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Cook County Health’s Unusual Pitch To Rival Hospitals: Help Us

Tuesday, October 29, 2019
WBEZ Chicago Public Radio
by Kristin Schorsch

The Cook County-run health system on Tuesday emailed a letter to the CEO of every other hospital in the county, pitching an unusual request.

Dr. Jay Shannon asked other hospital leaders for help. He said treating so many uninsured patients could sink the county.

“The 180 year mission of Cook County Health is to provide care to all Cook County residents regardless of their ability to pay,” wrote Shannon, along with Hill Hammock, chairman of the health system’s board of directors. “... I am writing to you today to tell you that our historical mission is threatened by a significant and unsustainable increase in charity care.”

“In the coming weeks and months, we will be exploring potential solutions to this challenge and would welcome your input, ideas and partnership as the hospital community in Cook County is stronger if its primary safety net is stronger.”

That primary safety net is Cook County Health, which includes flagship John H. Stroger Jr. Hospital on the Near West Side, Provident Hospital on the South Side, and a network of community clinics.

Charity care is medical care hospitals provide to patients who are typically uninsured and don’t pay. Next year, Cook County Health is set to provide about $409 million in charity care — more than double the tab six years ago.

The swelling amount of charity care is contributing to an estimated nearly $600 million in medical care Cook County Health won’t get paid to provide in 2020. The other contributing factor is bills the health system can’t collect from patients who have insurance but can’t afford to pay, and from insurance companies that refuse to reimburse the system.

Just on Monday, Shannon stopped short of publicly naming hospitals that don’t provide much charity care. But he said they contribute to his financial strain by sending uninsured patients his way, especially sick, expensive patients like those who need cancer treatment.

He again called on other hospitals to treat more uninsured patients. He’s done this before. There are nearly 70 hospitals in Cook County, yet the county health system’s two hospitals provide more than half of all the charity care in the county, a WBEZ analysis of state records show.

So asking other private and public medical facilities for a lifeline is an interesting twist, and likely a hard sell. By taking on more charity care, these hospitals would lose money, too. And legally they don’t have to provide charity care, but many do to help keep what can be lucrative property tax breaks.

But these hospitals could wind up treating more uninsured patients anyway if the county health system reduces services or consolidates facilities because they’re unaffordable, as Shannon and Hammock cautioned in their letter to hospital CEOs.

On Tuesday, Shannon defended his proposed $2.8 billion budget for 2020 before the Cook County Board as part of a series of county budget hearings. He said federal funding that is supposed to help cover charity care isn’t enough.

He asked commissioners for their ideas. They didn’t offer many realistic suggestions.

Democratic Commissioner Deborah Sims called the county’s climbing amount of charity care “scary.” She suggested going after other hospitals’ tax breaks.

“Maybe that will bring them at least to the table to talk about providing more charity care,” Sims said.

This would require at least a change in state law and would be unpopular among powerful lobbyists for hospitals that provide little charity care.

Democratic Commissioner John Daley, the influential chairman of the county board’s finance committee, has previously said the board should organize a summit and invite other hospitals to talk about the charity care issue.

The board has yet to convene that meeting.

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

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