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 Abhishek Gowda, MD to Provide Pain Management Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Abhishek Gowda, MD to provide pain management medicine and medical director services for the term of December 1, 2022 through November 30, 2024, in an amount not to exceed $794,968.
body
BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population, as well as access to services to its general population. Dr. Abhishek Gowda has provided pain management services at San Mateo Medical Center (SMMC) since June 2015.
DISCUSSION:
The County has a continuing need for pain management services. Dr. Gowda will continue to provide these services at SMMC’s main campus and the Daly City Clinic. In addition, he will supervise a clinic addressing behavioral and psychological issues associated with pain management.
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. Gowda will arrive on time to each clinic 90% of the time; 70% of patients who complete the Patient Satisfaction survey will recommend Dr. Gowda as a provider, and the wait time at SMMC for a patient to obtain an appointment for an epidural spinal injection (ESI) will be less than or equal to two weeks.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24Projected |
|
Percentage of time Dr. Gowda will arrive on time for each clinic scheduled Percentage of patients who complete the Patient Satisfaction Survey that recommend Dr. Gowda as a provider The wait time at SMMC for a patient to obtain an appointment for an ESI |
90% 70% ≤2 weeks |
90% 70% ≤2 weeks |
FISCAL IMPACT:
The term of the agreement is December 1, 2022 through November 30, 2024. The amount of the agreement is not to exceed $794,968 for the two-year term. Funds in the amount of $231,866 are included in the SMMC FY 2022-23 Adopted Budget. Funds in the amount of $397,484 are included in the SMMC FY 2023-24 Recommended Budget.
The total value of the new contract represents a 28% increase compared to that of the previous contract. This reflects an increase in hourly compensation for Dr. Gowda’s clinical and surgical services (6% increase compared to the previous contract) and Medical Director related time (22% increase). The increased rates in the new contract 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.
Additionally, the number of clinics, surgical block coverage, scheduled on-call days, and monthly medical director hours is conservatively estimated at the maximum possible quantity permitted under the contract, which did contribute to a higher not to exceed amount. Including this conservative estimate in the contract builds a measure of assurance that if there are exigent circumstances due to illness or a public health event, there will be additional authorized capacity for coverage.
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.