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Cook County health system to bolster front line in effort to improve patient services
85 nurses, others to be hired in effort to retain patients once new health care rules go into effect

Tuesday, January 31, 2012
Chicago Tribune
by Peter Frost

The Cook County Health & Hospitals System plans to hire up to 85 nurses and front-line health care workers in coming months as the cash-strapped public hospital system tries to boost patient satisfaction in preparation for national health care changes.

Ramanathan Raju, the health system's new chief executive, laid out on Monday a series of initiatives its plans this year to ramp up services amid intensifying competition among the region's hospitals.

Raju, speaking at a City Club of Chicago-sponsored event, said the county fears that once roughly 100,000 of its nonpaying patients become eligible in 2014 for an expanded Medicaid program, they may flee the county hospital system for for-profit and nonprofit health systems, like Northwestern Memorial and Rush University hospitals.

A mass exodus of these patients could cripple the system's fragile finances by shifting its patient mix further toward the uninsured, county officials said.

The Cook County health system, which includes Stroger Hospital, Cermak Health Services and the Rothstein CORE Center, classifies more than half of its patients as underinsured or uninsured. If a significant portion of newly insured patients were to leave the system, the percentage of uninsured patients could grow to the high 90s, Raju said.

The effect of such a shift, Raju said, "would be devastating."

The county health system this month said it collected $190 million in patient fees in its fiscal year ended Nov. 30. That's down significantly from the $360 million it had expected. It is facing an unspecified funding gap for 2012. Neither Raju nor Cook County BoardPresident Toni Preckwinkle would specify the size of the projected deficit.

Though Raju insisted that the county hospital system's quality of care is "very good," its customer service, such as wait times, availability of doctor appointments and staff friendliness, needs improvement.

The county system, he said, must improve such services if it wants to retain those patients who will become a new source of revenue once they're enrolled in government-sponsored insurance.

That effort starts with hiring nurses and other front-end health care providers who are "caring and compassionate," said Maureen O'Donnell, the county's human resources director, who recently was tapped to lead the health system's hiring efforts. Part of her initial focus is to expedite the hiring process.

The county needs to keep patients in its system because once "we get them enrolled in Medicaid, we'll have the opportunity to get reimbursed for care we're already providing," Preckwinkle said.

Raju, who took the health system's top job in October, said the county is pressing Illinois officials to secure a waiver from the federal government that would allow the health system to seek federal matching funds for the roughly 100,000 low-income patients it serves each year.

The program would allow counties and states to enroll patients under the expanded Medicaid guidelines earlier, thus providing the hospitals a leg up in retaining patients before implementation of health care changes in 2014, Raju said. He said he hopes the waiver will be approved this year.


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