CM-2021-351 - 12/17/2021FIRST AMENDMENT
TO
CLINIC SERVICE AGREEMENT
This First Amendment to Clinic Service Agreement (this "First Amendment") entered into as of the last
signature date below by and between City of Round Rock ("City") and Direct Care Medical PLLC
("DCM") Assignee under Assignment effective January 1, 2021 of that certain Clinic Service Agreement
dated November 20, 2018 (the "Agreement"), by and between CareATC, Inc. ("CareATC") and City.
WHEREAS, City and CareATC entered into the Agreement, pursuant to which CareATC provides Covered
Services through its private medical clinics to City for the benefit of eligible employees and other eligible
participants; and
WHEREAS, City and DCM desire to amend the terms of the Agreement;
NOW, THEREFORE, in consideration of the mutual covenants, promises and representations contained
herein and, in the Agreement, City and DCM agree as follows:
1. Rate and Performance Guarantee, the first paragraph of Section 3 of the Agreement, is amended as
follows: The Fees set forth in Exhibit B shall remain in effect for the initial term of this Agreement.
Commencing with the third renewal (January 13, 2022) the fees in Exhibit B will increase annually at
a rate determined by the Consumer Price Index ("CPI") issued by the U.S. Department of Labor, Bureau
of Labor Statistics, for Medical Care (Physicians') Services. The City reserves the right to accept such
increase, negotiate an increase, or terminate the Agreement as provided in Section 4 of the Agreement.
2. Clinic Monthly Fees set forth in Exhibit B "Fees" of the Agreement is amended as follows:
City's monthly administration fee is increased 3.9% to match the previous year's Consumer Price Index
for Medical Care (Physicians') Services. The new monthly administration fee will be $56,010,72, This
fee is calculated using our half day rate of $1,293.55 for 10 blocks per week.
3. Performance Guarantees set forth in Exhibit B "Fees" of the Agreement is replaced entirely with the
Performance Guarantees shown on the attached Exhibit B.
4. Except as amended by this First Amendment, all terms, provisions, and conditions of the Agreement
remain unchanged and shall continue in full force and effect. The Agreement, as amended by this First
Amendment, constitutes the complete and entire understanding of City and DCM with respect to the
subject matter thereof. In the event of a conflict between the terms and conditions of the Agreement
and this First Amendment, the terms and conditions of this First Amendment shall govern with respect
to the subject matter hereof. This First Amendment may be executed in counterparts, each of which
will be deemed an original and all of which together will constitute one and the same document.
Signature pages may be transmitted by facsimile, PDF, e-signature or other electronic means and shall
be deemed original.
CORR.01 A MCAS.20211115.THR
1
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment as of the last signature
date below.
Direct Care Medical PLLC
(DCM)
Name: Sccebickison
Title: Chief Financial Officer
Date: -
City of Round Rock
Name: t' Ayi !�
Title: 455 - C//,q g4kgn r-
Date: J86� / V
CORR.0I AMCAS.202111 l57HR
2
Exhibit B
Fees
3. Performance Guarantees
DCM has committed to achieving the following five (5) goals. Fees at risk are equal to 100"0 of clinic
management fee (clinic management fees are defined as 10% of the annual administration fee or
$67,212.90). Total fees at risk equate to $6,721.29 broken out by weighted categories below:
I . Financial return on investment of at least 1:1 (2% of clinic management fee)
2. Reduction in member risk profile (2% of clinic management fee)
3. Customer Satisfaction as measured by (2% of clinic management fee):
c: Net Promoter Score of clinic above 75
r PEX Score - Patient Experience - above 4
4. Same day next day appointment availability (2% of clinic management fee)
5. Account management satisfaction survey (2% of clinic management fee)
o Account manager will be available to meet with city's management team quarterly and be
available for bi-weekly calls
o Account manager will provide agenda prior to calls and minutes after calls
o Account manager will acknowledge receipt of request for information or assistance within
24 hours of any outreach
U At least 90% satisfaction with the program: support services, programs, program
management
To be eligible for performance guarantees, City must meet the following standards:
• City must provide access to the clinics at no cost to the patient enrolled in the City Health Plans.
• City must provide access to the clinics to all covered members — employees, spouses,
dependents (age 5 and up), and retirees.
• City agrees to provide DCM, through its health insurance provider, detailed medical and
prescription drug claims information and employee demographic data for at lease the previous
12-month period prior to the clinics opening to establish a baseline.
• City agrees to remove from the paid claims totals for any outlier claims in excess of $75,000
per claimant per year.
Annual performance periods shall begin on January 1 and end each year thereafter during the Term. If
DCM fails or refuses to meet the guarantees as described above during the effective year, City shall be
entitled to withhold from DCM's fees for services under this Agreement the percentages of the annual
amount of the administrative fees payable by the City during the following year for each area of
performance described above. The first performance guarantee evaluation will be performed in April.
CORR.0I AMCAS.20211115.THR
3
City of Round Rock
ROUND ROCK
TEXAS Agenda Item Summary
Agenda Number:
Title: Consider executing a First Amendment to a Clinic Service Agreement with Direct
Care Medical PLLC (formerly CareATC).
Type: City Manager Item
Governing Body: City council
Agenda Date: 12/17/2021
Dept Director: Valerie Francois
Cost: $25,228.94
Indexes: Self -Funded Health Insurance
Attachments: Direct Care Medical PLLC
Department: Human Resources
Text of Legislative File CM-2021-351
This Agreement provides Covered Services through its private medical clinics to City for the benefit of
eligible employees and other eligible participants.
Cost: An increase of 3% each month which totals $25,228.94 for (1) year. This is an extension of the
current contract.
Source of Funds: Self -Funded Health Insurance
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