Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with MedOnc INC to Provide Hematology and Oncology Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with MedOnc INC to provide hematology and oncology services for the term of October 1, 2025 through September 30, 2028 in an amount not to exceed $2,038,656.
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BACKGROUND:
San Mateo County provides hematology and oncology services to the public at San Mateo Medical Center (SMMC) to meet community need. Dr. Teja Bedi helps the County meet this need by having contracted to provide hematology and oncology services under her professional medical corporation, MedOnc INC since 2019.
DISCUSSION:
Under the previous agreement with MedOnc INC, Dr. Bedi provided a minimum of 480 4-hour outpatient clinic shifts, which split time providing care in SMMC’s infusion clinic and the hospital’s ambulatory clinic. Dr. Bedi also provided approximately half of the hospital’s on-call coverage for hematology and oncology services, consisting of at least 130 weekdays and 26 weekends of 24-hour on-call shifts. Medical Director services consisted of managing the hematology and oncology schedule, reviewing cases, managing recruiting, and aligning service to meet patient needs. Dr. Bedi’s administrative services as the hospital’s medical director would frequently overlap with her 1,920 hours of regular clinical coverage, all while the County paid a flat monthly sum.
The new agreement would provide Dr. Bedi’s services for up to 358 4-hour outpatient clinic shifts (including within the infusion clinic), the same amount of on-call shift coverage (130 weekdays and 26 weekends), and up to 384 hours of supplemental clinical services as needed to meet community need. Up to 10 hours per month would be dedicated to enumerated Medical Director duties, which will be logged. The total of Dr. Bedi’s clinical and administrative hours under the new contract is expected to be 1,936 hours – a nominal increase in hours compared to the previous agreement if all hours are worked. The major difference here is that the new agreement will pay MedOnc INC per hour of service that is logged and recorded.
The 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.
The 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. Bedi will document and perform advanced care planning during ambulatory Clinic Blocks for patients aged 65 and older 95% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of time Dr. Bedi will document and perform advanced care planning during ambulatory Clinic Blocks for patients aged 65 and older |
95% |
95% |
COMMUNITY IMPACT:
Dr. Bedi’s continued hematology and oncology coverage will positively impact health outcomes because delivery of hematology & oncology services at SMMC, a public safety net hospital, addresses community need. 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 training to its physicians and 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. Bedi 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 October 1, 2025 through September 30, 2028. The amount of the agreement is not to exceed $2,038,656 for the three-year term. Funds in the amount of $679,552 are included in the SMMC FY 2025-26 Recommended Budget pending adoption. Funds in the amount of $679,552 are included in the SMMC FY 2026-27 Recommended Budget. Similar arrangements will be made for future years.
The total value of the new contract represents a 6% 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.