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: Second Amendment to the Agreement with California Advanced Imaging Medical Associates, Inc. for Radiology Services
RECOMMENDATION:
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Adopt a resolution authorizing a second amendment to the agreement with California Advanced Imaging Medical Associates, Inc. for radiology services, extending the term of the agreement by two months through May 31, 2025, and increasing the maximum amount payable of the agreement by $567,342, to an amount not to exceed $10,807,342.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since 2008, California Advanced Imaging Medical Associates, Inc. (CAIMA) has provided radiology services under contract for San Mateo Medical Center (SMMC). During that time, CAIMA also provided SMMC’s Medical Director for Radiology under contract. Currently the parties are operating under that certain radiology services agreement for the term of April 1, 2022 through March 31, 2025, in an amount not to exceed $10,215,000. Radiology services are a necessary component of basic hospital services under California’s hospital licensing regulations, known collectively as “Title 22.” The agreement was amended once to add $25,000 to the “not to exceed” amount, bringing it to $10,240,000.
DISCUSSION:
The parties both agree that a two-month extension of the current agreement is needed for productive negotiations to continue. The proposed amendment would increase the “not to exceed” amount of the agreement by $567,342, reflecting two months of payment at the existing contract rate. The term would be extended by two months through May 31, 2025.
The rates in the current 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.
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 90% of examinations that require patients to stay in the department during evaluation will be accompanied by a radiologist who is available to review for technical adequacy within 30 minutes.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of examinations that require patients to stay in the department during evaluation will be accompanied by a radiologist who is available to review for technical adequacy within 30 minutes |
90% |
90% |
EQUITY IMPACT:
CAIMA’s continued radiology coverage will positively impact equitable health outcomes because continuation of radiology services at SMMC is required to maintain the hospital’s license under California law. SMMC is a public safety net hospital. Within the past 18 months, the largest cohorts of specialty care patients at SMMC were female (53%), Hispanic or Latino (57%), and primarily Spanish-speaking (54%). 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 CAIMA physicians 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 April 1, 2022 through May 31, 2025. The amendment increases the amount payable under the agreement by $567,342 to an amount not to exceed $10,807,342 for the 38-month term. Funds in the amount of $567,342 are included in the SMMC FY 2024-25 Adopted Budget.
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.