Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Jessica Marone, MD to Provide Pain Management and Musculoskeletal Medicine Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Jessica Marone, MD to provide pain management and musculoskeletal medicine services, for the term of October 1, 2025 through September 30, 2026, in an amount not to exceed $468,008, and authorizing and directing the President of the Board of Supervisors to execute the agreement on behalf of the County.
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BACKGROUND:
Jessica Marone, MD (Dr. Marone) is a non-anesthesia pain management specialist who graduated from the Shirley Ryan Ability Laboratory in Chicago, entered into a pain fellowship at the University of California, San Francisco, and performed her residency at San Mateo Medical Center (SMMC). Since Dr. Jarosz’s departure in 2023, SMMC has been operating with one physician short in the specialty of non-anesthesia pain management and physiatry (also sometimes referred to as musculoskeletal medicine). Dr. Jarosz was formerly SMMC’s Medical Director of Physiatry and her services were needed to help coordinate and assess pain management care to help minimize the risk of opioid use and dependency among SMMC’s patients. Dr. Marone fills the need for physician staffing for non-anesthesia pain management and assumes the role of Medical Director of Physiatry, following Dr. Jarosz.
DISCUSSION:
Under the proposed one-year arrangement, Dr. Marone would provide up to 312 four-hour outpatient clinic blocks, up to 24 four-hour surgery blocks for epidurals and deep joint injections in support of the operating room, up to 208 hours of supplemental clinical non-anesthesia pain management services, and up to 10 hours per month of administrative services as SMMC’s Medical Director of Physiatry, in exchange for payment in an amount not to exceed $468,000 (“Agreement”).
The rates in the Agreement are within fair market value according to VMG Health, a nationally recognized medical services valuation firm that relies upon multiple industry-standard provider compensation surveys and aggregates that data.
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).
It is anticipated that Dr. Marone will complete post-visit documentation within 24 hours at least 95% of the time, and more than 70% of patients with axial low back will receive appropriate imaging in line with American College of Radiology guidelines.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of time to complete post-visit documentation within 24 hours |
≥95% |
≥95% |
|
Percentage of patients with axial low back that will receive appropriate imaging in line with American College of Radiology guidelines |
>70% |
>70% |
COMMUNITY IMPACT:
Dr. Marone’s non-anesthesia pain management coverage and leadership as the Medical Director of Physiatry will positively impact equitable health outcomes because her services have an acute impact upon reducing the risk of prescribed opioid dependency among SMMC’s patients. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Within the past 18 months the largest cohorts of specialty care patients at SMMC were female (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%). SMMC strives to eliminate bias in the medical profession by providing culturally competent training to its physicians and by following up with patients to ensure that they continue to have access to specialized care. SMMC specifically tracks physician satisfaction survey results and requires Dr. Marone to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The amount of the agreement is not to exceed $468,008 for the one-year term. Funds in the amount of $351,006 are included in the SMMC FY 2025-26 Adopted Budget. Funds in the amount of $117,002 are included in the SMMC FY 2026-27 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 to 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.