COOK COUNTY HEALTH & HOSPITALS SYSTEM Strategic Planning Town Hall Meetings May 2016
Strategic Planning Timeline • February-June 2016 • Strategic planning presentations and discussions at CCHHS Board of Directors meetings. • May 2016 • Staff and community town hall meetings • Summer 2016 • Presentation & Approval of the Strategic Plan 2
Evolution of CCHHS: 2008 - 2016 2008: Independent Governance Insular safety net provider with little to no competition. Majority of patients uninsured. Focus on sick care. Reliant on local tax allocation and federal reimbursements. 2010: Adoption of Vision 2015 with increased focus on ambulatory services. Affordable Care Act adopted by Congress. 2011: Illinois General Assembly mandates that 50% of Illinois Medicaid beneficiaries move into managed care by 2015. To achieve this, nearly all Cook County Medicaid beneficiaries are required to enroll in a managed care health plan. 2012: 1115 Waiver to create CountyCare approved. System moves from provider role to provider and plan, expanding patient reach. 2014: ACA takes full effect. Majority of CCHHS patients insured. CCHHS and CountyCare competing for CCHHS’ traditional patients. 3
CCHHS today: key elements of an integrated delivery system • Two acute-care hospitals • Robust network of community-based health centers including three regional specialty and diagnostic centers and the CORE Center • Correctional Health Services • Cook County Department of Public Health • CountyCare Health Plan • Clinical Data Warehouse (and growing claims database) • 6700 budgeted FTEs 4
Vision 2015 Progress Core Goal : Access to Healthcare . Eliminate system barriers, strengthen ACHN, develop comprehensive outpatient centers at strategically located sites – Patient Support Center – Partnerships with FQHCs – Oak Forest Clinic as Regional Outpatient Center – CountyCare Health Plan – New ambulatory buildings on Central Campus, Provident campus and plan to renovate, relocate and/or rebuild CCHHS community health centers in next ten years – Medicaid enrollment at jail Core Goal: Quality, Service Excellence and Cultural Competencies . Execute System-wide performance improvement initiatives and implement system-wide service excellence and cultural competencies initiatives. – Creation of Chief Quality Office – Routine monitoring of metrics, annual system objectives with explicit targets Performance improvement (Emergency Department, Operating Room) – – Employee flu vaccine compliance – Development of comprehensive care coordination strategy 5
Vision 2015 Progress Core Goal: Service Line Strength. Continue to develop/strengthen key clinical services, develop the infrastructure to support clinical services. – Ophthalmology – Burn services accreditation – Capital investments: linear accelerators, cath labs, interventional radiology, mammography – Mail order pharmacy improvements Core Goal: Staff Development. Improve staff recruitment, training, and development systems and processes, implement staff satisfaction initiatives – Leadership Development Program – Decreased time to hire and vacancy rate Core Goal: Leadership and Stewardship. Develop CCHHS leadership, strengthen the stewardship responsibilities of System Board management. – Significantly lower tax allocation – Year-end financials 2014 & 2015 positive – Physician billing significantly improved 6
Cook County Health Fund Allocation Local Tax Dollars Supporting CCHHS $600 Insert FY16 $481M $500 $389M $400 $300 $276M $254M $252M $200 $175M $164M $121M $100 $0 2009 2010 2011 2012 2013 2014 2015 2016 (proposed) 22 7
Illinois Health CCHHS Health Insurance Insurance Coverage: 2014 Coverage: 2014 3.7% 1% 9% 12.1% 14% 36.5% 52% 19% 47.7% 6% Uninsured Medicaid Uninsured/Self Pay Medicaid Medicare Employer-Sponsored Medicare Commercial Military/VA Non-Group Source: Kaiser Family Foundation http://kff.org/other/state-indicator/total-population/?state=IL 8
CCHHS Payor Mix % Insurance Status of CCHHS CCHHS PAYOR MIX Patients 2013-2015 100 2013 2014 2015 90 54.4 80 45.6 47.7 50 70 63.5 67.7 60 36.5 32.3 32.2 50 40 30 54.4 20 36.5 13.5 32.3 12.1 10.9 10 0 4.2 3.7 2.5 2013 2014 2015 Uninsured/ self pay Insured SELF-PAY MEDICAID MEDICARE COMMERCIAL 9
CCHHS Uncompensated Care 2010 $ 487,856,436 2011 $ 577,316,767 2012 $ 538,505,860 2013 $ 535,781,085 2014 $ 313,582,232 2015* $ 413,191,000 * estimated 10
