Tag: Contracting
TBO offers contracting expertise as payer challenges intensify
March 27, 2026Liz Beaulieu, Editor
LAS VEGAS – Tactical Back Office (TBO) has added Lauren Barranti to its team, giving smaller home medical equipment (HME) providers access to high-level contracting expertise.
Barranti spent most of her career at Apria Healthcare, where she served as vice president of managed care.
“The nationals have VPs on board to address payer issues, but no one else can afford that,” said Todd Usher, president and founder of TBO. “Now we’re bringing that expertise to smaller...
Molina Healthcare taps DME Navigator to streamline provider workflows
March 24, 2026HME News Staff
LONG BEACH, Calif. – Molina Healthcare of Illinois (MHIL) on March 2 announced the implementation of a new DME Navigator program for all lines of business effective June 1, 2026.
“DME Navigator is an end-to-end solution operated by Optum and CareCentrix leveraging the CareCentrix DME provider network,” the company stated in a memo. “Using a digital DME Navigator Point-of-Care (POC) platform powered by Parachute Health, it streamlines provider workflows and reimagines how...
Crowds grow at Medtrade as industry seeks greater clarity
March 3, 2026HME News Staff
PHOENIX – Early numbers from Medtrade underscore the strong demand in the home medical equipment (HME) industry for guidance on competitive bidding, artificial intelligence (AI), payer contracting and more.
Show Director Kayla McGarry reports that the industry’s largest trade show, which featured more than 70 education sessions on Tuesday alone, saw a 14% increase in conference attendees this year.
The Exhibit Hall, which opened Tuesday morning, showcased more than 360 exhibitors.
“We...
AdaptHealth’s fast start on contract boosts confidence
February 25, 2026Theresa Flaherty, Managing Editor
PLYMOUTH MEETING, Pa. – AdaptHealth’s ability to service large, capitated agreements – underscored by the early ramp-up of a $1 billion contract – will underpin future growth, company execs said during a recent call to discuss fourth quarter and full-year 2025 earnings.
That contract, first announced in August, went live in December in three mid-Atlantic states covering approximately 50,000 members, said Suzanne Foster, CEO. When fully operational, it is expected to bring...
Newspoll: Provider-payer trends raise concerns over access, choice
October 29, 2025Theresa Flaherty, Managing Editor
YARMOUTH, Maine – Larger HME providers appear to be increasingly partnering with health systems, a trend that the respondents to a recent HME Newspoll say threatens access and limits patient choice.
Sixty percent of respondents reported seeing an increase in joint ventures or preferred agreements between larger providers and health systems in their markets.
“From a market perspective, these consolidated relationships are reshaping referral patterns and creating barriers...
Q&A: Cadie McGonagill on smarter contracting
August 15, 2025HME News Staff
ALEXANDRIA, Va. - HME providers need to think beyond units and widgets and dig deeper into the terms of the contracts. They also need to nurture their relationships with payers, says Cadie McGonagill, who recently joined AAHomecare as senior director of payer relations.
McGonagill, who has more than two decades of leadership experience in managed care contracting, reimbursement strategy and payer engagement, most recently at Lincare, spoke with HME News about payer best practices.
HME...
AAH advocates in several states
February 23, 2021HME News Staff
In Pennsylvania, AAHomecare is working with PAMS and other stakeholders to address concerns about Tomorrow Health. Tomorrow Health is performing double duty as a provider and a third-party administrator for Geisinger Health, raising concerns that the arrangement could impact patient choice and continuity of care for individuals covered under Geisinger’s Medicaid contract, as well as Medicare Advantage and commercial plans in the state. Providers in the state have seen a significant...
Contracting: Tailor your message
August 12, 2020Armando Cardoso
Q. How do I convey a compelling value proposition to payers? A. There are five critical questions to answer when creating a compelling value proposition to payers.How can I tailor my message to fit a payer's perspective?Like you, insurance is a business and has goals. You want to tailor your message to show how your organization supports their goals. Maybe emphasize if you have been declining their members, have a unique offering, or a geographic/customer service advantage. Do you lower the total...
Contracting: Know your strategy
July 9, 2020Armando Cardoso
Q. What questions do I need to answer before contracting?A. More contracts do not equal more value. Before you get started, ask the right questions, make a plan and be prepared to follow-up.Who are your patients today and are you expanding your services in the future?There are two key dimensions to consider: geography and your patient's insurance mix (Medicare, Medicaid, commercial, etc.). These factors will be the foundation of your payer strategy.Who else provides the same service(s) in your area?Payers...
Contracting: Understand contract terms
June 10, 2020Armando Cardoso
Q. What do I need to know when it comes to my managed care contracts? A. Unfortunately, there's no Rosetta Stone for payer contracting. You need to understand operational and strategic terms that can have a meaningful implication on your organization and financial performance. We've outlined five critical contract terms that need to be understood for each of your payer contracts.Term & terminationYou want to maintain your options, as this allows you to get out of unfavorable situations or pursue...