REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 21, 2024
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Data Subscription Agreement with Definitive Healthcare, LLC for Access to Claims Data
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to the Data Subscription Agreement No. 21-856 with Definitive Healthcare, LLC for access to medical claims data used for research and strategic planning, increasing the not-to-exceed contract amount by $102,968, from $296,949 to $399,917, and extending the term by one year for a total term of November 16, 2021 through November 15, 2025.
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Create, Maintain and Grow Jobs and Economic Value in the County.
Operate in a Fiscally-Responsible and Business-Like Manner.
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 amended increase in cost of $102,968 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 have been included in the Arrowhead Regional Medical Center (ARMC) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
The Amendment with Definitive Healthcare, LLC (Definitive) will give ARMC continued access to a database of medical claims data. This will assist ARMC to operate strategically and in a fiscally responsible manner by allowing the hospital to understand the actual market share and profitability of any medical service. By reviewing actual claims and payments data for other hospitals and providers in the area, ARMC will be better able to determine which opportunities and service lines are in high demand, thereby focusing resources on where the needs of the community exist. Additionally, this data will help ARMC understand why and where current patients are being referred out to, thereby assisting the hospital in restructuring and/or expanding its services in a manner to reduce the need to refer and/or transfer patients to other facilities.
Definitive collects claims data provided by the Center for Medicare and Medicaid Services (CMS) for all patients in the United States. This data allows providers to identify when patients are referred to outside providers. By identifying patient when patients are referred to outside providers, providers and hospitals can take necessary steps to reduce the loss of revenue and ensure the type of patient care needed is offered.
On November 16, 2021 (Item No. 4), the Board of Supervisors (Board) approved Data Subscription Agreement with Definitive Healthcare, LLC, for access to medical claims data used for research and strategic planning at a total cost of $296,949, for the term of November 16, 2021 through November 15, 2024.
ARMC recommends approval of Amendment No. 1 to give ARMC access to medical claims data used for research and strategic planning. This will assist ARMC to operate strategically and in a fiscally responsible manner by allowing the hospital to understand the actual market share and profitability of any medical service.
PROCUREMENT
The Purchasing Department continues to support this non-competitive procurement based on specialized credentials. While there are other vendors who perform similar services on the market, Definitive is the only one that has access to claims data from the CMS. Definitive compiles comprehensive claims data from CMS and provides a searchable database to its subscribers. This access allows ARMC to determine which opportunities and services may be initiated or expanded to better meet patient needs within ARMC facilities.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387- 5455) on March 29, 2024; Purchasing (Veronica Pedace, Buyer III, 387-2464) on April 1, 2024; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on April 29, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on April 30, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387- 5423) on May 1, 2024.