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: Third Amendment to Agreement with Scott Oesterling MD, Inc. to Provide Obstetrics and Gynecology Services
RECOMMENDATION:
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Adopt a resolution authorizing a third amendment to the agreement with Scott Oesterling MD, Inc., adding an assignment of physician’s right to bill and collect to the County, extending the term of the agreement through March 31, 2025, updating the agreement’s List of Approved Providers, increasing the monthly fees paid to the group effective January 1, 2025 through the remainder of the term by 3%, and increasing the amount of the agreement by $774,783.50, to an amount not to exceed $9,824,783.50.
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BACKGROUND:
On November 16, 2021, this Board approved an agreement with Scott Oesterling MD, Inc. (“the Oesterling Group”) to provide OB/GYN services to County patients for the term of January 1, 2022 through December 31, 2024. On December 6, 2021, the parties entered into an amendment to the agreement, to update the List of Approved Providers. On April 1, 2022, the parties entered into a subsequent amendment to the agreement, which again updated the List of Approved Providers.
DISCUSSION:
This most recent amendment to the agreement with the Oesterling Group will add an assignment of the providers’ right to bill and collect for their professional medical services to the County, extend the term of the agreement by three months for a new term of January 1, 2022 through March 31, 2025, and increase the monthly fees paid to the group by 3%, effective January 1, 2025 through the remainder of the term from $250,739 per month, to $258,261.17 per month. This amendment will increase the amount of the agreement from $9,050,000 to $ 9,824,783.50 to provide sufficient approved funds through March 31, 2025. This amendment will also update the List of Approved Providers.
The rates in the amendment 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.
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 estimated 95% of obstetrics and gynecology consults will be seen by a specialist within 30 days of referral.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of obstetrics and gynecology consults who will be seen by a specialist within 30 days of referral |
95% |
95% |
EQUITY IMPACT:
The Oesterling Group’s continued OB/GYN coverage positively impacts equitable health outcomes for San Mateo Medical Center (SMMC)’s patients by specifically addressing the obstetric and gynecological needs of the County’s most medically and financially vulnerable 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 the providers in the Oesterling Group to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The proposed term of the third amended agreement is January 1, 2022 through March 31, 2025. The amount of the agreement is not to exceed $9,824,783.50 for the 27-month term, accounting for a flat 3% increase in monthly payments to the Oesterling Group between January 1, 2025 and March 31, 2025. The increased cost of the agreement is $7,522.17 per month during the three-month extension, the cost of which is included in the SMMC FY 2024-25 Adopted 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.