CCHHS to Submit Proposal to Revamp Medicaid Managed Care Program

Cook County Health and Hospitals System Board Meeting - March 31, 2017

Significant Topics Discussed:

Cook County Health and Hospitals System (CCHHS), in response to a Request for Proposal (RFP) issued by the Illinois Department of Healthcare and Family Services, will submit a proposal to revamp its Medicaid Managed Care Program.  With goals of (1) improving healthcare quality, (2) ensuring access, and (3) controlling costs for Illinois Medicaid patients, applicants must commit to providing the full spectrum of Medicaid-covered services. 

• The RFP was issued Feb. 27 and is due May 15.  Oral presentations are scheduled for June 12-23; awards will be announced June 30; and successful plans must be able to go into effect Jan 1, 2018. 
• Proposals must address in detail the ways the managed care providers will meet the 3 goals. 
• Awards will go to one or two managed care providers serving only Cook County (but these must be government or minority-owned providers), and 4-7 providers serving the statewide Medicaid population over the state’s 102 counties. 
• An estimated 3.1m persons statewide receive Medicaid, of whom 1.6m live in Cook County; statewide they are currently served by a total of 11 managed care providers.
• Assuming CCHHS’ proposal will be successful, Steven Glass, Managed Care Executive Director, predicts that the reduced number of managed care providers might increase CountyCare enrollment, but that rates of reimbursement will decrease.  CCHHS will be contracting with “new players” who may be entering the state marketplace for the first time.

The Joint Commission on Accreditation of Healthcare Organizations awarded accreditation to Stroger Hospital March 30.
$4m in contracts were negotiated with 2 nursing home organizations to provide short- and long-term care.  Costs to care for patients in these facilities can be $5000-$6000 per month, and Deputy CEO Doug Elwell explained that these contracts won’t be renewed in the hope that these 400-500 patients can receive home care.  He said CCHHS is considering providing long term care for its CountyCare and indigent patients.

Current Data Presented: 

• CCHHS has experienced an 8% loss of operating revenue due to diminished patient fees. 
• Length of hospital stay has diminished; emergency room visits are up slightly.
• CountyCare enrollment lowered slightly, to 142,250;
• Pharmacy claims have been higher than budgeted. 
• 74% of Stroger Hospital patients would be willing to recommend the Hospital; 80% is considered the median percentage overall in other major institutions.
• CCHHS had 727 staff vacancies in February; 167 vacancies were filled in the first quarter of 2017; the average time to fill a vacancy is now 93 days.

Observer -  Linda Christianson                                                                         Meeting Length: 3 hours