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 Maurer Dermatology Associates to Provide Dermatology Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Maurer Dermatology Associates to provide dermatology services for the term of December 1, 2022 through November 30, 2025, in an amount not to exceed $1,629,000.
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BACKGROUND:
In January 2011, San Mateo Medical Center (SMMC) entered into an agreement with the University of California at San Francisco Medical Center (UCSF), under which Dr. Toby Maurer (who was at that time affiliated with UCSF) provided teledermatology screening and dermatology clinic services at SMMC.
In October 2017, Mauer Dermatology Associates (Maurer) and the County entered into an agreement under which Dr. Maurer and her associates provided a range of professional medical dermatology services to the County’s patients, including teledermatology screenings, dermatology clinics, advanced practice provider (APP) services (e.g. medical services provided by non-physicians that would typically be provided by a physician), on-call coverage, and the performance of dermpath biopsies.
DISCUSSION:
The proposed renewal of the agreement between the County and Maurer seeks to continue the professional in-person clinical and remote health coverage services indicated in the previous agreement.
Biopsy services will be eliminated from the new agreement due a decrease in overall demand. Maurer and the County have also agreed to eliminate APP services, due the availability of physicians to render these services and the difficulty faced by Maurer in attracting and retaining advanced practitioners to render said services.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
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).
In order to maintain the level of services historically provided and to monitor the quality of such services, it is anticipated that Maurer will maintain adherence to the following performance measures:
It is anticipated that telephone encounters, on-call services, documentation, compliance with SMMC Employee Health Requirements, and communication for starting late appointment will have 100% adherence to standard.
PERFORMANCE MEASURE:
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Measure |
FY 2022-25 Estimated |
|
a. Percentage of adherence to <72 hour standard for telephone encounters (TE) and laboratory results that must be addressed by responding to the referring physician. b. Percentage of adherence to <72 hour standard for all on-call services (whether personally provided or provided by telehealth) that will be communicated to the patient’s referring primary care physician or attending physician (as appropriate). c. Percentage of adherence to <72 hour standard for documentation (including charge capture), with no more than 10 delinquent charts each month. A delinquent chart is any chart which is not closed within 21 days. d. Percentage of adherence during the term of the Agreement, which Contractor’s physicians and advanced practice providers shall maintain compliance with SMMC Employee Health Requirements. e. Percentage of adherence to standard, if Contractor is more than 15 minutes late for the start of a dermatology clinic, that the Contractor will communicate immediately with County to assure clinic staff are able to adequately care for and communicate with clinic patients. |
100% 100% 100% 100% 100% |
FISCAL IMPACT:
The term of the agreement is December 1, 2022 through November 30, 2025. The amount of the agreement is in an amount not to exceed $1,629,000 for the three-year term. Funds in the amount of $316,750 are included in the SMMC FY22-23 Adopted Budget. Funds in the amount of $543,000 are included in the SMMC FY23-24 Recommended Budget. Similar arrangements will be made for future years.
The payment provisions and levels of services in this contract differ from that of the previous contract. The total value of the new contract represents a 5.1% increase compared to the previously approved “not to exceed” amount established in the previous contract. The new rates offered appear to be commercially reasonable and within fair market value upon review of meta-analysis of multiple nationally recognized physician compensation surveys provided to the County by Value Management Group Health, a nationally recognized resource for physician compensation. This contractor last received a rate increase in November 2019.
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.