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County finances to suffer one-two punch as coronavirus patients ‘swamp the health care system’

“This is a two-fold impact on our health care system,” Preckwinkle said. “One is the effect that we can’t do elective surgeries, and the other is that we’re going to have considerably more patients in our hospitals who are uninsured and require intensive services.”

Cook County Board President Toni Preckwinkle in 2020.
Cook County Board President Toni Preckwinkle speaks at a news conference about the COVID-19 pandemic on Friday.
Brian Rich/Sun-Times file

Cook County Board President Toni Preckwinkle said Tuesday that girding for an influx of coronavirus patients will have a “profound impact” on the finances of the health system.

But even as she sounded the alarm, Preckwinkle declined to predict just how bad the financial picture could become for the already challenged County Health System.

“Our focus is not on the finances,” Preckwinkle said. “Our focus has been on trying to figure out how we’re going to deliver care to all the people who are going to swamp the healthcare system.”

The County Health system’s decision to follow guidelines from the Centers for Disease Control to avoid elective surgeries — which bring in the most money — is a chief blow to the system’s coffers, Preckwinkle said at a news conference in which she thanked health care workers for their efforts combating COVID-19.

“I can’t tell you how much of a financial impact that it will have because we don’t know how long the pandemic will prohibit us from doing elective surgeries,” Preckwinkle said. “This is a two-fold impact on our healthcare system. One is the effect that we can’t do elective surgeries, and the other is that we’re going to have considerably more patients in our hospitals who are uninsured and require intensive services.”

“Social distancing in effect” signs posted at the Cook County Board of Commissioners meeting room on March 16.
“Social distancing in effect” signs posted at the Cook County Board of Commissioners meeting room on March 16.
Ashlee Rezin Garcia/Sun-Times file

Cook County Jail will “continue to be our biggest public health problem within the county,” Preckwinkle said.

A former “boot camp” for younger non-violent inmates at the jail was reopened Monday as a hospital for those who tested positive for coronavirus, Debra Carey, the interim CEO of Cook County Health, said.

Carey said the system is tracking the decline in revenues as well as expenses related to coronavirus treatment.

“We are definitely going to need to apply for any federal reimbursement or other reimbursement that will become available,” Carey said. “Again, we know that there’s no guarantee but we definitely believe the expenses that we’re incurring, as well as the loss of revenue, should qualify under some of the rules that we’ve seen thus far under the [Coronavirus Aid, Relief, and Economic Security] Act.”

The potential increase in uninsured patients needing intensive care during the pandemic could exacerbate one of the health system’s growing problems: charity care.

Those charity services are health care the county provides but for which it’s not paid.

For the 2020 fiscal year, there was already a $600 million charity care cloud looming over the finances of the health system — and the county at large.

The amount of care the county provides but isn’t paid for grew by $104 million between 2017 and 2019, and Preckwinkle previously said it would be a “principal challenge” for the 2021 fiscal year — long before the coronavirus crisis.

Without a “magic wand” to fix it, addressing that uncompensated care “is complicated and difficult and it’s truly something we’re going to work on,” Preckwinkle previously said.

On Tuesday, Preckwinkle didn’t say much more about the finances of the system as it faces the challenge of treating patients with coronavirus.