A look at Cook County Health's outpatient future

As Chicago's Cook County Health and Hospitals System works to shed its image as a provider of last resort, it's formally applied with state regulators to build an outpatient center with a sleek design that could cater to a wider array of patients.

The two-hospital Cook County Health, one of the largest public hospital networks in the nation, plans to replace Fantus Clinic. With narrow corridors and outdated infrastructure, the nearly 60-year-old outpatient facility is from a different era of medicine.

The proposed nine-story Central Campus Health Center would consolidate services and administrative offices now spread among Fantus and two other buildings on the Near West Side campus. Among the highlights of the $137.7 million proposal: expanding dental services, which are often hard for poor and uninsured patients to find, and offering a more modern space for cancer treatment.

"Everyone has a choice today," Doug Elwell, deputy CEO of finance and strategy at Cook County Health, said of patients. "We want to make sure we have the facilities that match our expertise."

Cook County Health revealed more details about its outpatient overhaul in a recent application to the Illinois Health Facilities and Services Review Board. The state regulatory board decides the fate of health care projects to prevent duplicate services. Cook County hospital officials hope the board votes on the project in September.

Replacing Fantus is part of a broader strategic shift at Cook County Health, which is working to expand its outpatient footprint. In the wake of Obamacare, insurers are paying hospitals to focus on preventive care and treat patients in the least expensive place. That's often in a doctor's office or at an outpatient clinic.

Part of the vision includes bringing medical services closer to where people live, and potentially beefing up nursing home care for Medicare patients. That would help prevent elderly patients from ending up back in the hospital too quickly after being discharged, which can be costly for hospitals if they are fined by the federal government.

Cook County Health is known as the safety net for the region, with more than 900,000 total outpatient visits across the system in 2015. More than half were at Fantus and on two floors of John H. Stroger Jr. Hospital, the nearby flagship hospital in the network. The system also includes Provident Hospital on the South Side and several clinics.

The proposed 278,000-square-foot Central Campus Health Center would remain on the Near West Side campus and would be connected to Stroger. Fantus would be demolished. Patients would see a variety of specialists, including primary care, ophthalmologists and endocrinologists who specialize in diabetes.

Patient volume for services that would be offered at the new health center is expected to grow nearly 3% a year, especially as Cook County Health contracts with more Medicaid insurers.

The $137.7 million project is more expensive than what hospital and Cook County leaders initially proposed. That's because it includes extensive renovations to Stroger to house both inpatient and outpatient women's health services on one floor, Elwell said. The health system plans to pay for the proposal partly by taking on $108.4 million in debt through a bond issue, and the rest in cash and other funds.

If the makeover isn't approved, Cook County Health officials estimate they would have to spend nearly $128 million to repair and maintain Fantus and the two other buildings that would be consolidated into the proposed health center.

"This is what Cook County Health's outpatient future looks like" originally appeared on the website of Crain's Chicago Business.