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: Amendment to the Agreement with Nordic Consulting Partners, Inc to Provide Revenue Cycle Consulting Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Nordic Consulting Partners, Inc to provide revenue cycle consulting services, extending the term of the agreement by three months through March 31, 2025, and increasing the amount by $398,000, to an amount not to exceed $594,000.
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BACKGROUND:
San Mateo Medical Center (SMMC) published a Request for Quotes (RFQ) in early 2023 for the development of a value-based care strategic playbook and previously awarded Nordic Consulting Partners, Inc (Nordic) a departmental level agreement effective July 1, 2023, in an amount not to exceed $50,000. This agreement was subsequently amended to add services for a population health analytics and insight summary, and extended through December 31, 2024, in an amount not to exceed $200,000.
SMMC then published an RFQ in late 2023 for advisory services pertaining to legacy accounts receivable management in the post-Epic-implementation environment. Again, Nordic was selected as the preferred vendor. SMMC entered into a contract with Nordic for “legacy Accounts Receivable management” advisory services effective November 27, 2023, in an amount not to exceed $ 200,000.
SMMC next published an RFQ in early 2024 for revenue cycle operating model redesign. Again, Nordic was selected as the preferred vendor. SMMC entered into a contract with Nordic for revenue cycle operating model redesign consulting effective April 1, 2024, in an amount not to exceed $ 200,000.
SMMC next published an RFQ in late summer of 2024 for revenue cycle services which focused on policy gap assessment, “quality assurance” dashboard and report recommendations, and revenue cycle work-queue analysis. Again, Nordic was selected as the preferred vendor. SMMC entered into a contract with Nordic for the aforementioned services effective September 3, 2024, in an amount not to exceed $195,000.
Concurrently, SMMC issued a separate RFQ in late summer 2024 and Nordic was awarded another separate agreement to provide revenue cycle organizational readiness services to support charge capture and revenue reconciliation training and readiness for the term of September 9, 2024, through December 31, 2024, in an amount not to exceed $196,000.
The sum of the contracts awarded to Nordic for various consulting services between 2023 and 2024 amounted to $991,000.
DISCUSSION:
During the Epic project go-live readiness phase, SMMC identified that different revenue cycle groups needed additional support to be fully ready to operate the new Epic functionality. As a result, SMMC published two additional RFQs in September 2024 seeking assistance with the following: 1) designing an operating model to support workflows and business requirements for a denials management program in SMMC’s Patient Financial Services department, and 2) providing Epic post-live revenue cycle operational support for SMMC’s Revenue Integrity department. After completing evaluation of all proposals, Nordic was deemed the best fit and providing the best overall value to the County to provide these services based on their expertise, comprehensive scope of services, and pricing for these additional services.
Nordic is expected to deliver, at a minimum, recommendations, Key Performance Indicators, and dashboards for a denials management program that includes elements such as denials reporting analysis, root cause identification using Epic reporting tools, monitoring work queue volumes, and preventing incoming denial backlogs after go-live. Additionally, Nordic will provide recommendations and assistance with a post-live revenue integrity management program that includes elements such as charge, and revenue performance tracking compared to historical baselines to minimize disruptions in cash flow collections.
Because Nordic was deemed to provide the best overall value to the County, SMMC is requesting this Board waive the requirements for formal solicitations for contracts exceeding $200,000, to allow SMMC to award additional services to Nordic based on the result of SMMC’s published competitive RFQs.
County Attorney has reviewed and approved the resolution and amendment 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 Nordic will meet the project milestones and deliver the project deliverables for the following services 100% of the time: 1) charge capture and revenue reconciliation; 2) denials management; and 3) go-live operational support.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of time Nordic will meet the project milestones and deliver the project deliverables for the following services: 1) charge capture and revenue reconciliation; 2) denials management; and 3) go-live operational support |
100% |
N/A |
EQUITY IMPACT:
The adoption and use of an integrated electronic health record system (EHR), such as Epic, can support San Mateo County Health (SMC Health)’s commitment to advancing health equity. By proactively addressing potential disparities, SMC Health can ensure the benefits of an integrated EHR are shared equitably across all populations we serve. Specifically, Epic is expected to enhance SMC Health’s ability to collect patient demographic and clinical data, allowing for better tracking of health outcomes across different populations and identifying health disparities more effectively. This can lead to enhanced care coordination among healthcare providers, especially for marginalized populations who may have more complex healthcare needs.
The services provided under the Nordic agreement will support SMMC’s optimized use of Epic’s revenue cycle functionality in an efficient and compliant manner in order to improve cash flow and provide the financial resources that supports SMC Health’s commitment to advancing health equity.
FISCAL IMPACT:
The term of the amended agreement is September 9, 2024, through March 31, 2025. The amendment increases the amount payable under the agreement by $398,000 to an amount not to exceed $594,000 for the seven-month term. Funds in the amount of $398,000 are included in the FY 2024-25 SMC Health Epic project budget.