COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

July 28, 2006

BOARD MEETING DATE:

August 15, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Agreement with James Meier, MD and Scott Oesterling, MD

RECOMMENDATION:

Adopt a resolution authorizing the President of the Board to execute an Agreement with James Meier, M.D. to provide obstetrics and gynecology services for the period July 1, 2006 through June 30, 2008.

VISION ALIGNMENT:

Commitment: To Ensure Basic Health and Safety for All.

Goal(s): Provide residents access to healthcare and preventive care.

The Agreement contributes to this commitment and goal by providing comprehensive obstetrics and gynecology services.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Number of OB-GYN visits for treatment at the San Mateo Medical Center

1300

1500

Meet agreed upon mean cycle time (registration to discharge) targets

80%<

80%<

SIPS: Timeliness and Appropriateness of antibiotics for hysterectomy

80%<

80%<

Maintain totals on vaginal, operative, and cesarean deliveries

100%

100%<

Intensive care nursery admission rates

<10%

<10%

Rates of apgar<7 less than 15%

<15%

<15%

Rates of chorioamnionitis infection during labor

<15%

<15%

Rates of preterm delivery < 15%

<15%

<15%

BACKGROUND/DISCUSSION:

Drs. Scott Oesterling and James Meier have provided obstetrics and gynecology services to the San Mateo Medical Center for the last several years. In particular these disciplines serve as the basis for routine evaluation and treatment of pre-, intra-, and post partum care (obstetrics) and the evaluation, diagnosis, treatment and monitoring of uterine, ovarian, endometrial, and vaginal disease (gynecology). SMMC has a continuous need for obstetrics and gynecology services and Drs. Oesterling and Meier will offer the hospital the benefits of experienced practitioners familiar with the complex nature of the County’s patient base.

The San Mateo Medical Center was engaged in extended negotiations for obstetrics and gynecology services for the past year. This Agreement represents the finalized long term contract, incorporating a reimbursement model that measures relative value unit (RVU) productivity. The group of physicians providing services under this contract has been increased to eleven and the number of RVUs is projected to increase accordingly. Dr. Scott Oesterling will be assuming more of the administrative director responsibilities for the entire line of service.

The total obligated amount of the previous contract was $2,053,596.00 annually. The increase over the previous rates of reimbursement is two percent (2%) annually above the base rate. An incentive amount of $486,489.60 payable as $49.20 per unit has also been included to cover increased productivity over the projected base RVU amount.

Risk Management and County Counsel have approved the Agreement. The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

TERM AND FISCAL IMPACT:

The term of the Agreement is July 1, 2006 through June 30, 2008. The maximum amount the County shall be obligated to pay Contractor is $4,667,673.60. Funds are included in the San Mateo Medical Center's FY2006-07 tentatively adopted budget and contract obligations for year two will be appropriated in the FY2007-08 budget.