Latest / Becker’s Healthcare Podcast / Advancing Health Equity and Community-Based Care at UI Health with Rani Morrison Williams

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Advancing Health Equity and Community-Based Care at UI Health with Rani Morrison Williams · Becker’s Healthcare Podcast

0:01
Every year, Becker's annual meeting brings health care
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leaders together to unpack the most pressing issues
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facing the industry.
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And every year, those conversations shift in profound
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and unexpected ways.
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This April, more than 3,500
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healthcare executives will return to Chicago
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for Becker's sixteenth annual meeting.
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Seven ninety five elite speakers will offer new
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lessons,
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new case studies, and predictions about what comes
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next. Join us April 13 through the sixteenth.
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For the agenda and event details,
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visit beckershospreview.com
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and click on the events tab in the
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upper right.
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This is Laura Dirdo with the Becker's Healthcare
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podcast. I'm thrilled today to be joined by
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Roni Morrison Williams, chief diversity and community health
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equity officer of University of Illinois Hospital and
0:48
Health Sciences System. Roni, it's a pleasure to
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have you on the podcast today. Thank you.
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I'm happy to be here. Absolutely. Now I'm
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excited for our conversation because I know there's
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so much happening in health care right now
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in a particularly unique time,
1:00
and space within, you know, the the world
1:03
to be thinking through the things that you're
1:05
thinking through on a daily basis, looking at
1:06
community health, looking at diversity, and everything else.
1:09
And so I'm excited to dig in a
1:11
little bit deeper. But before we do, can
1:13
you tell me a little bit more about
1:14
yourself and University of Illinois?
1:17
Yeah. Absolutely. So I am the chief diversity
1:20
and community health equity officer here at UI
1:23
Health.
1:24
We are an academic medical center located on
1:26
the West Side Of Chicago in the Illinois
1:28
Medical District.
1:29
We are the state's only tertiary and acute
1:32
care hospital,
1:33
because we are part of University of Illinois
1:36
and University of Illinois at Chicago.
1:38
So we have a unique situation,
1:40
with our positioning in the state.
1:43
We're also the,
1:44
only active medical center in the state that,
1:47
owns a federally qualified health center, Miles Square
1:50
Health Center, which has locations throughout Chicago and
1:53
in Rockford.
1:55
We are a, 400 plus bed academic medical
1:59
center with a variety of outpatient services,
2:03
specialty care building,
2:05
family medicine, and urgent care,
2:08
just a very robust
2:10
academic medical center.
2:12
And we hover around 50% Medicaid,
2:15
in terms of our payer mix.
2:16
So we, are very focused on health equity
2:20
and making sure that we have excellent care
2:22
for all of our patients regardless of pair,
2:25
ZIP code, or any other,
2:27
characteristics. So I'm super excited to be a
2:30
part of the family here at UI Health.
2:33
I've been here in various capacities for almost
2:35
twelve years. I'm a licensed clinical social worker.
2:38
I started off here leading our care coordination
2:41
efforts,
2:42
and over the last few years, in different
2:45
roles. I've now been in this role for
2:47
four and a half years where I lead
2:48
our, health equity efforts, our diversity inclusion,
2:52
team, our community relations team, care coordination,
2:55
case management, and inpatient and outpatient social work.
3:00
Wow. That's, an amazing responsibility, but I know
3:03
such a a needed leadership position within the
3:05
organization.
3:06
Now when you think back the last year
3:08
or so, could you talk to us a
3:10
little bit more about an important initiative that
3:12
you led? What did you do, and what
3:13
were the results?
3:15
I think the most impactful initiative we've, launched
3:18
in the last year,
3:19
that I'm super proud of,
3:21
has been our implementation
3:23
of on-site domestic violence response.
3:25
We partnered with a nonprofit
3:28
agency,
3:29
Wings, which is, located
3:31
primarily in the Northwest Suburbs,
3:34
but serves all over the city of Chicago
3:36
in the suburbs.
3:38
They received
3:39
a grant from the city of Chicago
3:41
to support,
3:42
twenty four seven domestic violence response in hospitals,
3:46
and we're the first hospital that they partnered
3:48
with. So for about a year, we've had
3:50
them
3:51
available
3:52
to,
3:53
respond to
3:55
domestic violence related needs of our patients.
