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Board retroactively approves extension and spending on Cerner electronic health record services for San Joaquin General Hospital
Summary
The Board approved a retroactive amendment and additional spending for Cerner electronic health record services at San Joaquin General Hospital, increasing the not‑to‑exceed contract amount to roughly $55.4 million; hospital leaders said the purchases supported billing, eligibility and other revenue‑cycle improvements.
The Board of Supervisors on Sept. 23 retroactively authorized additions to the county’s master services agreement with Cerner Corporation for electronic health record services for San Joaquin General Hospital and approved additional spending for FY2025–26, increasing the contract’s not‑to‑exceed amount to approximately $55.4 million.
Hospital and information‑systems staff said the Cerner system provides registration, clinical records, billing and other core hospital functions. Ken Hoach, the hospital’s chief information officer, told the Board that while the county previously approved a long‑term Cerner agreement, several additional purchases and services were executed between Jan. 2021 and June 2025 without prior board approval; those purchases total about $2.8 million. The hospital requested retroactive approval for that prior spending and approval of roughly $727,331 for FY2025–26 purchases, increasing the contract ceiling.
Hospital leaders said investments included an Experian eligibility product that improves patient insurance verification and a computerized assisted coding product that helps clinical documentation and billing. They reported measurable financial improvements since the investments: monthly collections rose from about $17 million to over $25 million per month and coding/eligibility work contributed to stronger revenue cycle performance.
Why it matters: The hospital said the software and services were necessary to bring clinical and billing systems up to modern standards and to protect revenue that supports patient care. County counsel and administrators stressed the preference for prior Board approvals and the retroactive action was framed as an administrative correction and a commitment to stricter procurement oversight going forward.
Board action: The Board approved the retroactive amendment and the FY25–26 spending request, 5–0. Hospital and ISD staff said going forward Cerner purchases would be subject to stricter review and preapproval to avoid future retroactive actions.
Ending: County officials said the net effect has been improved revenue capture and that stricter procurement discipline will be enforced so significant IT and vendor spending is brought to the Board in advance.
