Big Changes in Store for Cook County Hospitals System in 2018

Cook County Health and Hospitals System (CCHHS) Board Meeting - December 15, 2017                  

What did the Board Discuss:

• In addition to the 160,000 insurance members purchased from the Family Health Network in November, the System will add another 138,000 from Aetna in January 2018, bringing total membership in County Care to 400,000 and making it the largest Medicaid Health Care Insurer in the County.  The System’s 2018 Budget is conservatively based on 230,000 members indicating it expects to lose some of the acquired members due to provider, service, or location issues.  These new additions will require staffing up, and the System will oversee the integration of Aetna’s members into the Stroger Case Mgmt. Best Practices approach.
• Director Lowry, Chair of the Human Resources Committee, said that the focus for 2018 will be on TRAINING in preparation for all the changes that are coming.
• Budget management continues to be a problem with increased overtime, medicines, external claims, and supplies expenses a factor as well as the state taking back $78 million in 2017 for Medicaid expense reimbursements.  Current projection is that the System will end the year 11-12% over budget on an accrual basis.
• A concern is the likely elimination of the ACA Insurance Mandate which could lead to more uninsured patients coming to the System.
• Focus on maternal child health is seen as a big plus for the System and will receive significantly increased attention in 2018 with the emphasis on “patient centered medical homes” to include Pediatrics, Family, OB-GYN, family planning, behavioral health, dental, and WIC.

What did the Board Decide:

• Established a Psychiatry Department at Provident Hospital for the express purpose of providing outpatient psychiatric services at Provident Hospital-based clinics.
• Board President Hill Hammock asked Finance Chair, Ric Estrada, to dive into the reasons for only having a 2% minority representation in construction contracts.  This issue was raised at the Cook County Board’s December meeting; and, during public testimony, a minority contractor also called for more contracts with the System.

Other Comments or Observations:

• Highly respected Dr. Krishna Das, Chief Quality Officer, is retiring.
• The Hospital System received recognition for achieving the highest, stage 7, for electronic medical records integration and adoption.  Only 6% of hospitals in the U.S. have achieved Stage 7.
• U.S. News and World Report gave Stroger Hospital its highest rating for heart failure care in their annual Best Hospital rankings.
• CountyCare has received official notification of its accreditation by the National Committee for Quality Assurance.
• The Federal Chip Health Insurance for at risk children is still not funded.  Illinois Chip reserves are expected to last until September 2018.  
• The System’s Washington Lobbyist retired - to be replaced by the firm serving the Cook County Board and the National Association of Counties.
• Debra Carey has been promoted and is considered #2 behind Dr. Shannon.  
• Doug Elwell is #1.
• The System saw a 22.7% increase in births in 2017 compared with 2016.

Observers - Diane Edmundson and Beverly Bradshaw Marek, MPH            Meeting Length:  3 hours