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CountyCare Enrollment Declines by 33,000 in 2019

4/28/2019

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Cook County Health (CCH) Board Meeting - April 26, 2019

CountyCare - Managed Care Organization Update

Medicaid enrollment in CountyCare, Cook County's managed care organization, has declined by 33,000 from January-March of 2019. And statewide, since its April 2018 peak at 2,298,000, membership in Illinois' managed care organizations (MCOs) has declined by 205,890, most of them “Affordable Care Act” patients, older adults without children. The consequence of this decline for CCH is that the number of uncompensated emergency and primary care visits will increase.
CountyCare currently has 31.5% of market share, a total of 316,973 members, but Meridian (Wellcare) and Illinicare (Centene) will soon merge to become Cook County’s largest MCO with 33% of market share.
CEO Shannon praised new healthcare leadership in Springfield, including former CCH Deputy CEO Doug Elwell who now oversees the state of IL Medicaid program.
Dr. Shannon will visit Washington DC this summer to negotiate Medicaid and DSH (Disproportionate Share Hospitals) payments, hopefully to offset threatened funding cutbacks.

What did the Board discuss?

Personnel status - 7,265 positions, 1,265 vacancies, 2.8% turnover, 103 days to fill a position
A $33.6 million budget shortfall for 3 months ending in February 2019, less than the $43 million projected, due in part to lower-than-expected pension costs. CCH has 21 days’ cash on hand.
45% of patients are uninsured, 5% have commercial insurance; almost all others are covered by Medicare (15%) or Medicaid (33%).
Primary care visits are up 4%, specialty care up 3%, surgical care down 2%, ER visits down 3%. 65% of Stroger patients would recommend the hospital.

Items to Watch for in the Future

Many accolades went to Marketing/Communications Director Caryn Stancik after her presentation showing the consistent growth in the department’s activities to raise awareness of the value of CCH and alerting staff to the upcoming MAKING AN IMPACT campaign highlighting CCH accomplishments.

Other Comments or Observations

Dr. Terry Mason, Director of the Cook County Department of Public Health, alerted the board to a Countywide increase in sexually transmitted infections (STIs), due, he said, to the large number of phone apps that can lead to anonymous sex.

Observer - Linda Christianson Meeting Length: 3 hours

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Director Mary Richardson-Lowry Elected Vice Chair of Cook County Health Board

4/7/2019

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Cook County Health (CCH) Board Meeting
March 29, 2019

Director Mary Richardson-Lowry was elected Vice Chair of the Board replacing the long serving Commissioner Butler who resigned from the Board in 2018. Director Richardson-Lowry has been a member of the Hospital Board since 2015, Chairing the Human Resources Committee. A partner in the Chicago office of Mayer Brown law firm, her illustrious career includes having served as Commissioner of the Chicago Department of Buildings, Past President, Chicago Board of Education and Metropolitan Family Services Board member.

What did the Board Discuss?

Using locally sourced, market-savvy investigators, 2 million dollars in overpayments to providers in the 4th Quarter of last year were identified, only a small fraction has been recovered thus far, pending the appeals process.
Net operating loss exceeds budgeted loss of $72 million by $35 million in first 2 months of fiscal year due to persistent excess external claims expense paid to non-CCH network providers. Increasing use of CCH facilities is the challenge with below budgeted volumes this year of primary & specialty care, surgical cases and deliveries. Director Reiter said the financials are comparable to previous years.
Willingness to recommend Stroger and Provident Hospital in the bottom 40% of hospitals.
45% uninsured system-wide, composed of 32% African-American, 47% Hispanic, 4% Asian and approximately 17% White. Director Suleiman Gonzalez requested uninsured data based on language spoken to capture data on the numerous Polish and Middle Eastern groups.
Strategic Plan updates:

Dr. Fegan reported on the medical staff demographics (PowerPoint on CCHHS website), challenges of a unionized medical staff which has a lack of job title specificity, incentive structure and slow implementation of use of Relative Value Units, the industry standard measuring “work”. High value specialists are not retained. Board discussed hybrid system for physicians of unionized with incentives.
E-consult communication of physician with patients has been implemented with positive patient response.

Items to Watch for in the Future

CEO Shannon said the new merger of Healthcare companies Centene and WellCare will result in the largest Medicaid insurer nationally with 12 million beneficiaries and anticipated major savings in their cost of care provision which will threaten CountyCare’s current dominant position in the Cook County Medicaid market.

Observed by Barbara Hayes and Susan Kern Meeting Length: 3 hours 15 minutes

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CountyCare Enrollment Declines by 33,000 in 2019

Director Mary Richardson-Lowry Elected Vice Chair of Cook County Health Board

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