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Hospital revenue trailing budget

Wednesday, May 03, 2006
Daily Southtown
by Jonathan Lipman

Cook County's hospitals have collected about $23 million less than expected so far this year despite long-promised overhauls of the hospital billing systems.
The county health bureau has collected about $81 million of the $104 million projected by budget planners, according to a summary of the county's first fiscal quarter, which ended March 31.

"We're going to continue to monitor that," Comptroller Walter Knorr said. "Certainly, we're concerned anytime you have a shortfall ... but it's just a matter of keeping after the hospital and making sure they collect."

With other county fees also coming in below projections and sales and cigarette taxes doing better than expected, the county is about $16 million, or about 3 percent, behind on overall revenues for the first quarter.

Knorr said it was too early to worry about an impact on the county's overall $3 billion budget, but commissioners were less confident.

"I'd like to know what the plan is to get the numbers up," said Commissioner Bobbie Steele (D-Chicago). "By the end of the year, we'll have lost $100 million. We have to figure out why."

Commissioner Mike Quigley (D-Chicago) said he's beginning to worry the county will go broke before the end of the year.

"Their patient volume is up and their revenues are down, and that makes no sense," Quigley said. "They better detail a plan."

Stroger, Provident and Oak Forest hospitals care for some of the sickest and poorest of the region's patients and turn no one away regardless of ability to pay. Still, many of the patients are covered by Medicaid and other programs and can pay something for their care.

County health officials were not available for comment Tuesday afternoon.

Health bureau chief Daniel Winship has repeatedly promised an overhaul in the billing system, including retraining employees and the use of new software to create "superbills" that better track all of a patient's services.

"They tried to implement this superbill and they give you this hyped report, and then it kind of dies out," Steele said. "I haven't seen too much of a difference."

Against the advice of budget staff, commissioners voted to increase projections for cigarette taxes and some fees when passing the 2006 budget. Cigarette taxes are so far $7.6 million ahead of projections, but Knorr warned much of the boost came from a one-time floor audit that will not carry through the rest of the year.

The county also is spending below budget, Knorr said, so cash flow will not be an issue.

Quigley said he was less sure.

"Don't let the percentages fool you, $16 million would be a significant tax hike," Quigley said. "It was extraordinarily irresponsible to budget like this."

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