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Home-based care executives and an industry consultant said Medicare Advantage contracts need ongoing work after signing, including timely communication, performance data and coordination with clinical teams. Their examples point to ways providers and plans can address problems earlier, though the source does not report measured results from these practices.
Home-based care operators and a healthcare consultant said providers need to keep working with Medicare Advantage plans after signing network contracts, using performance data, regular communication and clinical-team input to address issues and demonstrate reliability. The advice, shared at a PAYER Summit in June, speaks to how providers can maintain payer relationships as plans assess access, quality and performance.
Chris Cycak-Dyos, director of strategic network operations at Pittsburgh-based Helion, said providers can falter when they secure a contract but do not maintain two-way communication with the plan. He advised providers to manage the full episode of care, rather than treating each visit as a separate transaction, and to bring their own performance information to payer discussions.
Cycak-Dyos said providers should establish a baseline and understand both operational measures and patient outcomes. He and other speakers said timely, high-quality data can be difficult for both sides to obtain; claims data may arrive about six months late. Having provider-generated information can help plans and operators discuss performance before delayed claims are available, though the speakers did not describe a common reporting standard.
Matt Lippitt, Bayada Home Health Care’s vice president and division director, said data collection and analysis help establish expectations at the start of a payer relationship and show whether the provider is meeting shared goals. Bayada provides home health and other services across 20 states. Lippitt said plans look for evidence of quality improvement, dependable access and reliability.
Keeping Contracts Working After Signing
The speakers’ message is that a signed agreement does not, by itself, resolve how care will be coordinated or how performance will be judged. Ongoing exchanges can give providers and Medicare Advantage plans a way to identify operational friction, clarify contract requirements and discuss whether care is meeting agreed expectations. For providers, that work can affect their ability to remain useful network partners; for plan members, dependable access and coordinated care are central concerns.
Bringing clinical staff into contract conversations may also help organizations spot requirements that could otherwise surface later as denials or disputes. The report presents these practices as advice from industry participants, not as evidence that a particular approach guarantees better outcomes or contract retention. No quantified results or comparative study were cited.
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Advice From Payer Summit Speakers
The report describes remarks from executives and an industry expert at the PAYER Summit in June. Helion provides technology, data and consulting services for home- and community-based care. Bayada offers adult and pediatric home health, personal care, hospice, private-duty nursing and other services. Ignite Medical Resorts, represented by senior vice president of managed care Justin Meara, provides skilled nursing and rehabilitation services across seven states.
Cycak-Dyos urged provider leaders to include clinical teams in discussions of contract clauses so staff understand requirements before problems arise. Meara described a case in which an Ignite facility in Texas experienced friction with a payer. Ignite responded by arranging weekly meetings with senior leaders to hear the plan’s concerns. Meara said the meetings showed the company’s willingness to communicate and work toward shared goals; the report does not specify the dispute’s details or final outcome.
“I think that’s where providers often fail.”
— Chris Cycak-Dyos, director of strategic network operations at Helion
Results and Reporting Standards Remain Unclear
The report does not provide data showing how often these practices improve contract retention, care quality, access or costs. It also does not identify a shared set of performance measures used across Medicare Advantage plans and home-based care providers. The speakers described claims data as potentially delayed by about six months, but the report does not say how broadly that delay applies or what other data sources providers should use.
Details about Ignite’s Texas payer dispute, including its cause, duration and resolution, were not provided. The speakers’ recommendations are industry perspectives from a summit, not formal policy requirements or guarantees of better outcomes.
Providers Must Put Advice Into Practice
The report does not announce a new rule, contract initiative or deadline. The next steps it describes are operational: providers can establish performance baselines, share information with plans, involve clinicians when reviewing contract terms and keep regular channels open with payer representatives. Providers and plans will need to determine which measures and meeting schedules fit their individual agreements.
Further evidence would be needed to judge whether these approaches consistently improve network relationships or member outcomes. For now, the summit participants’ account points to ongoing communication and clearer performance information as practical ways to manage payer contracts beyond the signing stage.
Key Questions
What is the main advice for home-based care providers?
Speakers recommended maintaining regular communication with Medicare Advantage plans, sharing provider performance data and involving clinical teams in contract discussions.
Why should providers bring their own performance data?
Cycak-Dyos said claims information may be delayed by about six months. Provider-held measures can help establish a baseline and support discussions while claims data is pending.
What did Ignite Medical Resorts do when a facility had payer friction?
Senior vice president Justin Meara said Ignite arranged weekly meetings with senior leaders to hear the payer’s concerns. The report does not say how the dispute ended.
Did the report show that these practices improve outcomes?
No. It recounts recommendations and examples from industry speakers but provides no measured results establishing effects on contract retention, quality, access or costs.
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