REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 24, 2022
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Agreement with Tegria Services Group-US, Inc. for Electronic Health Record Revenue Cycle Consulting Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 18-260 with Tegria Services Group-US, Inc. for Electronic Health Record revenue cycle consulting services on an as-needed, fee-for-service basis, updating the parties’ respective legal name and increasing the total aggregate contract amount by $5,000,000, from $4,350,000 to $9,350,000, with no change to the term of July 1, 2018 through June 30, 2023.
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The additional cost of $5,000,000 is funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue are included in the Arrowhead Regional Medical Center’s (ARMC) 2021-22 budget and will be included in the 2022-23 recommended budget.
BACKGROUND INFORMATION
Approval of this amendment will update the parties’ respective legal name and increase the total aggregate contract amount. The increase to this contract will allow for the continued support from consultants to assist with mitigating issues with changing revenue cycle workflows from the Meditech Electronic Health Record system into the new Electronic Health Record (EHR) system, Epic, within the project’s established timeframe. Meditech was the EHR system utilized by ARMC prior to implementation of Epic on February 12, 2022.
Tegria Services Group-US, Inc. (Tegria) provides the expertise required to support accounts payable in SAP/Meditech financials, analysis, programming, reporting, quality assurance, project management, and data migration from Meditech to Epic. Prior to implementation of the Epic system, ARMC requested services from Tegria for assessment of workflows, identification of high priority programming critical for successful implementation, and identification of necessary operational changes specific to the revenue and billing processes. As a result of these efforts, it was determined that an expanded revenue cycle team and the establishment of a revenue integrity team are needed to perform all processes necessary for accurate accounting of charges and expenses in Epic. ARMC is working with Tegria to change existing Meditech revenue cycle workflows into efficient Epic processes.
The revenue cycle and revenue integrity teams are those individuals who collect and verify insurance information. These teams ensure correct billing codes and charges are included in claims provided to the insurance companies. These staff also verify and audit all claims so that ARMC receives the correct compensation for charges.
As ARMC ramps up recruitment efforts to establish the revenue cycle and revenue integrity teams to perform the new Epic processes, Tegria will continue to provide qualified supplemental staff to ensure the new Epic processes are completed and successful. Tegria consultants will provide, as-needed, fee-for-service specialized support services to the ARMC revenue cycle team. This includes training and specialized support to current and newly hired staff. In preparation for the conversion from Meditech to Epic, ARMC worked with Human Resources to identify the need for this additional revenue cycle team staffing and a new revenue integrity team. ARMC will continue to work with Human Resources to recruit for qualified candidates, preferably familiar with the Epic system, for open positions within the existing ARMC revenue cycle team and anticipated revenue integrity teams, eventually eliminating the need for this temporary support. As candidates are hired at ARMC for these positions and the need for these consulting services decreases, ARMC will review the contract for early termination of these consultant services.
On May 22, 2018 (Item No. 29), the Board of Supervisors (Board) approved Agreement No. 18-260 with Navin, Haffty & Associates, LLC (Navin) for Meditech consultant services on an as-needed, fee-for-service basis with a total aggregate contract amount of $4,350,000 for the five-year period of July 1, 2018 through June 30, 2023.
On September 29, 2020 (Item No. 13), the Board approved an assignment of Agreement No. 18-260, which assigned the agreement from Navin to Providence Services Group-US, Inc. (Providence) as a result of Providence acquiring Navin. As a result of this assignment, all of the duties and obligations of Navin under the agreement were transferred to Providence. On October 27, 2020, Providence filed “Articles of Amendment Stock, For-Profit Corporation,” which changed its corporate name from Providence Services Group-US, Inc. to Tegria Services Group-US, Inc.
PROCUREMENT
This is a continuation of a competitive procurement that resulted from the Request for Proposal ARMC118-ARMC-2626 issued on October 17, 2017.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on April 20, 2022; Purchasing Department (Ariel Gill, Buyer, 777-0722) on April 19, 2022; Human Resources (Gina King, Deputy Director, 387-5571) on May 4, 2022; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on April 20, 2022; and County Finance and Administration (Diana Atkeson, Deputy Executive Officer, 387-5423) on April 20, 2022.