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 Gaurav Abbi, MD, A Professional Corporation, to Provide Orthopedic Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Gaurav Abbi, MD, A Professional Corporation, to provide orthopedic services for the term of December 1, 2022 through November 30, 2023, in an amount not to exceed $271,488.
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BACKGROUND:
Dr. Gaurav Abbi has been providing orthopedic services to patients at San Mateo Medical Center (SMMC) since September 2016 and has expressed interest in continuing to provide those services.
DISCUSSION:
The County meets community need for orthopedic services through its contract with Dr. Abbi and other orthopedists. Dr. Abbi will continue to provide the same level of services as stated in his previous agreement with the County.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $ 25,000.00 (in aggregate).
It is anticipated that 0% of orthopedic operative procedures performed by Dr. Abbi will result in infection, and that 85% of patients who complete the Patient Satisfaction Survey would recommend Dr. Abbi as a provider.
PERFORMANCE MEASURE:
|
Measure |
2021-2022 Actual |
2022-2023 Estimated |
|
Percentage of orthopedic operative procedures resulting in infection that occurs at or near the surgical incision within 30 days of the procedure, or within 90 days if prosthetic material is implanted at surgery. |
0% |
0% |
|
Percentage of patients who complete the Patient Satisfaction Survey that recommend Dr. Abbi as a provider |
70% |
85% |
FISCAL IMPACT:
The term of the agreement is December 1, 2022 through November 30, 2023. The amount of the agreement is not to exceed $271,488 for the one-year term. Funds in the amount of $158,368 are included in the SMMC FY 2022-23 Adopted Budget. Funds in the amount of $113,120 are included in the SMMC FY 2023-24 Recommended Budget.
The payment provisions and levels of services in this contract differ from that of the previous contract, with the new contract representing a 33% increase. This reflects an 18% increase in hourly compensation for Dr. Abbi’s clinic and surgery coverage, which will now be $325.50, capped at a maximum rate of $1,302 per clinic block and surgical block. This is a blended rate, based on surveyed hourly compensation rates paid to orthopedists in the specialties of general orthopedic surgery and those orthopedists who specialize in “hip & joint” surgeries. The rate is consistent with fair market value as captured by VMG Health’s valuation playbook created for SMMC. VMG Health does not rely on a single published survey, but instead conducts a meta-analysis of multiple well known survey publishers to obtain the broadest possible data set to support. Previously SMMC relied upon a single publisher of physician compensation statistics, Medical Group Management Association, whose physician compensation data is included within VMG Health’s broader set of data.
The new contract also includes an estimate of 144 hours for “supplemental services” per contract year for surgery and clinical follow up that cannot be ordinarily scheduled within the physician’s scheduled block time. This is especially necessary when non-emergent follow up care is required after on-call consultation. The prior contract made no provision for such supplemental services and did not previously account for this need.
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.