Cook County Health Continues to Have Funding Challenges

 Cook County Health (CCH) Board of Directors Meeting
October 25, 2019    

Board Discussion:
CEO Dr. Jay Shannon summarized recent Cook County Health (CCH) positive developments:

• The IL Health Facilities Board has approved the application for a new Provident Hospital;
• The National Committee for Quality Assurance (NCQA) has given CountyCare high approval ratings;
• The US Congress passed a continuing resolution through November 21, to continue the current $157m in “Disadvantaged Share Hospital” (DSH) funding to CCH, though, he cautioned, this agreement must be monitored.

But CCH faces serious funding challenges: it is $30m over budget in charity care despite $25m in new revenue this year.  In 2020 CCH anticipates providing $590m in uncompensated care, for which the only designated funding sources are the federal DSH ($157m) and BIPA ($132m) allocations.  The demand for charity care has grown by $100m since 2017.  CCH is now providing about 60% of all charity care in Cook County.  Of Stroger Hospital’s total patients, 47% are on Medicaid, 15% Medicare, 5% insured, and 35% uninsured.  The possible solutions to the funding gap do not inspire hope: more state and federal funding, possibly County funding from a sales tax.

Committee Reports: 

• Human Resources: Of 757 vacancies filled, 541 were external; average 101 days to hire. 
• Managed Care: 320,177 CountyCare members as of 10/6/19, 31% of the total 1,012,425 managed care members in IL.  83% of CountyCare members choose to re-enroll in the program. Since January 2018 managed care enrollment has diminished by 180,000.  An estimated 200,000 IL residents are eligible for Medicaid, but have not submitted applications.  96% of CountyCare claims are adjudicated within 30 days, but only 32% are paid within 30 days.
• Quality and Patient Safety: 72% of patients are now willing to recommend the Stroger Hospital.  The hospital’s readmission rate is currently 9.7%, vs. a 15% national average. 
• Finance: operating revenue is 23% below budget for 2019; the state is 2 months behind in payments.  Primary care visits are up by 10%, specialty care up 6%, Emergency Room visits down 2%, deliveries up 5%.

Significant contract awards: 

• Cerner Corporation for software support - $191m for 5 years, $38.2m per year
• Medline Industries for medical and surgical supplies - $70m for 36 months;
• Paschen Ashlaur Joint Venture  to construct Belmont-Cragin Health Center - $12m. 

Observed by:  Linda Christianson                         Meeting Length: 3 hours