MA Final and Mid-Year Risk Adjustment Estimates

Client Challenge:

Cirdan’s client, a Medicare Advantage health plan, needed help to determine estimates of the mid-year and final risk adjustment payment settlements.

Our Solution:

• CIrdan analyzed the RAPS and EDPS submissions to determine the mid-year and final sweep estimates to incorporate into their financial statements
• Cirdan’s analysis helped the client anticipate the impact of any encounter data submission issues and related impacts such as delays in cash flow and future financial results

The Result:

Our client was able to make informed estimates for required financial reporting and used our reports as support for financial audit purposes. Retaining Cirdan allowed access to actuarial experts with years of experience evaluating these settlements.