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Cook County Health finance chief departs
The system has hired a consultancy to review its fiscal 2020 budget and develop financial strategies, according to an internal memo obtained by Crain’s.

Monday, February 24, 2020
Crain's Chicago Business
by A.D. Quig Stephanie Goldberg

Cook County Health interim CEO Debra Carey is making changes amid financial pressures and a proposal that would shift health system control from its independent board back to the Cook County Board of Commissioners.

Chief Financial Officer Ekerete Akpan has left after about five years in the role, and the health system has hired consultancy AArete to review its fiscal 2020 budget and develop financial strategies, according to an internal memo obtained by Crain’s.

 

In the memo, Carey said Akpan’s responsibilities have been delegated to other Cook County Health leaders and that the health system is considering retaining a full-time interim chief financial officer.

Nick Shields, a spokesman for Cook County Board President Toni Preckwinkle, said of Akpan's departure, "This is a Cook County Health personnel matter and we’ll have nothing further to add."

Carey said developing the fiscal 2020 budget was “the most challenging in recent years for CCH,” noting that the “unanticipated and continued growth in uncompensated care over the last few years has created a financial challenge for CCH as a provider of health care that is unsustainable.”

With a $2.8 billion budget, Cook County Health, one of the largest public health systems in the nation, operates Stroger and Provident hospitals as well as clinics across the county. It also runs its own Medicaid managed care plan, CountyCare, which leaders say has contributed more than $1 billion to the health system over the past five years.

Akpan’s exit comes after CEO Dr. John Jay Shannon’s departure and Preckwinkle’s proposal to claw back some of the county’s oversight of the health system, which has been governed by an independent board since 2008.

Preckwinkle said the changes would “continue to provide for independent governance,” but would give the county “enhanced collaboration on various operational initiatives that impact county policy and appropriations,” like performance benchmarking, uncompensated care policy, and the health system’s legislative agenda.

The Cook County Board is scheduled to vote Wednesday on the major reorganization that would give Preckwinkle's administration more say in the choice of the next CEO and health system finances.

One of the health system’s most vocal critics, Commissioner Sean Morrison, said Akpan had been more forthright recently about the system’s budget challenges. He also said the timing of Akpan’s exit was “not a prudent move” without a deputy CFO ready to take on the role.

“You have complete chaos over there in management,” Morrison said.

Meanwhile, Chicago-based AArete was hired to assess the revenue cycle processes and uncompensated care; the system expects to spend roughly $590 million in fiscal 2020 on such care, which comprises charity care and bed debt.

 

 



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