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 Ronald Greenwald, MD for Neurosurgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Ronald Greenwald, MD for neurosurgery services from August 1, 2022 through July 31, 2025 in an amount not to exceed $1,650,718.
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BACKGROUND:
Neurosurgery services are provided under the general direction of the Chief of Surgery at San Mateo Medical Center (SMMC) and include evaluation and treatment of the brain, spinal cord, and peripheral nervous system disease. Dr. Greenwald has been providing professional neurosurgery services at SMMC since 1991.
DISCUSSION:
Under this agreement, Dr. Greenwald has agreed to continue to provide neurosurgery services. In prior contracts, Dr. Greenwald has been compensated for his on-call hours at a flat rate that was far below fair market value. That compensation has been increased to better reflect the Medical Group Management Association (MGMA) Provider Compensation and Production Report rates. MGMA is a tool SMMC uses to benchmark physician contract compensation, and MGMA rates for on-call were not previously used to negotiate Dr. Greenwald’s previous contracts. SMMC has also moved to eliminate per service agreements that result in unpredictable expenses and moved to a monthly stipend model, to compensate for a variety of duties that were previously separately compensated.
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 (in aggregate).
It is anticipated that 100% of services provided will adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California, Code of Regulations.
PERFORMANCE MEASURE:
|
Measure |
FY 2021-22 Actual |
FY 2022-23 Projected |
|
Percentage of services provided that adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California, Code of Regulations |
100% |
100% |
FISCAL IMPACT:
The term of the agreement is August 1, 2022 through July 31, 2025. The amount of the agreement is not to exceed $1,650,718 for the three-year term. Funds in the amount of $535,368 are included in the SMMC FY 2022-23 Recommended Budget. Similar provisions will be made in subsequent years.
The 21% increase in the stated contract compensation is largely due to the new on-call rate, set by the 2021 MGMA rate. The payment provisions of this agreement differ from those of the previous agreement, as this agreement represents a 21% increase compared to the previous agreement. This increase is largely due to the new on-call rate, set by the 2021 MGMA Provider Compensation and Production Report, as described above.
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.