What Orion ISO does

Orion Intermediary Services Organization (Orion ISO) is a Minnesota-based Financial Management Service (FMS) provider, founded in May 2001 by Marya Hage and headquartered in Golden Valley. The company serves individuals with disabilities and elderly participants across Minnesota who self-direct their care under state Medicaid waivers and grant programs, handling the full employer-of-record stack on participants' behalf: payroll processing, tax withholding, W-2 issuance, expense reimbursement, vendor billing to Medical Assistance, and reporting to the Minnesota Department of Human Services. Service lines span Consumer Directed Community Supports (CDCS), the Consumer Support Grant (CSG), Community First Services and Supports (CFSS) launched October 2024, and Individualized Home Supports (IHS) without Training under a 245D license; CFSS also underpins a paid Consultation Services line billed at $100 per session to counties.

The underlying technology stack is operational rather than proprietary. Orion ISO integrates third-party Electronic Visit Verification platforms—Pavillio for IHS and Cashe Software for CDCS, CSG, and CFSS—to satisfy the federal 21st Century Cures Act and Minnesota EVV mandates, enabling mobile clock-in/clock-out and remote approval of hours by Authorized Representatives or Managing Employers. Intake is delivered through JotForm online forms, a 176-language interpreter service, and direct phone/email coordinators; the company holds no AI/ML capabilities and exposes no API or developer platform. Back-office and training infrastructure is shared with the parent Orion Associates family via SharePoint and a training portal.

The business model is managed services plus, recently, professional services. FMS revenue is pass-through on payroll and billings to Medical Assistance with administrative fees retained; the new Consultation Services tier adds unit-priced ($100/session) advisory income paid by counties. Go-to-market is direct-to-consumer but referral-driven: case managers and county workers determine waiver eligibility and refer participants to Orion ISO, and the company leverages its website, Facebook, LinkedIn, and X (Twitter) presence for top-of-funnel awareness. Orion ISO passed the Minnesota Vendor Fiscal/Employer Agent FMS Readiness Review at 99% and is part of a family of related organizations (Meridian Services, Morning Sun Financial Services, Zenith Services, Orion Associates, Headwaters Relief Organization) that extend disability and elderly-services capability beyond Minnesota without Orion ISO itself operating outside the state.

Name

Orion ISO

Legal name

Orion Intermediary Services Organization

Website

https://orioniso.com

Company type

Private

Founded year

2001

Operating status

Operating

Headcount range

1–10 employees

Short description

Orion ISO is a Minnesota-based Financial Management Service provider founded in 2001 that acts as fiscal employer-of-record for individuals with disabilities and elderly participants self-directing care under state Medicaid waiver programs, including CDCS, CFSS, CSG, and IHS.

Ownership category

akta.pro rank

Product category

Disability Financial Management Services

NAICS

Services for the Elderly and Persons with Disabilities (62412), Services for the Elderly and Persons with Disabilities (624120)

SIC

Services-Engineering, Accounting, Research, Management (8700)

akta.pro primary industry

RPM Reimbursement, Billing & Program Operations Platforms (HLACAFAN)

akta.pro secondary industries

Remote Patient Monitoring (RPM) Platforms & Services (HLACAPAA), Home Cardiac Care & Remote Patient Monitoring (Skilled Oversight) (HLADAFAJ)

Keywords

• Financial management services
• Disability services
• Self-directed care
• Medical assistance programs
• Home and community-based services

Headquarters

HQ city

Minneapolis

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D

Revenue model

1. Financial Management Services (FMS) for CDCS: As a Financial Management Service provider, Orion ISO handles employer-related responsibilities for participants on Consumer Directed Community Supports, including payment of hours worked, reimbursement of approved goods and services, billing Medical Assistance, expense verification, and reporting to the Department of Human Services. The company serves as fiscal agent while the consumer or representative assumes the employer role.
2. Financial Management Services (FMS) for Consumer Support Grant (CSG): Orion ISO FS provides payroll services (processing timesheets, managing payroll tax withholding, distributing W2s, tracking paid time-off and holiday pay), expense services (reimbursements of approved goods and services), and monthly spending reports for CSG participants.
3. Financial Management Services (FMS) for CFSS: With the implementation of Community First Services and Supports (CFSS) from October 2024, Orion ISO provides budget model FMS services including assisting individuals to hire staff, purchase goods and services, and comply with applicable laws.
4. Consultation Services for CFSS: Orion ISO serves as a Consultation Service Provider under CFSS, educating participants on program service model options, supporting development of service delivery plans, and providing ongoing support. Consultation services have a $100.00 per service session fee authorized and paid by the county.
5. Individualized Home Supports (IHS) without Training: Orion ISO is a 245D licensed provider of Individualized Home Supports without Training, Respite, Homemaker and Chore services. Provides licensed staffing support for people on the developmental disabilities waiver.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels5 records

Core offering

Orion ISO is a Minnesota-based Financial Management Service (FMS) provider for self-directed services programs, delivering payroll processing, tax filing, expense reimbursement, and billing administration for individuals with disabilities, elderly adults, and their families enrolled in Minnesota Medicaid waiver programs (CDCS, CFSS, CSG, IHS). The company operates as a licensed 245D provider under the Minnesota Department of Human Services.

