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Cook County Health Considers Hiring Firm To Review Scathing OIG Report

Cook County’s inspector general raised significant financial questions about the county-run health system’s Medicaid insurance business.

A billboard advertises CountyCare, the Cook County health system's Medicaid business.

A billboard advertises CountyCare, the Cook County health system’s Medicaid business.

Shannon Heffernan/WBEZ

The Cook County health system is looking to hire a company to address significant financial issues that came to light after an investigation of its Medicaid business called CountyCare.

John Daley, an influential veteran Cook County Board commissioner, said the government-run health system would try to get a third party to review the findings Cook County Inspector General Patrick Blanchard raised in his June 21 report.

“We have to have this done in order to move forward,” said Daley, who runs the county board finance committee.

A spokeswoman for the health system confirmed the potential hire. Initially, after Blanchard released his report, the health system in a statement questioned if his staff understood the complexities of Medicaid.

Blanchard’s report raised serious questions about the way Cook County Health leaders run CountyCare, pay the doctors and hospitals in the insurance network, and communicate that in a transparent way to county leaders and to the hospital’s own board.

Among Blanchard’s most significant findings, CountyCare finished the 2018 budget year owing hospitals and other vendors nearly $701 million. Blanchard alleges the backlog was so bad that some vendors cut off supplies, leading to a shortage of pacemakers and anesthesia for surgeries.

He found that CountyCare does not generate enough money to pay all of its expenses at the end of each year, so it uses money coming in to pay old bills.

The investigation also raised concerns about whether the county health system is shuffling money around in order to make its finances appear better than they are.

Blanchard’s report set off a wave of anxiety. County commissioners publicly grilled health system leaders and questioned the sustainability of CountyCare. They want to audit the health system’s books, even though one just wrapped up.

They’re concerned because CountyCare is crucial to the finances of not only the health system, but also to the county budget. CountyCare has become a key money-maker since it launched in 2013. The health system makes up nearly half of the county’s roughly $6 billion budget, and its Medicaid business generated $1.8 billion last year. CountyCare has helped reduce the amount of extra money the health system needs each year from taxpayers.

The Medicaid plan also has increased access to medical care for low-income people. CountyCare insures about 317,000 people.

Dr. Jay Shannon, CEO of the county health system, has disputed some of Blanchard’s findings. He has said CountyCare is strong and transparent, and that CountyCare does not owe medical providers about $701 million. He has said CountyCare has paid all the bills it has received — a total of around $476 million as of February.

But Shannon and other executives on his team have largely saved going into more details about Blanchard’s findings until a county board meeting next week.

The county health system includes flagship John H. Stroger Jr. Hospital on the Near West Side, Provident Hospital on the South Side and clinics throughout Chicago and surrounding suburbs. The system treats patients who are largely poor and people of color, and provides far more free medical care to people who are uninsured or can’t afford to pay their bills compared to other hospitals in the county.

Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.

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