Hospital System CFO in Hot Seat at Cook County Board Meetings

Cook County Board of Commissioners and Committee Meetings - April 25, 2018
                                       Meeting Length - 4 hours, including breaks. Committee meetings started at 10am.

FINANCE COMMITTEE MEETING
The Finance Committee, which met from 10:09am to 11:40am, spent considerable time grilling the Cook County Health and Hospitals System (CCHHS) CFO about the $174 million in denials in 2016 and 2017 as reported in the Inspector General’s (IG) 4/13/18 quarterly report for 1Q 2018. 

• Commissioners, Boykin, Daley, Gainer and Morrison asked most of the questions in trying to determine what led to the loss of $174 million - $108 million in 2016 and $66 million in 2017. Boykin referenced the report stating that denials can be attributed to scheduling, patient registration, coding errors, physician and nurses, inadequate and inaccurate coding. He noted that 1/3 was written off because of untimely filed medical bills. 
• In response to Comm. Gainer’s question, the HHS CFO said yes – the $174 million was lost due to missed collection deadlines and clerical error. 
• The Finance Committee talked briefly about another topic, but then Comm. Gainer asked about the CCHHS collection rate. The CCHHS CFO responded that the charges are different from billing and different from collections. Typically, patient collectibles are 30% or a $50 million loss on $175 million in charges.
• In response to questions, it was revealed that there had been about 1,200 patients treated for gunshot wounds at a cost of $35,000 per patient. However, it was unknown what percentage was covered by insurance. 
• It was clarified that the $174 million written off was separate from uninsured. $317 million that was written off for charity care. 
• Comm. Boykin expressed frustration with the responses he received. Comm. Suffredin stepped in, stating that the CCHHS CFO came to the meeting prepared to address the monthly report – not the IG report. He suggested a special meeting to address the IG report be scheduled. 

Comm. Daley wrapped up the Finance Committee meeting stating that they need clarity on the $174 million in losses. 

ZONING AND BUILDING COMMITTEE MEETING
Next the Zoning Committee met from 11:40 am to 12:50 pm. They passed a bunch of recommendations. 

BOARD OF COMMISSIONERS MEETING
Pres. Preckwinkle called the meeting to order at 11:54 am, then went into recess at 12:26 pm; reconvened at 1:08 pm and adjourned at about 2:08 pm. 

• Regarding 18-3099 a lease agreement for CCHHS, a question was asked about the expenditure of $1.5 to $2 million to lease space rather than incorporate it in the new building. It appears to be a bonding issue, which limits the capitalization plan. It was noted that the rent will be $23/SF with 79 free parking spaces, which is $2 less than market comps in the Medical District around Stroger. Staff felt it was the best deal in the newly renovated space. 
• There was also reference to the Inspector General’s report on CCHHS billing issues at the Board meeting, that had been previously referred to in the Finance Committee meeting. 

Items to Watch for in the Future

• Special hearing on the $174 million in CCHHS denial of billing by insurance companies.

Other Comments or Observations

• Several members from the Illinois Committee of Blind Vendors spoke during public comment. They referenced the “Blind Lives Matter” movement, that the unemployment rate for people who are blind is 70%, as well as an Enterprise Program for the Blind (a training program). They referenced the Blind Vendors Act. (I found reference to the BVA in the 1/17/18 Board meeting materials where it was referred to the Asset Management Committee’s 2/7/2018 meeting, which appears to have been cancelled. There does not appear to have been another meeting.)
• They mentioned that blind vendors have the right of first refusal on federal and state property and are looking for commission-free opportunities and partnerships like they have with state and federal. They advocated for the commissioners to vote in favor of the Blind Vendors Act of Cook County.

​Observer - Peggy Pissarreck