Outpatient focus core of new Cook Co. health plan HEALTH SYSTEM OVERHAUL | Proposal would cut inpatient care at Oak Forest, Provident hospitals
Monday, July 12, 2010
by Lisa Donovan and Monifa Thomas
Cook County's health system is looking at a dramatic overhaul,
shifting away from costly inpatient care at two hospitals in favor of
more extensive outpatient services.
While the move is being praised by health experts, a new strategic
plan that lays out the overhaul is likely to face strong opposition when
it's introduced to the full Cook County Board this week, particularly
ahead of November's elections.
Under the five-year plan, Oak Forest Hospital would discontinue all
inpatient care and become a regional outpatient center that would
provide a wide range of primary care services.
Inpatient services would also be scaled back at Provident Hospital,
500 E. 51st, but the emergency room and a few short-stay beds would stay
open. Provident could retain more of its existing services, though, if a
partnership is brokered with the University of Chicago Medical Center.
Inpatient care reductions are expected to generate $72 million in
savings that would be used to beef up primary and specialty services and
compensate community hospitals for treating displaced patients from
Provident and Oak Forest.
The hospital system would also spend $202 million on capital
improvements, such as rebuilding Fantus Health Center at 621 S.
Winchester and building a new outpatient clinic in the northwest
More outpatient centers should translate to shorter waits for
mammograms, colonoscopies and other routine exams, hospital system CEO
William Foley said.
"We feel strongly that we're expanding services, not taking services
away," he said. "We're placing our services where our patient population
is to make it more accessible."
The plan, the culmination of a year-long $950,000 study with
Chicago-based Integrated Clinical Solutions Inc., was unanimously
approved last month by the independent Cook County Health and Hospitals
System Board. On Tuesday, it is scheduled to be introduced to county
commissioners, who will have the final say on whether the plan advances.
Dr. Quentin Young, a longtime health-care reform advocate and former
chief medical officer of Stroger Hospital, called the planned
reorganization "very forward-looking" and said the emphasis on
preventive medicine is the right one.
"Obviously, you want to have a skilled hospital when that need
arises, but the real solution to the county's care of the population it
serves is properly placed outpatient clinics," Young said.
He added that it's critical for the county hospital system to form
solid partnerships with private hospitals that would be able to treat
patients who would be displaced from Oak Forest and Provident hospitals.
Dr. Kevin Weiss, a professor at Northwestern University's Feinberg
School of Medicine who wrote a scathing report on the county health
system in 2006, called the plan a "double-win" that will improve the
financial health of the hospital system and provide better care to
But Harry Mitchum, who said he once waited in Provident's emergency
room for eight or nine hours to see a doctor, wasn't sure what to make
of the proposed changes.
"People who live over here, they want to come here to this hospital.
They don't want to have to go to the West Side," for an extended
hospital stay, Mitchum said, referring to Stroger Hospital.
And while there are other hospitals nearby, Provident is part of the
countywide system that everyone knows will see patients who have no
money to pay for health care, said Mitchum, who has diabetes and
Cook County Commissioner John Daley, a Southwest Side Democrat, said
the key to this plan's success is changing some patient attitudes,
including seeing a doctor for regular checkups instead of waiting until
they're gravely ill to go to the emergency room.
That was the goal of expanding the county's clinic system over the
years, Daley said, "but we still have a lot of people who wait to the
"How do you draw people in so they're not showing up in the emergency
rooms? It's something all hospitals are dealing with . . . and, yes, it
will be a hurdle here."
Commissioner William Beavers said Provident needs to continue
offering obstetric and gynecological services, not cut them as the plan
calls for, and Oak Forest needs a true emergency room, not just a
walk-in ER. His district is sandwiched between the 113-bed Provident and
115-bed suburban Oak Forest hospitals.
"If these were full-service hospitals, they would pay for
themselves," Beavers said.