HomeMy WebLinkAboutAgenda - 02-29-2000-8is
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ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: February 29, 2000
Action Agenda
Item No. „$. 1.
SUBJECT: Contract With DMG-Maximus, Inc. to Conduct a Cost Study for Personal Health
Services
DEPARTMENT: Health PUBLIC HEARING: (Y!N) No
ATTACHMENT(S): INFORMATION CONTACT:
Contract Rosemary Summers, ext 2411
TELEPHONE NUMBERS:
Hillsb6rough 732-8181
Chapel Hill 9fi8~501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: Contract between DMG-Maximus, Inc. and Health Department to conduct a cost
study for the purpose of setting fees for personal health services.
BACKGROUND: Traditionally the Orange County Health Department has charged very minimal
fees for only a few of the personal health care services it provides. The Department has billed
the Medicaid program for services provided to Medicaid-eligible clients, which has comprised
approximately 13% of the department's total budget and 19% of the personal health services
budget. These bills have been submitted in a "bundled" format. For example, a patient might
be seen for a well child check-up that would include a physical exam, an immunization, and
perhaps some laboratory tests, and all of those services would have been "bundled" and
submitted to Medicaid as a single bill. Beginning July 1, 2000 the North Carolina Medicaid
program is requiring all health departments to submit "unbundled" bills for all services eligible for
Medicaid reimbursement. The cost for each individual service rendered must be submitted to
Medicaid. The department must be able to show actual costs for each service to justify the
amount billed. This then requires the health department to establish cost figures for each
individual personat health service provided. A cost study will also allow the department to
establish fees and thereby bill third party payors such as Blue Cross and Blue Shield for Health
Choice clients and others who have private insurance.
There are approximately 40-50 procedure codes for which the department needs to establish
cost figures. Due to current workloads, staff in the health department do not have time to
conduct the study internally. The department conducted some preliminary work in this regard
last spring through the use of students from the School of Public Health, however, students
cannot meet the July 1 time frame that the_department must meet. In addition, the
establishment of fees is expected to impact budget projections for the fiscal year 2000-2001. In
consultation with the Finance Director, the department contacted DMG-Maximus, Inc. They
have conducted several of these studies for other counties. The attached contract with DMG-
Maximus, Inc. will provide a cost study that will meet the department's needs in this regard.
After DMG-Maximus,. Inc. finishes its report, the Board of Health will consider the fees to be
established and recommend their establishment as part of the regular budget process for 2000-
2001.
FINANCIAL IMPACT: The results of the cost study should enable the department to increase
its revenue earned through fees. It is difficult to project how much additional revenue can be
earned since the department has not kept financial eligibility information for patients in most
programs offered. In 1998-99 revenues eamed through Medicaid reimbursements totaled
$462,147.03 for personal health services. This cost study will enable the department to make
the required transition and remain stable in these earnings. In addition, it is projected that the
department will be able to eam at least $25,000 in new revenue through additional third party
reimbursements from private insurance companies currently not available due to a lack of an
established fee structure. This is a low number since it is assumed that a high number of the
health department's patients that are not Medicaid eligible will not have private insurance and
have incomes that will only allow them to pay a minimum fee. These new revenues will help
offset increased costs of medical and pharmaceutical supplies.
The contract amount of $11,000 was included in the department's approved budget for the
current fiscal year.
RECOMMENDATION(S): The Manager recommends that the Board approve the contract with
DMG-Maximus, Inc. and authorize the chair to sign.
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Agreement to Provide
Professional Consulting Services to
Orange County, North Carolina
THIS AGREEMENT, entered into this day of , 2000 and effective
immediately by and between DMG-MA~MUS, INC., (hereinafter called the "Consultant")
and Orange County, State of Narth Cazolina (hereinafter called the "County"), _~ .
