Podcast Summary: Dr. Tom Shanley on Expanding Pediatric Access and Advancing Lurie Children’s Mission

Becker’s Healthcare Podcast • Aired February 9, 2026
Host: Jacob Emerson
Guest: Dr. Tom Shanley, President & CEO, Lurie Children’s Hospital

Episode Overview

This episode features Dr. Tom Shanley, President and CEO of Ann & Robert H. Lurie Children's Hospital of Chicago. Dr. Shanley discusses the hospital’s evolution from a flagship urban facility to a broad pediatric health system, strategies for expanding pediatric access in underserved regions, confronting changes in Medicaid funding, workforce development and training, and the essential role of advocacy and research in advancing children’s health. The conversation provides a candid look at the current challenges in pediatric care and Lurie Children’s proactive response to national and local trends.

Key Discussion Points & Insights

Dr. Shanley’s Background and Lurie Children’s Mission

• [01:00] Dr. Shanley describes his background as a pediatric ICU physician and researcher in immunology, highlighting a long-standing commitment to combining discovery and bedside care.

• Lurie Children’s is the only freestanding comprehensive acute care pediatric hospital in Illinois, ranked #1 children’s hospital in the state.

• Academic and research collaborations with Northwestern’s Feinberg School of Medicine and a prominent medicaid provider (around 60% of inpatient care is Medicaid-covered).

• Multi-pillar mission: Clinical care, Advocacy, Research, Education ("C.A.R.E.")—all pursued to advance the well-being of children.

  "We ground ourselves in our multipillar mission: care stands for Clinical care, Advocacy, Research, and Education. Each area strives for excellence in advancing the health and well-being of kids we're privileged to serve."
  — Dr. Tom Shanley [02:56]

Pediatric System Expansion Strategy

• [04:07-09:20] Lurie is evolving into a health system by expanding suburban and community-based sites (e.g., outpatient facility in Schaumburg and planned inpatient/emergency facility in Downers Grove).

  • Key driver: Increasing access to high-quality pediatric specialty and primary care nearer to local communities, especially as other systems withdraw from pediatric services.
  • Downers Grove expansion addresses the outflow of patients for basic inpatient care; intent is to keep children closer to home for non-complex care, while highly specialized, tertiary care remains at the main hospital in Streeterville.
  • Pediatric Emergency Department in partnership with Northwestern Medicine—focus on specialized pediatric emergency care, a critical need outside of central Chicago.

  "We want to make sure that we're bringing service capability much closer so families aren't sort of forced to make that decision between convenience versus competence and excellence."
  — Dr. Tom Shanley [07:23]

  "That type of [complex, transplant] care will always be anchored here at this facility because it requires a unique environment and a unique workforce."
  — Dr. Tom Shanley [08:45]

Investing in Underserved Communities: The Austin Hope Center

• [10:09-14:23] Lurie will open the Austin Hope Center on Chicago’s West Side, focusing on social determinants of health for children in under-resourced communities.

  • Philosophy: A child’s zip code should not outweigh their genetic code in predicting health outcomes.
  • The project stems from “listening, not dictating”—clinical services are selected based on direct community input, aiming to complement rather than duplicate existing efforts.
  • Integrating primary care, behavioral health, social supports, and sub-specialty access to prevent unnecessary hospitalizations and emergency visits.
  • Long-term vision: Generational investment in health to break persistent cycles of disparity.

  "Too often a child's zip code has a much higher impact on their health outcomes than their genetic code."
  — Dr. Tom Shanley [10:11]

  "You can't go in as a system and say, 'we believe we know what you need.' You need to go in and understand from the community... to not duplicate but to complement."
  — Dr. Tom Shanley [12:17]

Medicaid Funding Changes and Strategic Responses

• [15:17-19:10] Discussion of HR1 and looming Medicaid reforms:

  • Nearly 60% of Lurie’s hospital stays are Medicaid-covered; half the nation’s children are on Medicaid.
  • Dr. Shanley is strongly critical of HR1—calls it "a disaster"—but notes the need for reform and federal government openness to improvement.
  • Illinois has secured temporarily higher Medicaid reimbursement rates, providing critical support ("a lifeline") during this transition.
  • Lurie is reviewing clinical programs for mission alignment and financial sustainability and exploring technologies (including AI) for operational efficiency.
  • Emphasis on advocacy at state and federal levels, highlighting the imperative to preserve and invest in pediatric Medicaid.

