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 Alan McBride to Provide Reimbursement Consulting Support Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Alan McBride to provide reimbursement consulting support services for the term of October 1, 2026 through September 30, 2031, for an amount not to exceed $1,000,000.
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BACKGROUND:
As a public hospital, San Mateo Medical Center (SMMC) serves a broad mix of patients, and the federal and State regulations governing reimbursement for medical services provided by SMMC are complex. Approximately 50% of SMMC’s annual revenue comes from federal and State reimbursement programs, such as Medicaid’s Disproportionate Share Hospital program, the California Department of Health Care Services’ (DHCS) Medicaid 1115 Waiver, Medi-Cal, Medicare, and other programs. In addition, the recently enacted Medicaid Managed Care Rule resulted in new funding programs.
Administering hospital reimbursement functions for these programs requires a high level of knowledge and experience due to the programs’ complexity and documentation requirements. SMMC requires support from a consultant who can analyze the hospital’s participation in these various programs and ensure that SMMC submits accurate cost reports and other requested documentation to support the ongoing reimbursement.
In June 2026, SMMC completed a Request for Proposals (RFP) process for Reimbursement Consulting Support Services.
DISCUSSION:
Alan McBride was elevated through a competitive RFP process due to his extensive background in this subject area, including experience working as a reimbursement manager for the County of Alameda and previously serving as Chief Financial Officer for multiple hospitals.
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 SMMC’s financial reporting requirements will be submitted on time to meet Centers for Medicare and Medicaid Services (CMS)/DHCS deadlines 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2026-27 Estimated |
FY 2027-28 Projected |
|
Percentage of time SMMC’s financial reporting requirements are submitted on time to meet CMS/DHCS deadlines |
100% |
100% |
COMMUNITY IMPACT:
Although Alan McBride’s reimbursement consulting support services do not directly impact SMMC’s patients, this service will strengthen SMMC’s ability to optimize for eligible reimbursement, improve regulatory compliance, and assist SMMC, a public safety net hospital, in providing health services to the community. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Since November 1, 2024, half of the specialty care patients at SMMC were female and half were male, with the largest ethnic cohorts being Hispanic or Latino (58%) and primarily Spanish-speaking (48%).
FISCAL IMPACT:
The term of the agreement is October 1, 2026, through September 30, 2031. The amount of the agreement is not to exceed $1,000,000 for the five-year term. Funds in the amount of $150,000 are included in the SMMC FY 2026-27 Adopted Budget. Funds in the amount of $200,000 will be included in the SMMC FY 2027-28 Recommended Budget.
The payment provisions and levels of services in this contract are the same as the previous contract. The total value of the new contract represents a 0% 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.
ATTACHMENT:
RFP Matrix