WTTNESSETH THAT:
WHEREAS, the Consultant is staffed with personnel lrnowledgeable and experienced
in the determination of costs and fees for various services of County departments, and
WHEREAS, the County desires to engage the Consultant to conduct a
comprehensive service cost evaluation study for the Personal Health Division of the Public
Health Department,
NOW THEREFORE, the parties hereto mutually agree as follows:
1. Employment of Consultant. The County agrees to engage the Consultant and the
Consultant hereby agrees to perform the following service,.
2. Scone of Services. The Consultant shall do, perform and carry out in a good and
professional manner consulting services in accordance with the Consultant's proposal dated
February 1, 2000, which shall be incorporated herein by reference. The study will provide a
thorough evaluation and analysis of costs and recommend fees for the above refereared areas
of service provided by Orange County. Five (5) copies of the draft report, containing the
methodology, facts, conclusions, and recommendations, shall be submitted to the Health
Director for review and distribution. Twenty-five (25) copies of the final report, containing a
written analysis for each area of service, shall be submitted to the Health Director for
distribution to the Board of Health and others whom she deems appropriate. One exit
conference to discuss conclusions and reconunendations shall be held with the Health Director
and staff and, if requested, one exit conference shall be held with the Board of Health.
3. Time of Performance. A draft report will be presented to the County within 20
days from project initiation. The final report will be provided within fifteen days of the
County's acceptance of the draft report.
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4. Compensation. The County agrees to pay the Consultant a sum of eleven
thousand dollars ($11,000) "for all services required herein, which shall include reimbursement
for expenses incurred. Consultant agrees to complete the project and all services provided
herein for said sum.
5. Information and Reuorts. The Consultant shall provide the County five (5)
copies of the draft report and twenty-five (25) copies of the final report. Additional
information regazding the project shall be provided upon request by the County.
6. _Method of Payment The Consultant shall be entitled to payment in accordance
with the provisions of this paragraph. Consultant's fees are to be paid as follows: 90%
($9,990) of the fee will be billed upon presentation of the draft report; the remaining 10%
($1,100) of the contract upon the presentation of the final report.
7. Chang. The County may, from time to time, require changes in the scope of the
services of the Consultant to be performed hereunder. Such changes, which are mutually
agreed upon by and between the County and the Consultant, shall be incorporated in written
amendment to this agreement.
S. Services and Materials to be Furnished by the County. The County shall"
locally furnish the Consultant with all available necessary information, data, and ,material
pertinent to the execution of this agreement. The County shall cooperate with the Consultant
in carrying out the work herein and shall provide adequate staff for liaison with the Consultant
and the affected agencies of County govennmeirt.
9. Termination of A Bement for Cause. It; through any cause, the Consultant
shall fail to fulfill in timely and proper manner his obligations under this agreement, the
County shall thereupon have the right to terminate this agreement by giving written notice to
the Consultant of such termination and specifying the effective date thereof; at least five (5)
days before the effective date of such termination.
10. Coeyright. The County acknowledges that the report format to be provided by
Consultant is copyrighted. Consultant shall ensure that all copies of its report bear the
copyright legend. The County agrees that all ownership rights and copyrights thereto lie with
Consultant. The Courrty may use the report solely for and on behalf of the County's
operations. The County agrees that it will take appropriate action by instruction, agreement or
otherwise with its employees to satisfy its obligations with respect to use, copying, protection
and security of the report format. This does not preclude the County from making copies for
internal use.
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11. Notices. Any notices, bills, invoices, or reports required by this agreement shall
be sufficient if sent by the parties in the United States mail, postage paid, to the address noted
below:
Orange County Health Department
300 W. Tryon Street
Hillsborough, North Cazolina 27278
DMG-MAXiMUS, INC.
1100 Logger Court, Suite D-100
Raleigh, North Carolina 27609
IN WITNESS WHEREOF, the County and the Consultant have executed this
agreement as of the date first written above.
County of Orange, North Carolina
By:
(county official)
DMG-MAXIMUS, INC.
By:
Timothy H. McKinnie
vice President
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