Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Ronald Greenwald, MD to Provide Neurosurgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Ronald Greenwald, MD to provide neurosurgery services for the term of July 1, 2017 through June 30, 2019, to an amount not to exceed $675,000.
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BACKGROUND:
Neurosurgery services are provided under the general direction of the Chief of Surgery at San Mateo Medical Center (SMMC). Such care includes the evaluation and treatment of brain, spinal cord, and peripheral nervous system disease, including brain cancer, brain aneurysms, spinal cord and nerve root impingement syndromes (ruptured/herniated discs), and peripheral nerve impingement syndromes (carpal tunnel). Dr. Greenwald has provided professional neurosurgery services at SMMC since 1991.
DISCUSSION:
Dr. Greenwald will continue to provide neurosurgery services at SMMC. He will perform surgeries and provide a half-day clinic every week for 50 weeks per year. He is the only neurosurgery “solo practitioner” in San Mateo 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 County Counsel 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).
The agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing patients access to the evaluation and treatment of diseases requiring neurosurgery. As a safety net hospital, SMMC is acutely aware of the importance of controlling hospital borne infections, especially in the surgical setting. Failure to control infection results in higher costs to the County for additional care of those patients who become victims of a preventable infection and for which the County is not reimbursed. It is anticipated that the rate of readmission due to surgical site infection will be less than five percent.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Estimated |
FY 2017-18 Projected |
|
Readmission due to surgical site infection |
< 5% |
< 5% |
FISCAL IMPACT:
The term of the agreement is July 1, 2017 through June 30, 2019. The amount of the agreement is not to exceed $675,000 for the two-year term. Funds in the amount of $337,500 are included in the SMMC FY 2017-18 Recommended Budget. Funds in the amount of $337,500 will be included in the SMMC FY 2018-19 Recommended Budget. Similar arrangements will be made for future years.
The payment provisions of the agreement are different from the previous agreement because services are based on the contractor providing a fixed amount of services (50 clinic blocks and 50 surgical blocks), in addition to on-call coverage services. The previous agreement was based on the number of Work Relative Value Units. The amount of the agreement is being increased to reflect a 6% increase (3% per year) in compensation, as per the 2016 Medical Group Management Association’s Physicians Compensation and Production Survey.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medical indigent or to those covered by programs that do not fully meet the costs of care are covered by the County General Fund contribution to SMMC, and are within the existing annual appropriation.