Cook County Health & Hospitals System: Strategic Planning Stakeholders Forum
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Cook County Health & Hospitals System: Strategic Planning Stakeholders Forum. November 14, 2008 UIC Student Center West 828 South Wolcott, 3:00 p.m. Cook County Health & Hospitals System. 2008 Cook County Health & Hospitals System. 2. Mission Statement.

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Cook county health hospitals system strategic planning stakeholders forum

Cook County Health & Hospitals System: Strategic Planning Stakeholders Forum

November 14, 2008

UIC Student Center West

828 South Wolcott, 3:00 p.m.


Cook county health hospitals system

Cook County Health & Hospitals System

2008 Cook County Health & Hospitals System

2


Mission statement

Mission Statement

2008 Cook County Health & Hospitals System

To provide a Comprehensive Program of Quality Health Care, with Respect and Dignity, to the Residents of Cook County, regardless of their ability to pay.

3


Today s goals

Today’s Goals

An overview of the strategic planning process and objectives.

An overview of our preliminary findings on the current environment.

2008 Cook County Health & Hospitals System

4


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Planning Process

Strategic Goals

  • Securing the operational stability of the CCHHS.

  • Developing more specific long term goals (in spite of immediate challenges).

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Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Planning Process

First Steps

  • Gathering, analyzing and interpreting data from the external environment.

  • Community participation in the planning process to solicit feedback and ensure transparency.

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Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Initial Findings

  • Changes in the surrounding community-population shifts, economic changes, birth rates

  • Changes in Cook County Health & Hospitals System (CCHHS)

  • Changing external forces will affect the future.

  • Existing internal forces will affect the future.

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Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Changes in Population

  • Total county population declining, but growth in Suburban Cook County partially offsetting decline in Chicago population.

  • Hispanic and non-white population growing—Suburban Hispanic population grew 34%, more than 100,000 individuals.

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Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Growth in Poverty

  • Income grew faster in Chicago than in suburbs.

  • Portion of population below poverty line grew faster in Suburban Cook County.

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The uninsured

The Uninsured

2008 Cook County Health & Hospitals System

  • Overall decline in uninsured between 2000 and 2005—but preliminary data suggests increases since 2005.

  • Metro and Chicago decline in uninsured.

  • All decline in Chicago—number of uninsured in Suburban Cook County increased by 43% (although still smaller than in Chicago).


Births declining faster in chicago

2008 Cook County Health & Hospitals System

Births Declining – Faster in Chicago

  • Births are declining everywhere in the County

  • More slowly in Suburban Cook County


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Where do Stroger patients live?

FY 2007

Note: There are 43 zip codes in Stroger’s Primary Service Area (PSA) that account for 18,902 or 80% of the hospital’s 23,548 total discharges. The top 3 zips, 60612 (West Town), 60623 (Lawndale) and 60608 (Pilsen) account for 13% of PSA discharges.

*Total discharges exclude normal newborns


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Where do Oak Forest patients live?

FY 2007

Note: There are 44 zip codes in Oak Forest’s PSA that account for 2,258 or 80% of the hospital’s 2,813 total discharges. The top 3 zips, 60426 (Harvey), 60628 (Roseland) and 60411 (Chicago Heights) account for 18% of PSA discharges.

*Total discharges exclude normal newborns


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Where do Provident patients live?

FY 2007

Note: There are 10 zip codes in Provident’s PSA that account for 4,802 or 80% of the hospital’s 5,944 total discharges. The top 3 zips, 60615 (Kenwood-Hyde Park), 60653 (Kenwood-Oakland) and 60609 (Bridgeport) account for 33% of PSA discharges.

*Total discharges exclude normal newborns


System hospitals average daily census by hospital 2004 thru 2007

2008 Cook County Health & Hospitals System

System Hospitals: Average Daily Census by Hospital, 2004 thru 2007

Source: IDPH Data, 2004-2007


System hospitals admission trends 2004 2007

2008 Cook County Health & Hospitals System

System Hospitals: Admission Trends, 2004-2007

Source: IDPH Data, 2004-2007


Achn clinic locations

2008 Cook County Health & Hospitals System

ACHN Clinic Locations


Visits ambulatory community health network clinic visits by location fy2005 2008

Visits: Ambulatory Community Health Network Clinic Visits by LocationFY2005 - 2008

2008 Cook County Health & Hospitals System

Source: ACHN Manual Counts


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

CCHHS Financing: Summary

CCHHS Sources of Support

FY04 - FY09 ($M)

1.66 Bill

2.02 Bill

1.88 Bill

1.74 Bill

1.79 Bill

1.71 Bill

Source: Audited Financial Statements, FY 04-08; Management estimate for FY 08-FY 09

Source: Audited statements and internal documents;


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

IGT/BIPA Funds Declining Over Time

Source and Notes: County’s Health Care System Lost $120.5 Million in “Supplemental” Medicaid Revenues Between FY05 and FY08; Slide provided by the Center for Budget and Tax Accountability (CTBA);


Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

BIPA Funding Shared with State


Cook county health hospitals system fy 2008 fy2009 budget comparison

2008 Cook County Health & Hospitals System

Cook County Health & Hospitals SystemFY 2008-FY2009 Budget Comparison


Adopted appropriations health fund

2008 Cook County Health & Hospitals System

Adopted Appropriations: Health Fund


Adopted appropriations capital

2008 Cook County Health & Hospitals System

Adopted Appropriations: Capital


Cchhs patient payor mix

CCHHS Patient Payor Mix

2008 Cook County Health & Hospitals System

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Public hospital subsidy

Public Hospital Subsidy

2008 Cook County Health & Hospitals System

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P olicy issues

Policy Issues

National healthcare reform.

Charity care as government policy.

Patient Safety and Quality Measurement/Pay for Performance structures.

Proposed regulations that may constrain providers of healthcare to the poor.

2008 Cook County Health & Hospitals System

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Regional national trends

Regional/National Trends

Shifting City/County Demographics

ongoing city gentrification, inflow of uninsured immigrants.

Increasing out-of-pocket expenses.

Public Hospital financing issues in the U.S.

Insufficiency of specialty care access and resources for the poor.

Anticipated shifts/trends in healthcare delivery.

The overall economic downturn that threatens tax revenue shortages.

2008 Cook County Health & Hospitals System

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Existing internal forces

Existing Internal Forces

Weakened infrastructure in IT and revenue cycle throughout the institution threatens our ability to move forward.

Tumultuous changes led to the loss of many critical human resources that need to be rebuilt in order to move forward.

Customer service scores display a gap that will keep us from succeeding.

2008 Cook County Health & Hospitals System

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Positive developments

Positive Developments

Support from the County Board President and Commissioners for the creation of an independent CCHHS Board, and the opening up of the governance decision-making process.

The opening of the new John H. Stroger hospital facility.

The preliminary acceptance of the CCHHS’ recommended 2009 Budget.

Reduction of costs through the use of a Group Purchasing Organization (GPO).

The work with the Revenue Cycle consultants is showing progress and positive returns.

2008 Cook County Health & Hospitals System


Next steps your input

Next Steps – Your Input

What are the Hard Decisions? You tell us.

What are the three mostimportant services CCHHS delivers to the people of Cook County?

What are the three services you are willing to give up in order to assure the most important services?

What questions do we need to answer in order to develop an actionable Strategic Plan?

2008 Cook County Health & Hospitals System

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Cook county health hospitals system strategic planning stakeholders forum

2008 Cook County Health & Hospitals System

Questions?


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