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Becker’s Healthcare Podcast
Advancing Health Equity and Community-Based Care at UI Health with Rani Morrison Williams
00:20:19
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
- [00:38]
B
This is Laura Deardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Ronnie Morrison Williams, Chief Diversity and Community Health Equity Officer of the University of Illinois Hospital and Health Sciences System. Ronnie, it's a pleasure to have you on the podcast today.
- [00:52]
C
Thank you. I'm happy to be here.
- [00:54]
B
Absolutely. Now I'm excited for our conversation because I know there's so much happening in healthcare right now in a particularly unique time and space within the be thinking through the things that you're thinking through on a daily basis, looking at community health, looking at diversity and everything else. And so I'm excited to dig in a little bit deeper. But before we do, can you tell me a little bit more about yourself and University of Illinois?
- [01:17]
C
Yeah, absolutely. So I am the Chief Diversity and Community Health Equity Officer here at UI Health. We are an academic medical center located on the west side of Chicago in the Illinois Medical District. We are the state's only tertiary and acute care hospital because we are part of University of Illinois and University of Illinois at Chicago. So we have a unique situation with our positioning in the state. We're also the only academic medical center in the state that owns a federally qualified health center, Miles Square Health center, which has locations throughout Chicago and in Rockford. We are a 400 plus bed academic medical center with a variety of outpatient services, specialty care building, family medicine and urgent care. Just a very robust academic medical center and we hover around 50% Medicaid in terms of our payer mix. So we are very focused on health equity and making sure that we have excellent care for all of our patients regardless of payer, zip code or any other characteristics. So I'm super excited to be a part of the family here at UI Health. I've been here in various capacities for almost 12 years. I'm a licensed clinical social worker. I started off here leading our care coordination efforts and over the last few years in different roles. I've now been in this role for four and a half years where I lead Our health equity efforts, our diversity and inclusion team, our community relations team, care coordination, case management, and inpatient and outpatient social work.
- [03:00]
B
Wow, that's an amazing responsibility. But I know such a needed leadership position within the organization. Now, when you think back the last year or so, could you talk to us a little bit more about an important initiative that you led? What did you do and what were the results?
- [03:15]
C
I think the most impactful initiative we've launched in the last year that I'm super proud of has been our implementation of on site Domestic violence response. We partnered with a nonprofit agency, Wings, which is located primarily in the northwest suburbs, but serves all over the city of Chicago and the suburbs. They received a grant from the city of Chicago to support 247 domestic violence response in hospitals. And we're the first hospital that they partnered with. So for about a year we've had them available to respond to domestic violence related needs of our patients. So if we have a patient in the emergency department who might be experiencing domestic violence, if they're on inpatient, if they're in the outpatient clinics, wings is available and will come to the bedside, come to the office to meet with them and help them in whatever way is needed. It can be anything from helping them get shelter and housing to providing them transportation, giving them alternate forms of communication, or sometimes just providing them support and education because maybe they're not ready for anything beyond that. They also are providing training and education for our staff, faculty and training. They've trained several hundred of our employees virtually and in person. And so being able to have that kind of information and expertise on hand has really enhanced our offering as it pertains to supporting our patients who are experiencing domestic violence. It's also allowed us an opportunity to learn more as individuals and providers and support each other, whether it's our colleagues or students. Domestic violence does not have a particular face or location. And so this partnership has allowed us to really deepen our offering and our understanding and be able to support not just our patients, but the broader campus community in a very meaningful way. We have just recently gotten referral numbers for the last quarter and it was great that we got referrals. The first three quarters of last year, pretty steady. The last quarter of 2025, the referrals doubled compared to the previous nine months. So it's sobering that we have that many over 150 referrals that have been received just at our hospital and clinics. But also it's reassuring to know that these services and this partnership came clearly were Needed.
- [05:51]
B
Absolutely. That's a huge, and I know a huge undertaking to put something like that together. It really must be, you know, a labor of love on your part and the part of the team, because, you know, I can imagine it takes a lot to put something like this together. And then, you know, to care for patients and people in this position is no easy task. And so I really appreciate you talking us through that. And, you know, throughout the process, was there anything that surprised you or that you had to kind of pivot from or change lessons that you learned? I guess that might help other organizations as they may see a similar need within their communities.
