December 3, 2013
For decades there’s been a lot of talk about how America can reinvent its health care system. As the world’s richest country, we spent $2.6 trillion on health care in 2010 alone or $8,402 per person. Yet, millions are still left without basic health care and all that spending has done little to improve our overall health.
As this country continues to debate the merits of the Affordable Care Act (ACA), it is imperative we understand the stabilizing force it has been to Cook County and the tens of thousands of Cook County residents it is already serving. The Cook County Health & Hospitals System (CCHHS) is the third largest public health system in the United States. Yet it cares for more uninsured patients than any of our national counterparts. CCHHS spends more than $500 million annually in uncompensated care to carry out its mission to serve everyone, regardless of their ability to pay.
Cook County was granted one of just a few federal waivers, which allowed us to create CountyCare, an early roll-out of the ACA. CountyCare has provided significant federal funding for patients we have long been caring for but who do not have the means to pay. This new revenue resulted in the reduction of Cook County’s subsidy to the health system by $76 million for 2014. Next year, Cook County taxpayers will contribute just 15 percent of the System’s $1.1 billion budget, compared to the 50 percent it contributed in 2009.
Stabilizing the finances of any company is just the first step in turning it around. Next, we must transform the way we deliver care. We must do it better and we must do it smarter. As with any company trying to reinvent itself, it requires investment. Next year, CCHHS will invest more than $150 million on strategies to improve the patient experience. Frontline staffing will be increased and investments in technology upgrades will be made to provide us with critical business intelligence needed to make informed decisions.
The ACA will not cover everyone. There will always be a need for public health systems. If we did nothing, CCHHS would have been largely left with a base of uninsured patients and we likely would have turned to Cook County taxpayers for more funding to care for them.
Instead, we chose a path that over time will create a sustainable business model that relies less on local taxpayers, provides a higher level of care and ultimately delivers on the promise of the ACA to create healthier communities and reduce healthcare costs.
Ram Raju, MD, MBA, FACS, FACHE
CEO, Cook County Health & Hospitals System