Big Financial Savings for Stroger Hospital Accompanies Surgical Quality Improvements!

Cook County Health (CCH) Board Meeting
​March 25, 2022     

Enrolled in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP), since 2014, Stroger is now winning big for patients by decreasing surgical site infection rate from 1.5 times the national (NSQIP) average in 2016 to 0.77 of the rate in 2022!  Annual Stroger savings of $237,210 with avoidance of prolonged hospital & ICU stay and even death of patients who suffer from post-op wound infections is the bonus.  Accomplished by implementation of rigorous procedures for disinfection of skin prior to surgery, additional pre and post-op antibiotics, changes of gowns, gloves and instruments twice: for surgery and again for wound closure and patient education were key elements of this successful plan.  Surgeon Wille notes that this is an ongoing process, with direct comparisons of outcomes to other hospitals nationally on the numerous targets of enhanced quality with decreased cost that are being studied.  Initially there was skepticism of the program Dr. Fegan, Chief Medical Officer, at CCH commented but the successes are now making believers of surgeons from all CCH specialties.  CCH’s low rate of surgical morbidity/complications for its patients places it in the top 20% of all NSQIP hospitals for 2021. 

Highlights from Board Reports:

• CCH Financial Report: $5.156 million positive operating margin year to date, vs budget which predicted loss ($19,257) - Gain due to higher inpatient volumes and decreased County Care claims expenses.  Pension costs ($160 million/year) not included.
• CCH hospital and CountyCare (Medicaid plan) financials combined - not separate accounting 
• Human Resources: 4 new outside contracts to improve hiring/retention/technology
• Charity care cost: projected $464.5 million to exceed 2022 budget of $452 million 
• CountyCare: 429,256 members slightly increased YTD 2022, largest managed Medicaid organization in Cook County followed by BCBS 334,273
• Redetermination for CountyCare membership delayed by State- is expected September.  CCH outreach efforts to retain members described for the Board.
• Hospital volumes: Admissions, patient days, average daily census, Emergency Room Visits, surgeries and ambulatory visits All still lagging 2020. 

Items to Watch for in the Future:

• Aaron Galeener still listed as Interim Chief Executive Officer, Health Plan Services (CountyCare, Medicare).  When will a permanent CEO of CountyCare be appointed?

Observer - Susan Kern, MD