Cook County Board Holds Hearing on Cook County Health Finances

Cook County Board of Commissioners Health and Hospitals Committee
Public Hearing
September 26, 2019

This hearing was requested by the Cook County Board of Commissioners to note and understand discrepancies between the Inspector General (IG) Report and the  rebuttal of Cook County Health (CCH) and the firm—Deloitte—hired by CCH to analyze the Inspector General's Report.  The IG Report generally stated that CCH’s insurance program, County Care, was unsustainable and was being subsidized by Cook County taxpayers.  The IG report looked at ALL of the CCH finances, not just County Care.   CCH disputed this and hired Deloitte to analyze the IG report —mainly the viability of County Care—and report to the Cook County Board.  Deloitte did NOT do an audit as this was done previously by another division at the firm.  It also only looked at County Care and not all of CCH.

There was a lot of confusion by the Board on what was being stated by both the IG Office and Deloitte.  Mainly this was because of the Accounting Systems used by CCH and the various ways accounts receivable, payable, assets, etc. can be interpreted.  All parties are looking  at the financials and cash flow differently.  The main question of the Cook County Board was “Do we have any concerns about the stability and viability of CCH?”

Here are the basic findings as this Observer understood them:

Inspector General Report

• CCH is using other assets to pay claims in County Care, so the “hospital system is subsidizing the County Care Insurance program.” 
• There is between $501-$700 million in outstanding bills -—not paid or paid late. 
• Vendors are not supplying some necessary hospital, medical items because they are not being paid.
• Transparency of revenues and losses is an issue. 

Deloitte Analysis--

• Revenues from County Care (provided from governments state and county) have covered its expenses.
• CCH needs to make more timely payments to providers (90% of claims are processed but not nearly that number are paid) and this is a concern
• County Care is profitable and can run the program
• Assets and Liabilities in County Care are sustainable
• At any point in time, County Care will have a $500 million or so liability because as old bills are paid, new ones come in that need to be paid -a backlog.
• Funds from the State and County are sometimes not timely, which puts payments behind.

Dr. Shannon (CEO of CCH) Statements:

• The premiums that County Care receives are more than enough to pay its expenses in County Care and in fact subsidizes some of the charity care and other programs that CCH undertakes. 
• CCH has suffered reputitional damage due to the IG report.  People will not be willing to use CCH if they don't feel confident in its sustainability and viability. 
• The State of Illinois needs to speed up its application process for Medicaid enrollees. 
• CCH is in deficit due to increased charity care and non-payment by individuals who have insurance—NOT because of County Care.

Cook County Budget Office:

• CCH will be working with the Cook County Budget Office to use best practices and increased transparency in reporting between CCH and Cook County Board. 
• There is room for improvement on the cash/payments flow system and they are working on it.

Observer :  Karin Hribar                              Length of Committee Hearing:  2 hours and 20 minutes