robb, there is no lack of home oxygen or durable medical equipment providers and there are few if any barriers to entry for new players. Apria and Lincare are the dominant players, but their real advantage is only in managing the obfuscating world of government and managed care contracts that a lot of the mom and pops do not want to mess with. Rotech is a distant #3 in market share and carries enormous debt which it chose to incur vs. other pathways and now wants to conveniently jettison by sticking it to long-patient shareholders who may just get the shaft. There is some compelling logic to suggest that maybe ROHI should just be left to die, a possibility that has received scant attention on this board.
The CMS bidding process is deeply flawed, IMO, but SOME intervention in controlling exhorbitant reimbursements for very simple medical services is long overdue. There is, to me, full irony that the CMS protocol designed to reduce costs actually favors higher-cost providers who simply have more wherewithal based on dimension to effectively navigate the ridiculous rules and paperwork requirements of bidding these contracts and dealing with VA's stupid rules. These guys make Medicare and Medicaid look simple to deal with by comparison.
Said differently, you don't need Nurse Rached or Doctor Kildare to come to your retirement home to swap out your oxygen tank or show you how to fill up a bottle from a concentrator and hook it up to a breathing tube. This isn't rocket science, or even science at all... it's like the Poland Springs guy that delivers jugs of water for your home cooler. Maybe "Cheap is good" to borrow a bit from Gordon Gecko, and maybe fools that incurred a half billion dollars in debt for the near equivalent of a newspaper delivery route need to be put out of their misery in a CH VII euthanasia.