- [06:31]
C
I think the biggest thing that we learned was just the. What? We clearly have an underreporting issue, which we knew, but we didn't realize just how much. When you look at. We do screen for social determinants of health at admission, and our screening rates in terms of people who endorsed experiencing domestic violence or intimate partner violence was fairly low. But to see the numbers that we've seen in terms of referrals, and these are people that are presenting on our campus in some way and saying, hey, I'm experienced in domestic violence and I want some help. To see those numbers escalate as they have, just shows us that we were definitely not getting the full picture just from the screening. And it really enforced the fact that we need to make sure that we're trained and feeling really competent to be able to assess and support outside of the basic screening, because people are not necessarily going to tell you yes in triage when they're checking into their appointment, that they're experiencing that. I know all of us, many of us get that screening at most places, you know, they ask you, do you feel safe at home, et cetera. They ask our kids that. But I think that this process and program has shown us that maybe those screenings are not telling the whole story. And as providers, we need to be more comprehensive and available to make sure that when a patient may feel comfortable disclosing, it might not be at the screening. It may be later in the interaction. It may be weeks into the interaction. And that we need to make sure that we have resources and the training to provide that support whenever the need shows up.
- [08:03]
B
I love that. Thank you so much for digging a bit deeper there. Now, when we look ahead into 2026, what are some of the big priorities and headwinds that you're focused on?
- [08:12]
C
Oh, 2026, I think the biggest for us, I refer to our payer mix being heavily Medicaid. And so for us, I think the headwind and the priority working through the upcoming Medicaid changes, knowing that the community engagement aspect was added to Medicaid and is basically effective January 1, 2027, we're going to spend a good portion of 2026 preparing for what that looks like. We need to be prepared for less people to be on Medicaid come 2027, either because they can't meet the requirements or maybe they don't know about them. We know that a lot of times patients can be transient, they move a lot. Are they being notified? Are they educated? Do they know how to submit the forms and the process that will be established by the respective states. That's something that is an unknown quantity right now. And so I think for us, we're spending a good chunk of 2026 preparing for those changes. When it comes to education and communication around the changes, as well as we need to be prepared financially for what may come. If we have a significant drop of our Medicaid patients who might then become uninsured, that makes a lot of sense.
- [09:34]
B
And you know, I know that that's a particular worry for a lot of hospitals and systems, but particularly for those situated like yourself, with just such a high percentage of the payer makes, you know, currently being in the Medicaid process. And so when you look at, you know, making those preparations financially, you know, assuming that everything goes effective January 1, 2027, some of the cuts and reductions happen that are currently expected to happen. You know, what, what ways are you looking at that from the executive level to make sure I think first and foremost that people have access to care, and then secondly, preparing the organization for, you know, the financial challenges that may come from it.
- [10:19]
C
I will say in Illinois, we've had a little bit of a dry run, we might say, because we were one of the, a handful of states that implemented Medicaid for undocumented persons a few years back. And due to state funding issues, that program was ended in 2025 because we were. The state was no longer able to afford it. So for a good chunk of our patients that were undocumented immigrants that were in kind of the middle age stage, if you will, the program was specific. It topped out, it was like mid-40s to early 60s, but was still a huge significant portion of the population when that program ended, we, along with all the other hospitals in the state of Illinois, had to make adjustments in terms of both financially and again, education, making sure that people understood what was going to happen with their Medicaid, making sure they understood what other programs might be available to them. Medicaid, making sure they're linked with fqhc, that type of thing. And so I look at that as being a little bit of our dry run, our practice. This is going to be on a larger scale, of course, but we've experienced it and so we kind of know how to navigate it. It's just going to be understanding what the full impact is. And right now it's a little murky in terms of we don't the state and we don't have a full understanding of how many of our patients are potential in particular going to be impacted when all the other aspects are taken into account. You have disabilities, you have people who, kids under age 14. There's all these caveats to it. I think for us it's going to be we've got to have a little bit of practice and how to do the education and how to make sure people understand and can get them into whether it's back on Medicaid or into another program. But I think we are a little bit of a disadvantage until we get a little bit clearer on what our impacted patients will look like for our organization in particular. But we're planning as best as we can. We're really focusing on education and communication. We're really focusing on looking at our finances and being as cost efficient as possible while still delivering excellent healthcare.
- [12:37]
B
That makes a lot of sense. Thank you so much for that kind of broader explanation. I think it's so helpful just to connect and hear how you're thinking about it now. What do you think the hardest thing you'll have to do in the coming.
- [12:48]
C
Year will be kind of a continuation of that. Right. So if you heard my introduction, a lot of the areas I am responsible for are not revenue generating. They are really about addressing social determinants of health, health equity, the things that, you know, cause our patients to come into our doors but aren't necessarily billable. Right. When you address them. And so I think from my perspective, it's going to be hard to continue to make a case for addressing those needs when we are in a resource restrained environment. When social determinants of health and the vulnerabilities our patients are experiencing have kind of been deprioritized at a national level, it's hard to continue to make that case. I'm fortunate that I work at an organization that again is very much aware of health equity and the importance of addressing health disparities and addressing sdoh. So I, you know, my team are in A better position than most, but it still becomes an equation. Right. And so that's going to be the hardest thing to do, is make sure that we can continue to show ROI around addressing social determinants of health. Whether it's reducing length of stay because we're addressing something, whether it's improving someone's quality of life, how do we quantify that? Whether it's, you know, how do we leverage this program to reduce no show rates? So continuing to deliver an ROI around whatever we can when it comes to addressing these areas in a resource restrained environment so that we aren't at risk of having to lose anything that's so important to our patients and getting them here and getting them and keeping them in care.
