Today, Cook County Health CEO Israel Rocha Jr. submitted to the CCH Board of Directors the health system’s preliminary Fiscal Year 2022 (FY2022) budget.

The $3.8B proposed budget contemplates returning to pre-pandemic volumes, enhancing specialty care and further expanding health services at Provident Hospital. The budget includes a tax allocation from Cook County of $137.7M, up from $122.7M this year, to carry out mandated correctional health and public health services, and cover a portion of the system’s charity care expenses. CCH generates 96% of its operating revenues from patient fees, capitation payments, grants and other revenues.

“Cook County Health’s role as an essential provider of care, public health steward and social safety net has never before been so important as during the course of the pandemic. With this budget, we are ensuring our ability to continue to serve the residents of Cook County now and long into the future,” said Rocha. “We are charting a path for a sustainable future; a path of modernization and responsible growth for Cook County Health and expanded access for the communities we so proudly serve.”

Some of the key components of the budget include:

  • Growing patient volumes, returning closer to pre-pandemic levels;
  • Investing in critical service lines, including cardiology, neurology and oncology;
  • Enhancing health care services on the South Side by expanding hemodialysis, ophthalmology and surgical services, reestablishing ICU operations, expanding med/surg capacity and restoring ambulance runs at Provident Hospital;
  • Providing $384M in charity care services to uninsured or underinsured patients;
  • Caring for an increased number of detainees at Cook County Jail (currently more than 6,000, up from 4,000 in April 2020), providing COVID-19 testing and vaccinations, and accommodating COVID-19 distancing requirements that remain in place;
  • Increasing FTEs by net 780 new positions, most in nursing and key clinical and operational areas;
  • Establishing an Equity and Inclusion Office and Strategic Planning and Implementation Office;
  • Projecting monthly average CountyCare membership of 390,000 and growth in MoreCare (Medicare Advantage product) membership;
  • Creating a $10M investment fund contingent on excess revenue generation;
  • Identifying $12M in contract savings;
  • Establishing a total Incurred But Not Received (IBNR) reserve of $50M, a best practice to ensure timely payment of providers by CountyCare.

CCH expects to spend $384M on charity care next year, increasing from $360 in 2021 as patient volumes continue to rebound. The current emergency Medicaid expansion and suspension of redetermination continue to allow for essential health coverage for many CCH patients. Additionally, some CCH patients are expected to gain health coverage in 2022 thanks to the State of Illinois’ expanded Medicaid program for 55–64-year-old residents who meet income requirements (138% FPL) regardless of immigration status.

Membership in CountyCare, CCH’s Medicaid managed care health plan, is expected to average 390,000 in FY2022, generating more than $2.6 billion in revenue. CountyCare revenue covers the cost of claims for care rendered to its members by both CCH and non-CCH providers. CountyCare is the largest Medicaid managed care plan in Cook County.

The budget presentation can be found here. Public hearings are scheduled for Monday, August 23 at 9:00 a.m. and Tuesday, August 24 at 6:00 p.m. For instructions on submitting testimony at one of the public hearings, please visit

Following approval of the budget, expected on August 27, the proposed FY2022 budget will be submitted to the Cook County Board of Commissioners for inclusion into the President’s FY2022 budget recommendation. The FY2022 fiscal year begins on December 1, 2021.


CCH FY2022 Proposed Preliminary Budget

Alexandra Normington, Associate Chief Communications & Marketing Officer