Quarterly Report to the Cook County Board ofCommissioners

First Quarter - 2010

COOK COUNTY HEALTH ANDHOSPITALS SYSTEM

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Our Mission

“To deliver integrated health services withdignity and respect regardless of a patient’sability to pay; foster partnerships with other

health providers and communities to enhancethe health of the public; and advocate forpolicies which promote and protect the

physical, mental and social well being of thepeople of Cook County.”

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Cook CountyBoard of

Commissioners

Cook CountyBoard President

Cook County Health& Hospitals System(CCHHS) Board of

Directors

CCHHS ChiefExecutive Officer

Compliance

Intergovernmental Affairs &

Policy

GeneralCounsel

Audit

Diversityand

MulticulturalAffairs

HumanResourc

es

Department ofPublic Health

FinanceClinical

ServicesInformation Systems

Healthcare

Operations

Performance

Improvement

CommunityRelations &

Public Affairs

MedicalAffairs

Stroger

Hospital

Provident

Hospital

OakForest

Hospital

Ambulatory &Community

HealthNetwork

CORECenter

CermakHealth

Services

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Community Involvement

Town Halls: We held 14 meetingsthroughout the County, reaching over 1,500residents.

Budget Hearings: For the first time, weheld budget hearings separate from theCounty.

Partnerships: We are engaging otherproviders to pursue ways to expand accessand enhance care.

Outreach: We asked community groups,healthcare advocates and other interested

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2009 Financial Impact

• Achieved greater efficiencies in thesystem

• Enhanced revenue collections

• Enhanced federal funding

• Result: Financial Improvement

• Value: In excess of $350M5

2009 Financial Impact(continued)

• $20M annualized savings from entering intoa Group Purchasing Organization (GPO)

• $90M improvement in revenue followingimproved processes and procedures inregistration, coding, and billing

• $65-72M opportunity from performanceimprovement project, including $60M insavings from rebalancing our staff

• $200M in new federal funding from theDisproportionate Share Hospital Program(DSH)

• County tax subsidy reduced from $382M inFY2009 to $308M in FY2010. A 19%reduction.6

2009 Financial Impact(Continued)

• The CCHHS surpassed revenue projectionsand made a positive impact to the taxpayersby:

• Contributing more than $230M to theCounty’s general fund in FY2009

• Bringing in $194M more revenue than wasbudgeted in FY2009

• Spending less -- about $42M less -- inSystem operations than anticipated forFY2009

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2010 CCHHS Leadership Goals

Nine goals

Anticipated improvements in multipleareas – quality, patient satisfaction,diversity awareness, technology,operations

Dashboard updates to monitor progress8

Goal 1: Approval of Strategic Plan

Plan will include 5-year financial plan

Enhance access to our services for ourpatients

Develop a comprehensive marketing andcommunications plan to educate the public

Completion date: June 20109

Vision 2015

Proposed Vision Statement

“In support of its public health mission,CCHHS will be recognized locally, regionally,and nationally -- and by patients andemployees -- as a progressively evolvingmodel for an accessible, integrated, patient-centered, and fiscally-responsible healthcaresystem focused on assuring high-quality careand improving the health of the residents ofCook County.”

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Vision 2015

Proposed Goals

I. Access to Healthcare Services – expand access

II. Quality, Service Excellence & Cultural Competency –enhance care and service for our patients

III. Service Line Strength – Trauma/Emergency, InfectiousDisease/AIDS Center, Surgery, Women/Children’sHealth

IV. Staff Development – employee satisfaction, educationand training

V. Leadership and Stewardship – leadershipdevelopment and accountability11

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Regional Health Centers

Goal 2: Implement EnterpriseResource Planning System

Decision support system for finance,payroll, materials management and humanresources

General ledger is complete

Working with County on human resources,materials management and accounting

Completion date: November 201013

Goal 3: Complete ManagementRestructuring

Complete management assessment

Restructure system-wide management

Establish leadership developmentprogram

Completion: November 201014

Goal 4: Achieve 2010 Budget

Achieve target reductions:

o$80M from performance improvement

o$26M related to half-cent roll back andCounty hold back

Completion: November 2010

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Goal 5: Workforce Rebalancing

Phase I: Eliminated 1,000 vacant and filledpositions

Phase II: Reduce an additional 350positions

Savings of $70M

Completion: August 201016

Goal 6: Quality and Patient Safety

Implement a system-wide quality, patientsafety and risk management structure

Recruit System Director of Quality andPatient Safety and Director of RiskManagement

Maintain accreditation status at all facilities

Achieve established quality benchmarks

Completion: November 201017

Goal 7: Service Excellence

Implement a service excellence planfocusing on employee satisfaction, patientsatisfaction and cultural competency

Recruit System Director of Diversity andMulti- Cultural Affairs

Conduct baseline employee satisfactionsurvey

Completion: November 201018

Goal 8: Internal Auditing andCorporate Compliance

Develop and implement internal audit andcorporate compliance functions

Directors have presented organizationalplans to build and implement functions tothe Audit and Compliance Committee of theCCHHS Board

Completion: June 201019

Goal 9: Graduate MedicalEducation

Complete assessment of the GraduateMedical Education Program includingresidency programs and all affiliations

Conduct cost/benefit analysis

Finalize recommendation for restructuring

Completion: November 201020

2011 Financial Challenges

Full year impact of the half cent taxrollback: $76M

Potential termination of FederalStimulus Program (FMAP): $39M

5% inflation factor: $40M

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