August 16, 2013 – Cook County Health and Hospitals System Chief Executive Officer, Dr. Ram Raju submitted his proposed FY2014 preliminary budget to the CCH Board of Directors today. The $1.1 billion budget reduces the System’s reliance on taxpayers by $76 million to $175 million or a 30% reduction over last year. Officials credit this reduction to the success of CountyCare, a program developed under a Federal 1115 Waiver* to allow those who would be eligible for coverage under the Affordable Care Act in 2014 the opportunity to enroll early.

“CountyCare is the first step in the transformation of the System to ensure its long term stability,” said Dr. Raju. “The waiver was a win-win. Patients are getting more coordinated care earlier than 2014 and the taxpayers in Cook County are getting relief as we are being reimbursed sooner than expected,” said Raju. CountyCare revenues are projected to increase by more than $270 million in 2014 as a result of enrollment and increased Federal reimbursement.

System officials note that they are exceeding their early projections and since February have initiated more than 88,000 applications toward their year-end goal of 115,000. In 2014, the System expects to receive reimbursement under CountyCare for more than 56,000 enrolled members, a conservative number based on 2013 enrollment trends.

“We have to remember that we went from zero to one-hundred fifty miles an hour practically overnight. Both the System and the State of Illinois had to develop and implement new processes to enroll people into CountyCare. As the enrollment process works through growing pains and applications are processed with greater efficiency, the numbers will increase. That being said, budgets require us to estimate based on what we have experienced, not what we think will happen,” said Raju. “I want to thank the State of Illinois for partnering with us in this endeavor. No other public system has had this level of success in such a short time. We truly are a national model.”

“This year’s health system budget contains the lowest subsidy provided by County government since I took office,” Cook County Board President Toni Preckwinkle said. “The reduced subsidy reflects a $76 million savings to taxpayers and is a clear sign our public health system is becoming a more self-sustaining and efficient entity while enhancing patient care. Dr. Raju and his team should be commended for their work implementing CountyCare and ensuring that we continue to provide the care our underserved communities deserve.”

Additionally, System officials plan to continue the transformation in other areas next year. “The patient experience is our biggest priority for next year. We will be evaluating every touch-point, working with and training staff and making sure our primary focus is on our patients,” Raju continued. Additional investments in Information Technology and Human Resources will provide greater efficiency and coordination of care throughout the System.

The creation of Patient Center Medical Homes (PCHM) which is at the core of CountyCare will benefit every patient by increasing access to care through CCH facilities or the more than 130 primary care providers the System has partnered with. The System has been testing their PCMH model in 4 clinics and will roll it out System-wide in 2014.

Raju is cautiously optimistic in his predictions for the coming years. “While the Affordable Care Act expands access to a new population of people, there will still be millions who are not eligible or will fall through the cracks and will rely on public systems for their care. There will still be a need for safety-nets. Our job is to make sure we remain viable going forward. I am confident that we are well on our way,” Raju concluded.

Public hearings on the CCH budget will be scheduled for the week of August 19th. Upon approval by the CCH Board of Directors, the 2014 budget will be submitted to Cook County for final adoption.


*The 1115 Waiver was granted by the Federal government to the State of Illinois to early enroll people who would be newly eligible for coverage under the Affordable Care Act. The Waiver project, known as CountyCare, is a partnership between the State of Illinois and the County of Cook. CCH is responsible for the submission of applications to the State for final adjudication. The approval rate has averaged 87% of applications submitted.