Item Description:
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Amd 7 to Agmt PR00001249 with Cirdan Health Systems, Inc., a subsidiary of Health Management Associates, Inc., for actuarial and consulting services to Hennepin Health, 09/01/24-08/31/25, incr NTE by $727,604
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Resolution:
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BE IT RESOLVED, that Amendment 7 to Agreement PR00001249 with Cirdan Health Systems, Inc., a subsidiary of Health Management Associates, Inc., to provide Hennepin Health with actuarial and consulting services for the period September 1, 2024 through August 31, 2025, increasing the not to exceed amount by $727,604 for a new total not to exceed amount of $4,110,604 be approved; that the Chair of the Board be authorized to sign the Agreement on behalf of the County; and that the Controller be authorized to dispense funds as directed.
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Background:
Cirdan Health Systems Inc., a subsidiary of Health Management Associates, Inc., has provided actuarial and consulting services to Hennepin Health (formerly known as MHP) since 2001. An Actuarial Services RFQ was conducted in 2017 and Cirdan Health Systems Inc., a subsidiary of Health Management Associates, Inc., was selected. This contract provides actuarial, consulting and financial analysis support in the following capacities:
Professional and Actuarial Support Services:
• Prepare and assist in the development of quarterly reserves for the months ending September 2024, December 2024, March 2025 and June 2025.
• Prepare annual Actuarial Opinion of actuarial assets and liabilities, and related actuarial memorandum and actuarial report.
• Support MN DHS data submissions and help reconcile transactional data to audited financials where appropriate. Provide miscellaneous/other adjustment data and review final report.
Provide assistance as necessary to support DHS contract rate negotiations. This includes:
• Attending meetings
• Analyzing benefit changes initiated by the legislature or DHS
• Assisting in the development of the negotiation strategy
• Review and rebuttal DHS actuarial rate memorandums
• Performing ad hoc analyses in support of HH negotiation positions
Develop and maintain a process to create, reconcile and submit HH’s encounter data, including actionable error reporting:
• DHS encounter data-participate in DHS encounter data work groups and assess the impact of submissions on revenues and performance measures
• RHC submissions and related support
• Load carve-out claim data from DHS for immediate use for crucial analyses (e.g., PCA, FQHC, IHS, dental, etc.)
• MDH OnPoint encounter data submissions
• Provide access to the Cirdan Encounter Analytics and Oversight (EAO) tool
Provide miscellaneous assistance to Hennepin Health as requested, including:
• Review projections and budgets developed by HH finance staff
• Produce quarterly reports summarizing inpatient and ambulatory services for NAIC exhibits
• Support the HH ACO finance committee work group, attending monthly meetings as scheduled
• Attend meetings of the finance/operations work group expected to occur weekly
• Maintain a detailed claim database to support the preparation of the DHS rate data submissions and any ad hoc analyses requested by HH
This board action request aligns with Hennepin County disparity reduction efforts by improving access to culturally specific/sensitive health services and increase community well-being.
recommendation
Recommendation from County Administrator: Recommend Approval