Recently Announced Strategic Initiatives 11
Behavioral Health Strategy The downstream impact of decreased local, state and federal funding has disproportionately impacted CCHHS through our emergency rooms and the jail. To address this, CCHHS recently announced: • Community Triage Center • Integration of Behavioral Health Services into Primary Care Medical Homes • Behavioral Health Consortium • Expanded Substance Abuse Treatment 12
Outpatient Strategy - New Women and Children’s Center in Stroger - Centralized Registration Area - Improved Patient Parking - New Regional Outpatient Centers in Provident community and South Suburbs - Plan to renovate, rebuild or relocate community health centers over next ten years. New Cicero and Logan Square health centers are a priority. 13
Outpatient Strategy Coming 2018: $118.5M Outpatient and Administration Building on Central Campus 14
Our Goal Build a high quality, safe, reliable, patient-centered, integrated health system that maximizes resources to ensure the greatest benefit for the patients and communities we serve. 15
Impr ove He alth E quity He a lth e q uity is a c hie ve d whe n e ve ry pe rso n ha s the o ppo rtunity to a tta in his o r he r full he a lth po te ntia l a nd no o ne is disa dva nta g e d fro m a c hie ving this po te ntia l b e c a use o f so c ia l po sitio n o r o the r so c ia lly de te rmine d c irc umsta nc e s. 16
Impr ove He alth E quity E xample s: CountyCare Medicaid Health Plan Primary Care Medical Home Model Linkage to Community Services Medicaid Applications at the Jail Leverage Public Health Information to develop clinical and community initiatives 17
Pr ovide high quality, safe and r e liable c ar e T he q ua lity o f pa tie nt c a re is de te rmine d b y the q ua lity o f infra struc ture , tra ining , c o mpe te nc e o f pe rso nne l a nd e ffic ie nc y o f o pe ra tio na l syste ms. T he funda me nta l re q uire me nt is the a do ptio n o f a syste m tha t is ‘ pa tie nt c e nte re d’ a nd the imple me nta tio n o f hig hly re lia b le pro c e sse s. 18
Dime nsions of quality: “ST E E E P”* Car e that is… .. S a fe T ime ly E ffe c tive E ffic ie nt E q uita b le P a tie nt-c e nte re d *Institute of Medicine, 2001 19
Pr ovide high quality, safe and r e liable c ar e E xample s: Pa tie nt Ce nte re d Me dic a l Ho me Mo de l I mple me nta tio n o f Syste m-wide Po lic ie s a nd Pro to c o ls Culture o f Sa fe ty Jo int Co mmissio n Ac c re dita tio n Pa tie nt Suppo rt Ce nte r 20
De monstr ate value , adopt pe r for manc e be nc hmar king Be nc hma rking c re a te s a stro ng fo unda tio n to me a sure tra nsfo rma tive c ha ng e . I t a llo ws us to ha ve a da ta -drive n unde rsta nding o f whe re we a re a nd ho w we a re suc c e e ding a t re a c hing o ur g o a ls. 21
De monstr ate value , adopt pe r for manc e be nc hmar king E xample s: Busine ss I nte llig e nc e Unit Vizie nt a nd o the r industry c linic a l a nd o pe ra tio na l da ta b a se s Co mp Da ta Cla irvia 22
De ve lop human c apital Our 6,270 e mplo ye e s a re o ur b ig g e st a sse t. Building e mplo ye e s’ skills thro ug h e duc a tio n a nd le a rning o ppo rtunitie s sho uld no t o nly impro ve e ffic ie nc y a nd q ua lity o f c a re , b ut sta ff a nd pa tie nt sa tisfa c tio n. 23
De ve lop human c apital E xample s: L e a de rship De ve lo pme nt Ma na g e me nt c urric ulum Custo me r Se rvic e T ra ining 24
L e ad in c linic al e duc ation and c linic al inve stigation r e le vant to vulne r able populations Co o k Co unty ha s a ric h histo ry o f me dic a l tra ining a nd to p no tc h c linic a l re se a rc h, pa rtic ula rly fo r vulne ra b le po pula tio ns. Ma inta ining tha t histo ry is a n impo rta nt pie c e o f o ur c ulture a nd he lps us e sta b lish o ur dire c tio n fo r the future . 25
L e ad in c linic al e duc ation and c linic al inve stigation r e le vant to vulne r able populations E xample s: F unde d re se a rc h in o nc o lo g y, infe c tio us dise a se s, ma ny o the rs Physic ia n tra ining in >25 spe c ific a re a s Multiple nursing sc ho o l a ffilia tio ns 26
Discussion Please approach the microphone, introduce yourself and ask your question or make your comment. Please be respectful of others who wish to speak by limiting your remarks to 3 minutes. 27
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