Decision on Illinois' Managed Care Reorganization Due in August - How Will CountyCare Fit In?

Cook County Health & Hospitals System (CCHHS) Board Meeting - July 28, 2017 

Beginning January 1, 2018, all Illinois managed care organization members, including those enrolled in CountyCare, will have 90 days during which they may opt for a different plan.
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Significant Topics Discussed:
CountyCare (Managed Care):

• Managed Care Director Steven Glass departs his post for a job in the private sector.
• CountyCare seems likely to be chosen by the state of IL as one of 4-6 managed care organizations in the state’s reorganization of the delivery of managed care, with a decision on this due in August. Once the reorganization takes effect on January 1, 2018, Medicaid reimbursement rates to managed care organizations are likely to decline.
• CountyCare enrollment continues at 141,000, 1.5% under budget.

Finance:    

• CCHHS will lease 13,700 square feet from Westside Health Authority to accommodate the behavioral health services currently housed in Fantus Clinic, with the anticipation that an additional site for behavioral health services will be identified on the south side.
• For the first 6 months of 2017 revenue was $103,000 below budget projections, attributed to overtime (8% of payroll) and external claims expenses, including CountyCare payments to non-CCHHS providers.
• 2018 budget planning assumes an anticipated need of $84 million before considering any new expenditures and must include $30 million for staff pay increases; $28 million in capital needs; $26 million in furnishings and equipment for the new facilities.
• 73% of CCHHS budget is personnel-related; 90% of staff are unionized. 

Quality and Patient Safety:

• 65% of Stroger patients would recommend the hospital, cleanliness the most pressing concern. A Director of Environmental Services has yet to be approved.
• 69% of ambulatory care patients expressed satisfaction with their patient visits.

Human Resources:

• 715 identified vacancies, 117 days required to hire a new Full Time Employee (FTE), a 4% turnover of total FTE’s, a 5.4% nursing turnover.  The board raised questions concerning the length of hiring time.  

Other Comments:

• “To survive we must grow.”  Deputy CEO Doug Elwell spoke of the “bolus” of uninsured patients CCHHS is committed to care for.  CCHHS looks to improve the patient experience, increase volumes, sustain its financial position, sustain and grow CountyCare membership.
• Public speakers representing nurses spoke of ICE agents entering CCHHS buildings without authorization.

Observers -  Linda Christianson and Jackie Buttafuoco                         Meeting Length - 3 hours