ALEXANDRIA, Va. — For HME providers, successful contracting isn’t just about numbers on a page—it’s about understanding the fine print and building strong payer relationships. That’s the message from Cadie McGonagill, newly appointed senior director of payer relations at AAHomecare.
With over 20 years in managed care contracting, reimbursement strategy, and payer engagement—most recently at Lincare—McGonagill brings deep experience from the provider side. She spoke with HME News about best practices for navigating payer agreements and strengthening partnerships.
HME News: Will your provider-side experience help in your new role?
Cadie McGonagill: Absolutely. Our industry needs a better grasp of how to contract effectively and work with payers. Too often, providers see a contract, glance at the price, sign it, and file it away. There’s so much more to review, ask about, and understand. And we also need to work on building relationships—because, frankly, many payers don’t fully understand our industry.
HME: Besides pricing, what should providers focus on in negotiations?
McGonagill: Education is key. Providers need to know what makes them different—do you have a strong clinical model? Serve a unique geographic area? Offer a brand or product your competitors don’t? Have exceptional customer satisfaction ratings? And once you have that contract in hand, are you reading all the terms? Do you understand the requirements? And if you need to walk away—do you know how?
HME: How can a provider tell when it’s time to walk away?
McGonagill: It’s tough. But if reimbursement isn’t sustainable long term, if there’s an excessive administrative burden, or if service requirements are unrealistic, it’s worth reconsidering. Entering a contract you know you can’t meet sets you up for failure. We all struggle to say no because we want the business—but sometimes making the hard choice is the right choice.
HME: Once a contract is in place, how can providers maintain good relationships with payers?
McGonagill: Even a simple annual check-in can make a big difference. Be persistent but respectful of their time. Use that touchpoint to highlight the unique ways you serve their members. When payers understand what we do and how we do it, it benefits everyone.
HME: With the shift from fee-for-service to value-based care, has contracting improved?
McGonagill: In other health care sectors, value-based care is more established. In HME, we’re still finding our footing. The model has potential—it focuses on keeping patients healthy, reducing comorbidities, and ensuring compliance—but we haven’t landed on the perfect approach for our industry yet. The good news is we have a lot of innovative minds working toward that goal.
