Cook County Tells the Hospital System to Slash their Budget by $27 Million

Cook County Health and Hospitals System (CCHHS) Board Meeting - October 27, 2017

Budget Cut Discussion Highlights:
Cook County has requested that CCHHS cut their budget to help fill the $200M hole left by the repeal of the sweetened beverage tax. While the 10% budget cut request indicated was $27m, CCHHS CEO Shannon cautioned that higher numbers were being floated by Cook County leadership: 10% ($190 million) of the Hospital’s  $1.9 billion total revenues ;  $80 million (10%) of the budget  exclusive of  the $1.2 billion Medicaid which Shannon said “can’t be touched as it was Federal money”.  Why not just 10% ($11 million) of the $110 million Cook County subsidy to CCHHS queried Director Reiter?  Shannon will argue against draconian cuts at the Cook County budget hearing Nov. 7 that he iterated would result in closing certain operations and cutting staff in the Hospital System.  CCHHS cost savings ideas that have been suggested which Shannon opposes:

• Sweep vacancies or freeze hirings
• 10% salary cut of all non-union employees over a certain income
• Consolidation of Human Resources (HR) and Procurement services with other County departments

Significant Topics Discussed:

• 160,000 of disbanding Family Health Network managed Medicaid members to be added to CountyCare Nov. 1, 2017 swelling rolls to 297,000 .  Open enrollment Jan -March 2018, when any CountyCare member may select different non-HHS Medicaid Plan.  Efforts ongoing to retain members and physician providers.  4 large FHN physician groups (4000 members) have chosen not to join CountyCare, primarily due to geographic distance from Stroger.
• Financial Metrics: Net operating loss $286 million at 9 months into year, due to pension, overtime, salaries & benefits and external claims expense which are paid to non-CountyCare network providers.
• Below budget target are: Total CountyCare members (1% drop to 139,723), primary care physician visits, specialty care, total inpatient discharges, surgical cases and ER visits.  Deliveries are above target last 2 months.
• Quality Metrics through Aug. 2017:  No improvement in Patient Experience/willingness to recommend Stroger or Provident Hospital with cleanliness still the most cited negative.  Stroger ranks in the 35% in national comparisons of  hospitals “willingness to recommend”.
• New Central Campus development multi-story building replacing Fantus Clinic, construction is right on schedule with massive structure ready for window installation.
• Provident Hospital inspection by Joint Commission: no deficiencies in the Medical Home component 
• CountyCare to add member incentives for engaging in their own healthcare and improving quality metrics:  payments to members for making prenatal & postpartum visits, getting childhood immunizations, diabetes and blood pressure control etc.

Observer - Susan Kern, MD                                                     Meeting Length:  2 hours and 45 minutes