Suffredin- An Advocate for All of Us  

Forest Preserves
Public Safety
Cook County Budget
Forest Pres. Budget
Property Tax Appeal
Health & Hospitals
Land Bank Authority
Policy Resolutions
Unsung Heroine


  Office phone numbers:  

The Cook County Code of Ordinances are the current laws of Cook County.


Search current and proposed Cook County Legislation in Larry's exclusive legislative library.

  Cook County is the second most populous county in the nation. It is the 19th largest government in the U.S.

County looks to salve pain of its hospital.

Thursday, October 18, 2007
Chicago Tribune
by Bruce Japsen

Right prescription for alleviating financial drain may need to come from outside specialists

If Cook County decides to move away from operating Stroger Hospital, it would be joining a trend by governments to distance themselves from running health-care facilities.

That said, more hospitals in rural and suburban areas, rather than urban facilities, are moving to outside management companies because those institutions face less competition. Stroger, like other urban government-owned facilities, operates in a competitive market of nearly 100 hospitals and treats an abundance of uninsured that makes it a more complex business to run.

Stroger Hospital and its affiliated health facilities and clinics represent one drain on the finances of Cook County, which has a $300 million budget hole. As part of its effort to attain financial health the county is publicly mulling a change in the management of Stroger and the rest of the county health system, with no options specifically ruled out.

Increasingly, government-owned hospitals have negotiated outright sales, management deals and even long-term lease agreements with outside companies, according to industry statistics. Some have generated savings while shedding the facilities altogether to free up taxpayer dollars for roads, infrastructure and even funding indigent care over the course of decades.

In return for management of the hospital, outside companies are paid fees or, if they take an ownership stake or lease the facility, reap profits and pay the seller in the form of proceeds from a lease or outright sale.

Although an outright sale of the Cook County system is unlikely, industry analysts say outside management deals represent one option.

Short of a sale or lease, some government hospitals also are turning to non-political boards or public authorities, one option the county has said is under consideration.

County Board President Todd Stroger, along with his health chief, Dr. Robert Simon, have pushed through cuts in services and are now looking at other possibilities to improve operations.

Stroger and Simon, who met with the Tribune's editorial board Wednesday along with other county executives, said the county is in the early stages of studying how to go about improving the operation at the county hospital and is not ready to make recommendations on what to do. But they are not ruling out outside management.

"I have no problem changing over governance," Stroger said.

Getting outside expertise would be a good idea, hospital analysts say.

"There are things that government hospitals can learn from private hospitals, and so they usually go outside to figure out what are they behind on in terms of everything from contracting with physicians to buying supplies to collecting bills," said Sandy Lutz, director of the Health Research Institute at PricewaterhouseCoopers consulting firm.

In other areas of the country governments have moved to get out of the hospital business, for various reasons. Some have sold, particularly rural facilities, to for-profit companies while others have hired management firms. Some have made strides to distance their facilities from politics by creating outside authorities to run the hospitals.

Suburban and rural focus

Hospital management companies and for-profit firms that have taken over government owned hospitals tend to look at suburban markets and rural areas where the facility it is poised to run tends not to face the competition for patients that exists in the Chicago area.

For example, Tennessee-based Community Health Systems, which is the largest publicly traded hospital company in the U.S., operates a hospital management company, QHR, formerly known as Quorum, with a growing interest in running government hospitals.

The company would not provide details, but the list on its Web site indicates that most of the hospitals under management are in smaller markets.

Tom Scully, the former head of the Centers for Medicare and Medicaid Services in the George W. Bush administration and now a partner in a New York private-equity firm, said Cook County officials should consider an outside public authority to run its system.

In Atlanta, Fulton County commissioners are considering a transfer of daily management of publicly owned Grady Health System to a "non-profit, community-based group," according to a report in last Friday's Atlanta Journal-Constitution. The health system is projecting a deficit of more than $50 million this year, the report said. Dr. Simon said Grady is among the public health systems Cook County officials are monitoring.

"The real issue is to insulate the hospital from politics and setting up a private authority would do that," Scully said. "You could sell it, but do you want to sell a public trust?"

Scully also said finding a for-profit management company to run it could "add significant value and detach the system" from the county.

Politics may be a problem

But some people who are familiar with what for-profit hospital firms are interested in say it's unlikely a company would want to buy Stroger or take an investment stake in a facility with so many political issues.

"As far as large urban county hospitals, it's extremely difficult to think one of those would be sold, and no one I know would be willing to expose themselves to the political firestorm that would ensue," said Josh Nemzoff, president of New Hope, Pa.-based Nemzoff & Co., a financial advisory firm that works with government and non-profit hospitals on merger issues and restructurings.

Nemzoff thinks one solution may be to ensure the hospital has good management rather than hire an outside firm.

"It would be a lot cheaper just to go out and hire a good management team and let them run the place," Nemzoff said. "If you hire a management company, its mission in life is to stay there as long as possible because they are paid by the hour. And before you know it, you will have 11 people from the management company and you might not be better off than you were before."

Recent Headlines

Thursday, May 16, 2019
Special to

Cook County Assessorís Office Publicly Releases Residential Assessment Code and Models
Thursday, April 18, 2019
Special to

EDITORIAL: Long in the MWRD pipeline, IG plan needs a yes vote
Wednesday, April 17, 2019
Chicago Sun-Times

Cook County Health Cuts Ribbon on Outpatient Center in Arlington Heights
Tuesday, April 16, 2019
Daily Herald

Celebrate Earth Day with the Forest Preserves of Cook County
Tuesday, April 16, 2019
Special to

Homeowners in Chicago have just a few weeks to get current on their 2017 property taxes - or risk losing their homes. WBEZís Odette Yousef reports.
Tuesday, April 16, 2019
WBEZ Chiacgo Public Radio

Editorial: The Foxx-Smollett questions for Inspector General Blanchard
Tuesday, April 16, 2019
Chicago Tribune

Cook County pet owners warned of spring coyote dangers
Monday, April 15, 2019
Chicago Sun-Times

Cook County inspector general to review prosecutors' handling of Jussie Smollett case
Saturday, April 13, 2019
Chicago Tribune

Foxx requests Cook County IG investigation into handling of Jussie Smollett case
Friday, April 12, 2019
Chicago Sun-Times

A challenge to one of Chicago's biggest draws for companies
Friday, April 12, 2019
Crain's Chicago Business

What Evanston's assessments tell us about the new assessor's new math
Friday, April 12, 2019
Crain's Chicago Business

$3.85 million granted in lawsuit against ex-Cook County forest preserve worker charged in fatal on-the-job crash
Thursday, April 11, 2019
Chicago Tribune

A Day in the Life of a Cook County Burn Crew
Wednesday, April 10, 2019

EDITORIAL: Splitting up the regionís sanitation board is an idea that stinks
Monday, April 08, 2019
Chicago Sun-Times

Lawmakers Look To Keep 10-Year-Olds Out Of Jail
Thursday, April 04, 2019

Property Tax Workshops Help Homeowners Appeal Assessments
Wednesday, April 03, 2019
Evanston RoundTable

Large crowds of Evanston residents turn out to appeal property tax assessments
Tuesday, April 02, 2019
Chicago Tribune

Family of slain cabbie accuses Cook County state's attorney's office of dodging FOIA request
Monday, April 01, 2019
Chicago Tribune

Property Tax Appeal Seminar Set For New Trier Township Residents
Monday, April 01, 2019
Journal and Topics Online

all news items

Paid for by Larry Suffredin and not at taxpayer expense. A Haymarket Production.