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 Sutherland Healthcare Solutions Inc to Provide Coding Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Sutherland Healthcare Solutions Inc to provide coding services for the term of July 1, 2026 through June 30, 2029, in an amount not to exceed $7,000,000.
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BACKGROUND:
San Mateo Medical Center (SMMC) has been contracting for ongoing as-needed support coding services since 1998. In February 2026, SMMC completed a Request for Proposals for coding services, and Sutherland Healthcare Solutions Inc (Sutherland) was elevated based on their experience in the industry and competitive pricing in comparison to the proposals that were submitted.
DISCUSSION:
SMMC continues to have an ongoing need for support coding services. Sutherland has agreed to meet or exceed SMMC’s productivity standards for coding services for the term of July 1, 2026, through June 30, 2029, with the option to extend the agreement by two years, in an amount not to exceed $7,000,000.
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).
The Technology Services Department has reviewed and approved the IT component of this agreement.
It is anticipated that Sutherland shall provide coding services at an accuracy rate of 95% or above.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of accuracy rate of coding services provided by Sutherland |
≥95% |
≥95% |
COMMUNITY IMPACT:
By having Sutherland provide coding services to SMMC, a public safety net hospital, it will positively assist SMMC in providing safe, timely, and high-quality care to SMMC’s patients. Accurate coding services will strengthen SMMC’s financial stability and compliance, enabling more accurate billing and reimbursements that improve access, quality of care, and overall health outcomes. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Since November 1, 2024, half of the specialty care patients at SMMC were female and half were male, with the largest ethnic cohorts being Hispanic or Latino (58%) and primarily Spanish speaking (48%).
FISCAL IMPACT:
The term of the agreement is July 1, 2026, through June 30, 2029. The amount of the agreement is not to exceed $7,000,000 for the three-year term. Funds in the amount of $1,400,000 are included in the SMMC FY 2026-27 Recommended Budget.
The payment provisions and levels of services in this contract differ from those of the previous contracts due to Sutherland being able to provide both emergency room and provider coding, which were previously split between two vendors. The total value of the new contract represents an 18% decrease compared to that of the previous contracts.
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.
ATTACHMENT:
RFP Matrix