Product overview

Orion ISO is a Financial Management Service Provider (FMS) offering a portfolio of self-directed service programs for people with disabilities, the elderly, and their families in Minnesota. The core offerings include Consumer Directed Community Supports (CDCS), Individualized Home Supports (IHS) without Training, and Consultation Services. The company also supports Community First Services and Supports (CFSS), which launched in October 2024 as a new self-directed flexible healthcare program replacing Consumer Support Grant and PCA services. As an FMS, Orion ISO handles administrative tasks including employer setup, budget development, payroll processing, expense reimbursement, human resources support, billing and reporting, and consultation services. The company partners with Pavillio and Cashe Software for Electronic Visit Verification (EVV) compliance solutions.

Differentiator

Problem solved

Functional benefit

Products and services

• Financial Management Services (FMS) End-to-end financial administration for self-directed waiver participants, including payroll processing for personal care attendants, employer tax filings, expense reimbursement, and Medicaid billing/reconciliation. Targeted at individuals with disabilities, elderly adults, and families enrolled in Minnesota Medicaid waiver programs such as CDCS, CFSS, CSG, and IHS.
• Self-Directed Services Consultation

Quantifiable outcome

• 99% overall score on Minnesota Vendor Fiscal/Employer Agent Financial Management Services Readiness Review
• +2 more outcomes

Named customers2 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature2 records

Partnerships

Nine partnerships are on record, tiered core and minor.

• Morning Sun Financial ServicescoreStrategic or Co-development PartnerMorning Sun Financial Services is a related organization under the same corporate family that provides fiscal intermediary services in Alabama, Colorado, Ohio, Oklahoma, and Utah, extending Orion's service reach nationally. This allows Orion ISO to focus on Minnesota while the related entity serves other states.
• Meridian ServicescoreStrategic or Co-development PartnerMeridian Services is a related company founded by Marya Hage (also founder of Orion ISO) that serves individuals with disabilities. Both organizations are part of the Orion family of companies serving the disability community.
• Headwaters Relief OrganizationminorStrategic or Co-development PartnerHeadwaters Relief Organization is part of the Orion family of companies and has been active since the beginning of the COVID-19 pandemic, creating storybooks ('When We All Wore Masks', 'When We All Stayed Home') to help children and families cope with the pandemic.
• Zenith ServicesminorOthersPart of the Orion family of organizations serving individuals with disabilities and the elderly. Shares corporate social responsibility initiatives including COVID-19 response and community support.
• Orion AssociatescoreOthersThe parent/administrative entity for Orion ISO, providing shared infrastructure including training portals (training.orionassoc.net), SharePoint resources, and corporate HR/administrative functions.
• PavilliocoreTechnology or IntegrationOrion ISO partners with Pavillio for Electronic Visit Verification (EVV) Compliance Solutions for Individualized Home Supports (IHS) services. Pavillio's mobile app allows employees to clock in/out and Authorized Representatives to approve hours worked, satisfying Minnesota state and federal EVV mandates.
• Cashe SoftwarecoreTechnology or IntegrationOrion ISO partners with Cashe Software for Electronic Visit Verification (EVV) Compliance Solutions for CDCS, CSG, and CFSS programs. The Cashe system allows employees to clock in/out via mobile app and Managing Employers to approve hours worked, fulfilling federal EVV requirements under the 21st Century Cures Act.
• Minnesota Department of HealthcoreOthersOrion ISO follows guidelines defined by the Minnesota Department of Health for COVID-19 preparedness and ongoing health and safety protocols.
• Centers for Disease Control and Prevention (CDC)coreOthersOrion ISO follows CDC guidelines for health and safety protocols, including COVID-19 response measures.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Palco: FMS/fiscal employer agent supporting self-directed Medicaid waiver programs in multiple U.S. states. Similar business model to Orion ISO: handles employer-of-record, payroll, tax, billing, and EVV for self-directed care participants.
• Consumer Direct Care Network: Multi-state FMS (Fiscal/Employer Agent) provider for Medicaid self-directed programs serving individuals with disabilities, elderly, and their families. Closely comparable in scope of services (payroll, billing, EVV, consultation) and customer segment.
• Acumen Fiscal Agent: Specialized FMS provider serving self-direction programs across multiple states. Directly comparable in operating model (fiscal/employer agent for HCBS waivers including New Mexico, where it originated) and participant mix.
• Morningsun Financial Services: Related organization under the same corporate family as Orion ISO providing FMS/fiscal intermediary services in Alabama, Colorado, Ohio, Oklahoma, and Utah. Sister-entity peer with identical service model (payroll, billing, EVV) but in different geographies.
• Public Partnerships: Largest FMS/fiscal employer agent provider in the United States, serving Medicaid self-directed care programs across many states. Directly comparable to Orion ISO in role as fiscal intermediary handling payroll, EVV, billing, and consultation services for HCBS waiver participants.
• GT Independence: National FMS provider operating in multiple states supporting self-directed HCBS programs for individuals with disabilities and elderly participants. Directly comparable model: fiscal/employer agent services for Medicaid waivers with case-manager-driven referrals.

Others

• HHAeXchange: Leading Electronic Visit Verification (EVV) and home-care billing platform used by FMS providers and state Medicaid agencies. Comparable as an enabling technology layer for HCBS self-directed programs; Orion integrates Pavillio and Cashe for the same compliance function.
• Meridian Services: Related organization founded by the same founder (Marya Hage) serving individuals with disabilities under the Orion family. Sister-entity peer across the disability services continuum (case management / 245D services) with overlapping customer base.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/OrionISOMN
• Facebookfacebook.com/OrionISO
• LinkedInlinkedin.com/company/orion-iso

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Orion ISO