  "Let's make no mistake about it. HR1 is a disaster...[but] there's an opportunity to make the program better."
  — Dr. Tom Shanley [15:45]

  "My bigger concern as we look at what the future brings is to not forget where the biggest bang for healthcare investment, including Medicaid investment, is in the country. And that's still in the future generations of this country."
  — Dr. Tom Shanley [18:22]

National Pediatric Landscape: Access Gaps and Workforce Woes

• [20:11-25:14] 20% of hospital pediatric units have closed nationally in the last decade.

  • Drivers: Financial pressures (adult beds are more profitable), declining entry into pediatrics/subspecialties, and a shrinking workforce.
  • Lurie’s competitive pediatric residency program is part of the solution; focus on “training your own” to fill essential roles.
  • Research growth: From $20M to $140M in annual research expenditures over 10 years—research identified access gaps and informs Lurie’s leadership in stepping up.
  • Prediction: large, independent, urban children’s hospitals will be the critical anchor points for pediatric care nationwide.
  • Community-based expansion (e.g., clinics and partnerships) mirrors strategies of leading hospitals nationwide (Children’s Hospital of Philadelphia, Seattle Children’s).

  "...Much of this really started and was even... before the pandemic, but was accelerated... Systems that had small inpatient pediatric beds provided them to adults. And suddenly realized that when there's an adult in the bed paid for by Medicare, you do much better than when you have a kid in that bed provided by Medicaid."
  — Dr. Tom Shanley [20:42]

  "Being able to sort of train your own and populate that critically important workforce is really critical."
  — Dr. Tom Shanley [22:26]

  "You can't have a static system... what we're so proud of is the extraordinary growth of our research enterprise."
  — Dr. Tom Shanley [23:37]

Final Reflections: Mission in the Face of Adversity

• [25:26-27:07] Dr. Shanley highlights the daunting pressures facing pediatric providers:

  • Reimbursement challenges, vaccine hesitancy, drug access, and threats to programs like 340B.
  • Admonishes colleagues to stay anchored in their mission to serve children, take opportunities to adapt and advocate, and remain hopeful despite adversity.

  "Despite the challenges... stay anchored in our mission... How we educate and advocate for changes... will impact the well-being of our kids and, therefore, the future of our city and our country."
  — Dr. Tom Shanley [25:55]

Notable Quotes

• “We want to make sure families aren’t sort of forced to make that decision between convenience versus competence and excellence.” — Dr. Tom Shanley [07:23]
• “Too often a child's zip code has a much higher impact on their health outcomes than their genetic code.” — Dr. Tom Shanley [10:11]
• “Let's make no mistake about it. HR1 is a disaster... but the opportunity is making the program better.” — Dr. Tom Shanley [15:45]
• “Being able to train your own and populate that critically important workforce is really critical.” — Dr. Tom Shanley [22:26]
• "As long as folks remain anchored and committed to what we come to work every day to do... I think we will continue to thrive..." — Dr. Tom Shanley [26:28]

Important Timestamps

• Dr. Shanley’s background: [01:00]
• Lurie Children’s mission & Medicaid focus: [01:46-03:34]
• Expansion strategy (Schaumburg, Downers Grove): [03:34-09:34]
• Austin Hope Center, approach to underserved communities: [09:34-14:23]
• Medicaid / HR1 discussion: [14:23-19:10]
• Nationwide pediatric access and workforce gaps: [19:10-25:14]
• Closing advice and message: [25:26-27:07]

Summary

This episode offers a thoughtful, candid exploration of the strategies and challenges shaping the future of pediatric healthcare at Lurie Children’s and beyond. Addressing financial pressures, access gaps, social determinants of health, workforce constraints, and policy upheaval, Dr. Tom Shanley underscores the crucial need for unwavering mission focus, innovation, community partnership, and advocacy to ensure children everywhere receive the care they need.