN | December | $14.1 | 41% | $320.5 | 47.6% | 1,859 | 11.9% |
| Pediatric Services of America | PSAI | September | $14.1 | 156.4% | $197.5 | 7.3% | 4,104 | (13.8%) |
| Praxair | PX | December | $409 | 4.9% | $5,128 | (0.6%) | 25,010 | 3% |
| ResMed | RMD | June | $37.5 | 223.3% | $304.1 | 31.5% | 1,250 | 31.2% |
| Respironics | RESP | June | $38.4 | 14.3% | $494.9 | 17.2% | 2,600 | 23.8% |
| Tyco International | TYC | September | $9,412 | (4.7%) | $35,6 | 43.7% | 267,500 | 10.3% |
| Walgreen | WAG | August | $1,019 | 15.1% | $28,681 | 16.5% | 141,000 | 9.3% |
| Parentheses indicate a loss. Source: Hoovers.com | ||||||||
| 2002 Rank | 2001 Rank | Code | Description | Allowed Charges |
|---|---|---|---|---|
| 1 | 1 | E1390 | oxygen concentrator | $1,858,331,759 |
| 2 | 3 | K0011 | power wheelchair | $820,159,701 |
| 3 | 2 | A4253 | test strips | $743,077,701 |
| 4 | 4 | J7644 | ipratropium bromide | $605,170,873 |
| 5 | 5 | J7619 | albuterol | $420,521,660 |
| 6 | 6 | E0260 | hospital bed | $326,612,622 |
| 7 | 9 | B4150 | enteral formula I | $218,221,504 |
| 8 | 7 | E0431 | portable gaseous oxygen | $215,656,659 |
| 9 | 8 | B4035 | enteral feeding kit | $213,287,551 |
| 10 | 10 | E0277 | powered mattress | $129,790,932 |
| 11 | 11 | E0439 | stationary liquid oxygen | $129,696,108 |
| 12 | 12 | K0001 | standard wheelchair | $111,862,679 |
| 13 | 14 | K0004 | lightweight wheelchair | $90,523,632 |
| 14 | 15 | E0601 | CPAP | $89,924,179 |
| 15 | 13 | K0533 | noninvasive assist device | $81,197,592 |
| 16 | 18 | B4154 | enteral formula IV | $78,183,213 |
| 17 | 16 | A4259 | lancets | $77,937,498 |
| 18 | 19 | E0570 | nebulizer | $72,530,911 |
| 19 | 20 | E0143 | folding walker | $71,229,318 |
| 20 | 21 | K0003 | lightweight wheelchair | $54,305,534 |
| Source: Centers for Medicare and Medicaid Services | ||||
| Code | Description | Region A Payment | Region B Payment | Region C Payment | Region D Payment | Total |
|---|---|---|---|---|---|---|
| E1390 | oxygen concentrator | $202,650,615 | $336,526,974 | $581,691,514 | $296,536,645 | $1,417,405,748 |
| K0011 | power wheelchair | $71,355,846 | $40,557,711 | $440,572,583 | $100,953,305 | $653,419,445 |
| A4253 | test strips | $78,115,182 | $141,154,230 | $234,882,582 | $85,393,296 | $539,545,290 |
| J7644 | ipratropium bromide | $49,651,553 | $93,894,599 | $248,412,697 | $79,982,543 | $471,941,392 |
| J7619 | albuterol | $32,676,443 | $63,570,043 | $178,813,723 | $47,021,925 | $322,082,134 |
| E0260 | hospital bed | $40,656,604 | $43,164,170 | $118,707,690 | $39,266,473 | $241,794,937 |
| B4150 | enteral formula I | $27,498,037 | $30,321,494 | $55,981,094 | $42,509,323 | $156,309,948 |
| E0431 | portable oxygen | $23,878,155 | $39,432,222 | $67,359,093 | $34,227,563 | $164,897,033 |
| B4035 | enteral feeding kit | N/A* | $28,347,564 | $65,441,059 | $26,711,249 | $120,499,872 |
| E0277 | powered mattress | $15,073,046 | $15,559,928 | $44,928,753 | $23,793,154 | $99,354,881 |
| *The amount for Region A was not
provided. Source: Centers for Medicare and Medicaid Services |
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The costs associated with treating chronic diseases account for 78% of the nation's total medical care costs, including almost 80% of Medicaid expenditures.
Source: Johns Hopkins University, Partnership for Solutions, Dec. 2002
