Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Trifecta Group, Inc. to Provide Epic Transition Revenue Cycle Advisor Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Trifecta Group, Inc. to provide Epic transition revenue cycle advisor services for the term of October 1, 2023, through September 30, 2025, in an amount not to exceed $1,000,000.
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BACKGROUND:
San Mateo County Health and San Mateo Medical Center (SMMC) are implementing a new electronic health record (EHR) system (Epic), which will include significant advances in revenue cycle capabilities that address accounts receivable management, net revenue, claim denials, and increased workflow automation. To support this project, a Request for Proposals for revenue cycle advisory services for the Epic transition was completed in June 2023, and Trifecta Group, Inc. (Trifecta) was selected due to their knowledge and expertise of California safety net public hospitals, FQHC billing, and the Epic system.
DISCUSSION:
Trifecta would document current billing and collection workflows, create benchmark data, perform a gap analysis between Epic best practices and existing processes in SMMC’s patient financial services; and assess staffing, procedures, and work distribution to maximize effectiveness and efficiencies in preparation for the transition to Epic while concurrently guiding the Epic build.
Additionally, Trifecta would provide resources to support remit payment posting logic in SMMC’s legacy patient accounting system, Invision. SMMC follows a manual process to post payments and ensure reconciliation is complete. Transitioning this task to Trifecta would allow SMMC staff to focus on developing Epic workflows. It is anticipated that supported payment posting needs will be required for up to two years as legacy system accounts receivable are collected.
The County Attorney has reviewed and approved the resolution and agreement as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
This agreement is going to this Board late due to prolonged negotiations with the vendor.
It is anticipated that all electronic payments received will be posted within 90 days of receipt.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Number of days for all electronic payments received to be posted |
≤90 days |
≤30 days* |
FISCAL IMPACT:
The term of the agreement is October 1, 2023, through September 30, 2025. The amount of the agreement is not to exceed $1,000,000 for the two-year term. Funds in the amount of $375,000 are included in the SMMC FY 2023-24 Adopted Budget. Funds in the amount of $500,000 will be included in the SMMC FY 2024-25 Recommended Budget.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or those covered by programs that do not meet the full costs of care is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.
ATTACHMENT:
RFP Matrix