Durable Medical Equipment (DME) is one of the largest blind spots in healthcare spending, costing payors millions in fraud, waste, and abuse (FWA) while creating operational bottlenecks and delaying patient care. 

In Florida alone, the HHS showed the Medicare FFS improper payment rate at 38.2%, the highest in the country highlighting a critical need for smarter fraud prevention and efficiency solutions. 

Tomorrow Health estimates the improper payment rate for Medicare Advantage in FL to be as high as 27.8% and for Medicaid as high as 25.2%.

Despite billions spent, delays in fulfillment and poor coordination drive up costs and increase readmission risk by 30%. For every dollar invested in DME, the healthcare system stands to save between $23 and $41¹, but only with the proper oversight and execution.

Tomorrow Health (TH) was founded in 2018 as a technology-enabled benefit manager specializing in rewiring the fragmented home-based care system. Tomorrow Health partners with health plans across all lines of business with a focus on Medicare Advantage, Medicaid and Duals, delivering measurable savings, enhancing operational efficiency, and improving member satisfaction— ultimately reducing per-member-per-month (PMPM) costs.

Tomorrow Health’s AI-powered fraud detection system proactively flags overutilization in real time, preventing financial leakage before it occurs. Additionally, its extensive supplier network—spanning both national and local providers—delivers critical equipment 85% faster, ensuring members receive what they need, when they need it. With 100% of orders routed to high-performing, in-network suppliers, Tomorrow Health minimizes waste and maximizes efficiency.

To date Tomorrow Health has helped health plans realize a 3-5% savings while achieving ~3x ROI within the first 12 months of go-live. Tomorrow Health’s novel approach allows care teams to spend 45% less time ordering and managing home-based care, giving them time they can reinvest in what matters: improving member outcomes. 

¹ The Case for Medicare Investment in DME, Brian Leitten