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Cook County Health System Gets a New Name and Opens State of the Art Clinic Facility

10/31/2018

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Cook County Health (CCH) Board Meeting - October 26, 2018

What did the Board diiscuss:

As part of its goal to attract patients to The Cook County Health and Hospitals System, CEO, Jay Shannon, announced a name change to “Cook County Health” and the ribbon cutting for the new Fantus Clinic & Professional Building for Monday, October 29. He also announced that the new “model” Arlington Heights Ambulatory Clinic will open sometime in December with preventive and specialty care services such as dental and behavioral health. A similar model clinic will open early in 2019 in Riverside.
The County Health’s insurance plan called, “County Care” is aggressively marketing its benefits to current and potentially new customers as the open enrollment period for Medicaid patients is from October 2018 to February 2019. See the LWVCC October 18, 2018 Managed Care Eyewitness Report for more details. As a reminder, County Care is the largest Managed Care Medicaid Provider in Cook County followed by Blue Cross Blue Shield.
Cook County Health continues to decrease the hiring cycle – from 203 days in 2014 to 95 days in 2017 and 2018. The interim HR Director acknowledged that even more needs to be done and has implemented a new technology and outreach plan to achieve its goal of 90 days. Overall vacancies stand at 725 of which 244 are nursing positions. Filled positions stands at 575, separations through the 3rd quarter are 367 including 161 retirees. Turnover 6%.
Dedicated efforts including new hires and a change in contractors has resulted in an improvement in the cleanliness of the hospital environment. Guiding principles in 2018 and going forward include improving the patient experience, patient safety and satisfaction, and the health system’s reputation. A recent in-house inspection found no cleanliness issues. Changing patient perceptions will take longer, and the System continues to educate and train its workforce on the importance of patient experience to the success of the system. In addition to cleanliness perceptions, CCH is focusing on waiting times and phone access.
The Finance report through the first eight months showed no new surprises. Revenue is 33% higher than budgeted due to the influx of new Managed Care Patients from Health Network and Aetna. However, revenue is offset by the expenses incurred to service these new members. The System serves the highest number of Charity Care patients [by visit] at 42%. The next highest is Northwestern Hospital at 7% and Mt. Sinai at 4%. The YTD net loss is almost $17 million above budget or $98.8 million against a budgeted loss of $72 million.
noted that the System has been successful in getting the State Legislature to lift the “moral or philosophical objection clause” for health care workers. Workers will now or soon be required to take the Flu Shot.
He also mentioned the $8 billion Federal package to address the Opioid epidemic in the US is a good first step but the problem will not be effectively addressed by grants alone. Federal laws are needed.
CEO Shannon gave a brief overview of the 2020-2022 Strategic Planning and a recap of the 2017-2019 Plan. To see the Strategic Plan update report delivered by CEO Shannon go to this link.

Items to Watch For in the Future

Director Lowery asked for a comparison of the System’s nursing openings to other like institutions across the country.
Board Chair, Hil Hammock, asked for feedback on what percentage of claims are never collected because of coding, timeliness, and/or processing issues.
Chair, Hil Hammock asked for a detailed dive into pension costs, projections, and percentage of takeover from the County by the Cook Health System.
In the context of the 2020-2022 Strategic Plan, CEO, Jay Shannon, mentioned that that System will be evaluating “incentive based” motivation for management to hit targets.
A Board decision on County Care’s proposal to stop paying providers who treat County Care patients when the patients’ visit is outside their assigned network of providers.

Observers - Diane Edmundson & Sarah Edwards Meeting Length: 2 ½ Hours

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CountyCare Has Largest Share of Cook County Medicaid Managed Care Market

10/25/2018

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Cook County Health & Hospitals System
CountyCare Managed Care Committee Meeting - October 18, 2018

What was Discussed:

CountyCare holds largest share of Cook County Medicaid managed care market, ahead of Blue Cross Blue Shield, with 335,484 enrollees as of August 2018.
CountyCare has launched a series of social media marketing strategies to promote enrollment for 2019, including two YouTube videos with over 400,000 views combined within the last month
New campaign slogan designed to appeal to working enrollees: “You don’t have time for a sick day”
CountyCare enrollment goal for 2019 is 345,000; CountyCare saw a small drop in their Affordable Care Act enrollment in 2018
Primary care providers in Cook County agreed to send out a total of 130,000 letters to potential enrollees supporting CountyCare as the best managed care option for their patients
Patients with CountyCare can now get LASIK eye surgery and qualify for a monthly package of diapers if children are fully vaccinated

How is CountyCare doing?