- [14:37]
B
That's such an excellent point. And you know, being able to find that value. I know the soft and hard ROI can be a challenge, but you know, outlined so clearly how you've been able to do that and started to think through some of those outcomes in knowing that not only this is this right thing to do for the patients, the community, but then it actually has an impact on the organization and a financial one as well. When you're talking through that with your colleagues at the C suite level, is there anything that, you know, you want to make sure that you message so that they truly understand the impact of the work that you're doing.
- [15:12]
C
But we've been really trying to quantify that. Right. So I just shared with you some of our numbers around the domestic violence program. I'm sharing those numbers. I actually was in a meeting today with my colleagues and some local politicians sharing the information, sharing that our outpatient transportation program, for those that were enrolled in it, it reduced their no show rate by 30%. That's significant. Right. So that's impact. And we are currently evaluating actually what the outpatient transportation's impact is in terms of visits and the reduction on no show and what visits and the relative cost of the visits that they did make it to. How does that align with what we actually spent on that individual's transportation? So we're doing those calculations and trying to make sure that we can show and demonstrate value where we can. Sometimes it'll be kind of easy, like with outpatient transportation. Sometimes it's going to be a little bit more challenging, like with our dv. Can I draw a straight line from DV intervention to save dollars or, you know, or something along those lines? Not necessarily. Can I tell a story about improved quality of life and safety? I can. So it's really picking, you know, from the different areas, what we can, what we can prove with data and what we can show with stories. And that's what we have to be creative around and make sure that we're sharing it at every turn. And again, I shared some of this information just today in our meeting and, and my colleagues were a great reminder to them of all the things that we do that aren't necessarily out in front. Right. It's not gonna result in a new building with a beautiful atrium like we have, but it is gonna result in patients who are connected to our organization and can come here for care and feel safe and feel taken care of and ideally have a better outcome than if we hadn't offered that particular service.
- [17:05]
B
That's amazing to hear. Thank you for going through some of those details with us, Ronnie. Now, I'm curious, before we wr, I wanted to ask, where do you see some of the best opportunities for organizational growth?
- [17:17]
C
I think for us the biggest opportunities are really how creative are we going to be? Changing environment again, resource restraints. I think that we continue to grow our ambulatory footprint. We have a lot of ambulatory services and specialties and subspecialties here on our immediate campus in the Illinois Medical District. We're continuing to look at how we can grow that around the city of Chicago and even outside of the city of Chicago so that we can connect more people with care. We need to continue to be creative around things such as telehealth and behavioral health and how we're delivering that and the patient populations. We have some great ideas in that regard about some new programs in the behavioral health space. So really excited about those types of things, expanding the advanced practice workforce. Really looking at, you know, what are we doing with our APRNs, what are we doing with our physicians assistance, how are we leveraging them within our organization, within the ambulatory space to grow, especially in areas where there oftentimes might be a significant strain when it comes to access. So how can we be creative around that using our apps? Then I'll say finally, and I am not an early adopter, but I'm having to admit AI is here. It is something that we definitely have to continue to adopt and be thoughtful around. I think tech adoption and AI efficiencies are really how we can position ourselves well for growth. Looking at how we can save time, how we can communicate better, how we can make more intelligent decisions using technology and AI are going to to be really key again in a resource restrained environment. And so I'm excited about those possibilities. Still cautious but excited about the possibilities for growth that come out of those areas.
- [19:14]
B
I love that. Ronnie, thank you so much for joining us on the podcast today. This has been such a fun conversation and, you know, I really appreciate your time and effort. It's cool to hear about all the things that you're doing. And, you know, I am looking forward to seeing you as well at our annual meeting. I know you'll be speaking on one of our panels, and so it'll be just a ton of fun to see you in person and catch up.
- [19:34]
C
Yeah, absolutely. I will be there. I enjoy Beckwith annual meeting every year. I've been there and been a speaker multiple times. Welcome to Chicago, everybody. Hopefully the snow will be gone by April.
- [19:47]
B
Fingers crossed. Absolutely.
- [19:51]
C
Looking forward to. Thank you for the opportunity to share kind of what we have going on. I always love the opportunity to share. We do so much and I'm really connected to UI Health and I'm very proud of the work that we do. Despite, you know, again, the headwinds and all the things coming at us. We are very committed to serving our patients and lifting health equity in Chicago and throughout the state of Illinois.