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Early Obamacare rollout a boon to Cook County

Monday, December 02, 2013
Crain's Chicago Business
by Ram Raju

For decades there's been talk about how America can reinvent its health care system. As the world's richest country, we spent $2.6 trillion on health care in 2010 alone, or $8,402 per person. Yet millions still are left without basic health care, and all that spending has done little to improve our overall health.

As this country continues to debate the merits of the Affordable Care Act, it is imperative that we understand the stabilizing force it has been to Cook County and the tens of thousands of county residents it already is serving. The Cook County Health & Hospitals System is the third-largest public health system in the United States. Yet it cares for more uninsured patients than any of our national counterparts. CCHHS spends more than $500 million annually in uncompensated care to carry out its mission to serve everyone, regardless of their ability to pay.

Cook County was granted one of just a few federal waivers, which allowed us to create CountyCare, an early rollout of the ACA. CountyCare has provided significant federal funding for patients we long have been caring for but who do not have the means to pay. This new revenue resulted in the reduction of Cook County's subsidy to the health system by $76 million for 2014. Next year, county taxpayers will contribute just 15 percent of the system's $1.1 billion budget, compared with the 50 percent it contributed in 2009.

Stabilizing the finances of any company is just the first step in turning it around. Next, we must transform the way we deliver care. We must do it better and we must do it smarter. As with any company trying to reinvent itself, it requires investment. Next year, CCHHS will invest more than $150 million on strategies to improve the patient experience. Frontline staffing will be increased and investments in technology upgrades will be made to provide us with critical business intelligence needed to make informed decisions.

The ACA will not cover everyone. There will always be a need for public health systems. If we did nothing, CCHHS largely would have been left with a base of uninsured patients and we likely would have turned to Cook County taxpayers for more funding to care for them.

Instead, we chose a path that over time will create a sustainable business model that relies less on local taxpayers, provides a higher level of care and ultimately delivers on the promise of the ACA to create healthier communities and reduce health care costs.

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