Dear Colleagues,
The 180 year mission of Cook County Health is to provide care to all Cook County residents regardless of
their ability to pay. For decades we have been able to remain true to that mission thanks, in large part,
to local, state and federal funding streams but I am writing to you today to tell you that our historical
mission is threatened by a significant and unsustainable increase in charity care. Like most hospitals
following the implementation of the Affordable Care Act, we saw our uninsured rate dip to its lowest in
recent history, however, in the last couple years, we have experienced a steady increase that private,
non-profit hospitals have not experienced. This year, 45% of the people we are caring for do not have a
payor. In FY2017, Cook County Health provided $273M in charity care or 50% of all the charity care in
Cook County. This year, we are on track this year to exceed $377M - a $104 million increase in 2 short
years. We expect our charity care costs to exceed $400 million in FY 2020, and this is unsustainable.
The Cook County Health board of directors recently adopted its latest strategic plan which affirms our
historical mission but asks critical questions about the ability of the organization to meet the
dramatically increased demand and costs of charity care. For the past several years, we have been
successfully implementing strategies to attract more insured patients to help offset charity care but we
find ourselves at a serious point as the sheer volume of uninsured patients is requiring us to consider
difficult choices: seeking more federal, state or county funding and as a last resort, reducing services or
consolidating facilities.
Attached please find a white paper that outlines our accomplishments these past several years and
details the challenges we face in light of the increased demand for charity care. In the coming weeks and
months, we will be exploring potential solutions to this challenge and would welcome your input, ideas
and partnership as the hospital community in Cook County is stronger if its primary safety net
is stronger.
Sincerely,
Jay Shannon, MD
CEO, Cook County Health

Hill Hammock
Chair of the Board, Cook County Health