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 Steve Hassid, MD to Provide Non-Invasive Cardiology Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Steve Hassid, MD to provide non-invasive cardiology services for the term of July 1, 2024, through June 30, 2027, in an amount not to exceed $2,377,200.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This includes services for cardiology disorders and the management and supervision of those services. The County’s need for cardiology services is increasing due to the aging of its patient population.
Dr. Hassid has served as a non-invasive cardiologist at San Mateo Medical Center (SMMC) for over 33 years, previously through a physician group and more recently as an independent contractor.
DISCUSSION:
Dr. Hassid will continue to provide full-time cardiology services that include four-hour clinic blocks, inpatient cardiology consultations, and reading services including electrocardiograms, “stress echoes”, “stress tests”, and Holter monitors. Dr. Hassid will also provide on-call coverage and will continue to serve as the Medical Director of Cardiology.
In response to increased community need, Dr. Hassid is willing to provide expanded cardiology services. Where previously Dr. Hassid provided 1920 annual hours of clinical cardiology services, the proposed contract would increase Dr. Hassid’s maximum coverage obligation by 8.3% to 2080 annual hours of clinical coverage services (480 four-hour clinical services blocks previously vs. 520 four-hour clinical services blocks). Additionally, Dr. Hassid’s Medical Director hours are being increased by 50% from 10 hours per month to 20 hours per month due to expected need for his administrative services during the Epic Systems implementation and supervision of expanded services. There is no change in the amount of on-call services that will be provided.
County Administrative Memorandum B-1 provides that contracts for physician services are exempt from competitive procurement requirements.
The rates in Dr. Hassid’s renewed contract are within fair market value according to Value Management Group 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 anticipated that 95% of the time, Dr. Hassid will document and perform nutrition counseling for patients during ambulatory clinic visits when patients have body mass index greater than twenty-five.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of documentation and performance nutrition counseling for patients during ambulatory clinic visits when patients have Body Mass Index greater than twenty-five |
95% |
95% |
|
Percentage of patients who complete the Patient Satisfaction Survey recommending contractor as a provider |
85% |
85% |
EQUITY IMPACT:
Dr. Hassid’s continued cardiology coverage will positively impact equitable health outcomes because delivery of cardiology services at SMMC, a public safety net hospital, addresses community need. Specifically, in the past 12 months 68.3% of SMMC’s patients were enrolled in Medi-Cal with an additional 6.1% of SMMC’s patients enrolled in the Access to Care For Everyone (ACE) program. 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 (56%), Hispanic or Latino (58%), 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. Hassid to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the agreement is July 1, 2024 through June 30, 2027. The amount of the agreement is not to exceed $2,377,200 for the three-year term. Funds in the amount of $792,400 are included in the SMMC FY 2024-25 Adopted Budget. Similar arrangements will be made for future years.
The payment provisions and levels of services in this contract differ from that of the previous contract, due to the 8% increase in the maximum number of annual clinical services hours, the 50% increase in Medical Director hours, and an adjustment from a flat combined monthly-rate compensation model to an hourly compensation model based on the same hourly rate recently offered to Drs. Bindra, Shreibati, and Zheng. For these reasons, the total value of the new contract represents a 37% increase compared to that of the previous contract.
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.