State of Illinois is behind on making payments to CountyCare. Because of this delay, CountyCare is paying only around 50% of their claims to medical providers within 30 days of submission
CountyCare saw a decrease in completed patient care plans for members in July after absorbing Aetna plan patients. Care plans are vital for managing high-risk patients
As of now, 30% of visits to primary care do not occur with assigned primary care provider within the Ambulatory and Community Health Network clinics (these numbers are similar to other provider groups within the CountyCare network). CountyCare plans to stop paying providers who treat patients who have a different primary care provider

What else did the Board discuss:

The board discussed sending out a patient survey to determine why some patients seek care outside of their assigned primary care provider

Items to Watch For in the Future

New member enrollment into CountyCare plan and how well the plan holds onto current members for 2019
The impact of the new marketing campaign on 2019 enrollment
An explanation for why 30% of primary care visits do not occur with assigned primary care provider within the Ambulatory and Community Health Network clinics

Observer: Sarah Edwards Meeting Length: One Hour

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Cook County Hospitals System Bottom-line May be Threatened by Decrease in Medicaid Enrollees and Federal Rule Changes for Immigrants

10/13/2018

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Cook County Health & Hospitals System (CCHHS) Board Meeting
September 28, 2018

Threats to 2019 CCHHS budget predictions presented by CCHHS Administration and Staff:

Illinois Healthcare & Family Services actuaries predict a decrease in Medicaid Affordable Care Act (ACA) enrollees in Illinois by 5% and a drop in the Medicaid FHP category in Cook County by 10% in the next year reported Hospital System CountyCare/Managed Care staff.
CEO Shannon added that the US Dept. of Health and Human Services is chipping away at the ACA provisions such as proposed imposition of work rules which may result in loss of Medicaid eligibility.
Further threats to the increased volume of patients on which the 2019 Hospital System proposed budget is predicated may be the proposed change in Federal Immigration rules. Federally funded programs including Food stamps, WIC, & other Public Aid, when accessed for the legal children of illegal immigrant parents, are considered to be benefiting the entire family. This may be considered a violation of the “public charge law” which will be held against the adults when applying for Green Card/Visa/ Citizenship.
CEO Shannon warned that immigrants might be fearful of accessing the Hospital System.
Nearly 80% of CCHHS patients are Medicaid (36%) or Uninsured/immigrants (42%)

What did the Board Decide?

Approved 73-million-dollar Sole Source contract (MHN ACO, LLC) for care coordination at Federally Qualified Health Clinics (FQHCs) covering approximately 117,000 of the 335,039 CountyCare members. This improves health and reduces cost of care.

What else did the Board discuss:

Heather Prendergast, MD introduced as a new CCHHS Board Director. She is an Emergency Room physician, in leadership positions, at U. of Illinois Hospital which has a similar patient demographics as CCHHS.
A Public Testimony speaker reported that limited patient/visitor parking due to the Central Campus Redevelopment construction may hinder patient use of the Hospital System. CEO Shannon responded that this would be addressed.
Shakman Decree (law to prevent political hiring) imposed by the Courts on Cook County decades ago is set to be lifted next month as compliance in hiring has been achieved at CCHHS.

Items to Watch For in the Future:

CC Board President, Preckwinkle to appoint County Commissioner representation on Hospital Board after Mid-term Elections when new CC Board is seated
Hospital System 2.97-billion-dollar Budget hearings at CC Board scheduled in October 2018
New Professional/Administration Tower to open for business in October, 2018

Meeting Length: 2 hours 30 minutes
Observers - Susan Kern, MD, Michele Niccolai, Sarah Edwards, & Ellen Hunt

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Cook County Health System Gets a New Name and Opens State of the Art Clinic Facility

CountyCare Has Largest Share of Cook County Medicaid Managed Care Market

Cook County Hospitals System Bottom-line May be Threatened by Decrease in Medicaid Enrollees and Federal Rule Changes for Immigrants

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