Competitive bidding is not just a pricing event. For DME providers, it can become an operational stress test.

CMS is preparing for Round 2028 of the DMEPOS Competitive Bidding Program, bringing competitive bidding back after the temporary gap period. The program is in its bid-preparation phase, with registration and bidding expected to take place ahead of contracts and new single payment amounts, which take effect no later than January 1, 2028.

January 2028 may sound far away. The preparation timeline is much closer.

With bidder registration and the bid window expected in 2026, operational readiness is already becoming a current priority.

The decisions providers make now—how well they understand their costs, how efficiently orders move through their organization, how consistently documentation is handled, and how much visibility they have into performance—can determine how prepared they are when the economics of competitive bidding become real.

The Next Round Is Different

Round 2028 is expected to include Class II continuous glucose monitors and insulin pumps, urological supplies, ostomy supplies, hydrophilic urinary catheters, and several categories of off-the-shelf braces. CMS has also structured these categories under a nationwide Remote Item Delivery competitive bidding area, covering all states, territories, and the District of Columbia.

That nationwide structure matters.

Providers can no longer think only in terms of isolated local markets. For organizations participating in affected categories, operational scalability, fulfillment capabilities, documentation quality, and the ability to understand the true cost of serving patients across a larger footprint all become more important.

CMS has made clear that bidders will be evaluated on more than price. Supplier eligibility, financial sustainability, accreditation, quality standards, and other requirements are part of the evaluation process.

In other words, preparing a competitive bid begins long before someone enters a number into a bidding system.

A Competitive Bid Is Only as Good as the Operation Behind It

The obvious question in competitive bidding is:

What price can the business sustain?

The harder question is:

Does the business actually know?

A provider can know its reimbursement and still lack a clear understanding of its true cost to serve an order.

Every unnecessary manual touch adds labor. Every correction adds another interaction. Every documentation gap creates additional work. Every disconnected system creates another place where information needs to be reconciled.

Individually, those costs can appear small.

Across thousands of orders, they become part of the provider’s operating model.

That is why competitive bidding should push providers to look beyond reimbursement rates and examine the entire path an order takes—from intake and eligibility through documentation, fulfillment, delivery, billing, payment, and reporting.

The organizations with the clearest view of that path have a better foundation for knowing what their economics actually look like.

Visibility Becomes a Competitive Advantage

Operational efficiency is difficult to improve when performance is scattered across systems, spreadsheets, departments, and manual reports.

Providers preparing for a more price-sensitive environment should be able to answer questions such as:

• Which workflows consume the most staff time?
• Where are orders routinely delayed or reworked?
• Which product lines, payers, or processes create the greatest administrative burden?
• How long does revenue remain outstanding?
• Where are documentation or authorization issues affecting the revenue cycle?
• What does the complete journey from referral to payment actually cost?

Those questions are not only reporting questions.

They are business-model questions.

The more precisely an organization can see where time, labor, and revenue are being lost, the more intelligently it can decide where automation, workflow redesign, or process standardization will have the greatest impact.

Preparation Has Already Started

CMS is already encouraging prospective Round 2028 bidders to get their enrollment, licensing, and accreditation requirements in order. After the temporary Medicare supplier enrollment moratorium expired on August 27, 2026, CMS specifically urged prospective bidders that need to take enrollment action to submit completed applications as soon as possible, so processing time does not jeopardize their eligibility for the upcoming bid window.

There is a lesson in that which extends beyond compliance:

Waiting for the bid window to open is too late to begin understanding the business.

Providers can use the preparation period to examine their operations before external pressure forces the issue.

That means knowing the categories that may affect the organization, validating enrollment and accreditation readiness, understanding cost structures, identifying avoidable manual work, reviewing revenue-cycle performance, and establishing reliable operational data.

The goal is not simply to become “more automated.”

It is to build an operation where fewer unnecessary steps stand between a referral and a completed, reimbursed order.

The Bigger Opportunity

Competitive bidding naturally creates concern about reimbursement.

But it can also force an important question:

How much of the current cost structure is actually necessary?

Technology cannot control reimbursement policy. It cannot determine the winning bid. And automation does not eliminate the underlying economics of the DME business.

What it can do is expose and reduce some of the operational friction surrounding those economics.

When information moves cleanly between intake, documentation, delivery, billing, and reporting, providers gain something increasingly valuable in a competitive environment: control over the parts of the equation they can actually influence.

Competitive bidding may determine the environment.

Operational readiness determines how effectively a provider operates within it.

And the best time to build that readiness is before the pressure arrives.