CountyCare CEO resigns

The chief executive of Cook County Health’s Medicaid managed care plan is stepping down next month.

James Kiamos is leaving CountyCare after more than two years at the helm, CCH confirmed. 

“Jim has been instrumental in the growth and success of CountyCare since joining us in 2018,” Cook County Health CEO Debra Carey wrote in a letter to county commissioners yesterday. “Please join me in thanking Jim for his commitment to our health plan members and to the mission of Cook County Health. We wish him the best in his future endeavors.”

Carey is working on a transition plan and will announce interim leadership “as soon as possible.” Kiamos’ last day is Aug. 21. He did not respond to a request for comment. A CCH spokeswoman says he left voluntarily. His exit follows that of CCH CEO John Jay Shannon in November, and CFO Ekerete Akpan in February. Health officials told commissioners they expect to announce potential new CEOs within the coming weeks, according to the Sun-Times. 

CountyCare serves roughly 330,000 members, or 15 percent of Medicaid beneficiaries in the state. It’s one of five private health insurers (not including NextLevel Health, which is closing) administering Medicaid benefits in Illinois and the only plan that operates solely in Cook County.

Prior to joining CountyCare, Kiamos led Family Health Network. The now-defunct insurance company exited the market in 2017 when the state’s managed care program was relaunched with seven (now five) insurers, down from 12. Family Health Network's 220,000 members moved into other plans, including CountyCare.

Under Illinois' Medicaid managed care program, the state pays CountyCare and other insurers a set amount per patient, rather than paying for each medical service provided. The goal is to improve people's health and control costs by ensuring all care is appropriate and high-quality.

But the program is not without criticism. Health care providers—especially safety-net hospitals that treat large numbers of low-income patients—say claim denials and late payments from insurers threaten their operations.

A pattern of late payments from CountyCare caught the attention of the federal Centers for Medicare & Medicaid Services—which funds a portion of the joint federal and state health insurance program—earlier this year. The plan has since submitted a corrective action plan to the agency and, as of June 7, it had about $175 million in unpaid claims—down from about $350 million on Feb. 9.