CountyCare Enrollment Declines by 33,000 in 2019

Cook County Health (CCH) Board Meeting - April 26, 2019

CountyCare - Managed Care Organization Update

• Medicaid enrollment in CountyCare, Cook County's managed care organization, has declined by 33,000 from January-March of 2019. And statewide, since its April 2018 peak at 2,298,000, membership in Illinois' managed care organizations (MCOs) has declined by 205,890, most of them “Affordable Care Act” patients, older adults without children.  The consequence of this decline for CCH is that the number of uncompensated emergency and primary care visits will increase.   
• CountyCare currently has 31.5% of market share, a total of 316,973 members, but Meridian (Wellcare) and Illinicare (Centene) will soon merge to become Cook County’s largest MCO with 33% of market share. 
• CEO Shannon praised new healthcare leadership in Springfield, including former CCH Deputy CEO Doug Elwell who now oversees the state of IL Medicaid program. 
• Dr. Shannon will visit Washington DC this summer to negotiate Medicaid and DSH (Disproportionate Share Hospitals) payments, hopefully to offset threatened funding cutbacks.

What did the Board discuss?

• Personnel status - 7,265 positions, 1,265 vacancies, 2.8% turnover, 103 days to fill a position
• A $33.6 million budget shortfall for 3 months ending in February 2019, less than the $43 million projected, due in part to lower-than-expected pension costs.   CCH has 21 days’ cash on hand.
• 45% of patients are uninsured, 5% have commercial insurance; almost all others are covered by Medicare (15%) or Medicaid (33%).
• Primary care visits are up 4%, specialty care up 3%, surgical care down 2%, ER visits down 3%.  65% of Stroger patients would recommend the hospital. 

Items to Watch for in the Future

• Many accolades went to Marketing/Communications Director Caryn Stancik after her presentation showing the consistent growth in the department’s activities to raise awareness of the value of CCH and alerting staff to the upcoming MAKING AN IMPACT campaign highlighting CCH accomplishments.

Other Comments or Observations

• Dr. Terry Mason, Director of the Cook County Department of Public Health, alerted the board to a Countywide increase in sexually transmitted infections (STIs), due, he said, to the large number of phone apps that can lead to anonymous sex.

​Observer - Linda Christianson                                Meeting Length: 3 hours