Cirdan’s mission is to simplify the complexities of healthcare and bring down the barriers that prevent local players from entering and growing in the healthcare industry and making real improvements. Whether you need a few services or many, Cirdan makes it simple.
Cirdan believes healthcare improvement will come from going local, not national. That starts with focusing on smaller localized health plans. Why? Because healthcare works best when it’s attuned to the needs of the patient and that can only happen when you truly understand your community. That’s something local, more focused organizations do best.
Local health plans come in many forms, each with a unique story about how they serve patients and local communities better. Cirdan has worked with plans that serve:
- Rural areas – as the single Medicaid health plan serving local communities; we’ve helped set up new care coordination and gain-sharing models with local providers, public health, and social services.
- Inner cities – as a Medicaid plan that takes a holistic approach to the needs of urban communities by effectively combining healthcare and broad range of community resources.
- Persons with disabilities – as a single regional Medicaid/Medicare plan for persons with physical, mental, and developmental disabilities, forging new provider partnerships.
- Seniors – as a local health plan that combines Medicaid/Medicare benefits, including a wide range of non-medical “waiver” services, to help the elderly stay in community settings.
- Employers – through a pool of rural employers that wanted to have more control, flexibility, transparency, and financial stability in their health coverage plans; we helped set up innovative funding designs to meet the goals of employers, unions, and members.
Dealing with big data and financials in healthcare is intimidating. Add to that ever-changing operating and financial regulatory requirements, and it’s clear why local health plans have a hard time getting started and expanding into new lines of business. As a healthcare consulting company that specializes in local health plans, we break this barrier by providing the actuarial, financial management, and data services you need to stay compliant and reach your financial goals. You also get access to our partner network that offers services such as claims payment and call centers.
We have been delivering healthcare consulting and professional services to managed healthcare organizations since 2001. It all started with an in-depth study that our founders performed in Minnesota. The topic? The feasibility of counties forming their own health plans to provide high quality and coordinated managed care services for Medicaid eligible persons.
This study proved that locally-based health plans could be successful and legislation was passed to permit this type of managed healthcare entity. This gave us the opportunity to work with start-up county-based purchasing plans from their earliest beginnings and help them to develop and manage their actuarial, financial, and data services functions.
Since our start in 2001, we have added other managed healthcare clients, and our mix of services continues to expand. But by far the most satisfying part of what we do is knowing the positive impact it has on local markets, seniors, and other special needs communities. The fact that we enable small health plans to succeed keeps us striving toward innovation in our field.
Our data services consultants manage the enrollment, revenue, claim, encounter, and risk adjustment data needed to manage contracts, Medicaid and Medicare products, identify cost drivers, and support risk-based provider contracts.
Our actuaries and consultants are experienced in valuation, financial reporting, Medicare bids, Medicaid rates, risk adjustment, product pricing, and health plan startup feasibility analysis.
Financial Management Services
Our consultants prepare the statutory annual and quarterly statement filings for our clients. We also provide support for budgeting, forecasting, monthly financial reporting, internal and external audits, financial controls, and organizing accounting systems.