3:57
So if we have a patient in the
3:58
emergency department who might be experiencing domestic violence,
4:02
if they're on inpatient, if they're in the
4:04
outpatient clinics,
4:06
Wings is available and will come to the
4:09
bedside, come to the office to meet with
4:11
them and
4:12
help them in whatever way is,
4:15
needed. It can be anything from,
4:18
helping them get shelter and housing to providing
4:20
them transportation,
4:22
giving them, alternate forms of communication,
4:25
or sometimes just providing them support and education
4:28
because maybe they're not ready for anything beyond
4:30
that.
4:31
They also are providing training and education for
4:34
our staff, faculty, and trainees. So they've trained
4:37
several 100 of our employees
4:39
virtually and in person,
4:41
and so being able to have that kind
4:43
of information
4:44
and expertise
4:45
on hand has really enhanced
4:48
our, our offering as it pertains to supporting
4:50
our patients who are experiencing domestic violence. It's
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also allowed us an opportunity to learn more
4:54
as individuals and providers
4:56
and support each other, whether it's our colleagues
4:59
or students.
5:00
Domestic violence does not have a particular,
5:03
face or location,
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and so this partnership has allowed us to
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really deepen,
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our offering and our understanding and be able
5:10
to support not just our patients, but the
5:12
broader campus community in a very meaningful way.
5:16
We have just recently gotten referral numbers for
5:19
the last quarter,
5:20
and
5:21
it was great that we got, referrals the
5:24
first, three quarters of last year, pretty steady.
5:26
The last 2025,
5:29
the referrals doubled
5:31
compared to the, previous nine months.
5:34
So it's,
5:35
sobering that we have that many, over a
5:38
150 referrals that have been received just at
5:40
our hospital and clinics.
5:42
But, also,
5:43
it's reassuring to know that these services and
5:45
this partnership came
5:47
and clearly
5:49
were needed.
5:50
Absolutely.
5:51
That's a huge and I I know a
5:53
huge undertaking to put something like that together.
5:55
It really must be, you know, a a
5:58
labor of love on your part and the
5:59
part of the team, because, you know, I
6:01
can imagine it takes a lot to put
6:03
something like this together and then, you know,
6:05
to care for,
6:08
patients
6:09
and and people in this position,
6:11
is no easy task. And so,
6:13
I I really appreciate you talking us through
6:15
that. And, you know, throughout the process, was
6:17
there anything that surprised you or, that you
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had to,
6:22
kind of pivot from or or change lessons
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that you learned, I guess, that might help
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other organizations as they may see a similar
6:28
need within their communities?
6:30
I think the biggest thing that we learned
6:32
was just the what we clearly have an
6:35
underreporting issue, which we knew, but we didn't
6:37
realize just how much. When you look at
6:40
we do screen for social determinants of health
6:42
at admission,
6:43
and our screening rates in terms of people
6:44
who endorsed experiencing domestic violence or intimate partner
6:47
violence was fairly low.
6:49
But to see the numbers that we've seen
6:51
in terms of referrals, and these are people
6:53
that are presenting
6:54
on our campus in some way and saying,
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hey. I'm experiencing domestic violence, and I I
6:59
want some help.
7:01
To see those numbers,
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escalate as they have,
7:04
just shows us that we were definitely
7:06
not getting the full picture just from the
7:08
screening and to really enforce the fact that
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we need to make sure that we're trained,
7:12
and feeling really competent
7:14
to be able to assess and support outside
7:17
of the basic screening. Because people are not
7:19
necessarily gonna tell you, yes,
7:21
in triage, when they're checking into their appointment,
7:24
that they're experiencing that. I know all of
7:25
us,
7:26
many of us get that screening at most
7:28
places that we go. You know? They ask
7:30
you, do you feel safe at home, etcetera.
7:32
They ask our kids that.
7:34
But I think that this
7:36
process and program has shown us that maybe
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those screenings are not telling the whole story.
7:41
And as providers, we need to be,
7:44
more comprehensive
7:45
and and
7:46
available to make sure that when a patient
7:48
may feel comfortable disclosing, it might not be
7:51
at the screening. It may be later in
7:52
the interaction. It may be weeks into the
7:55
interaction,
7:56
and that we need to make sure that
7:57
we have resources and the training to provide
7:59
that support whenever
8:00
the need shows up.
8:02
I love that. Thank you so much for
8:04
digging a bit deeper there. Now when we
8:06
look ahead into 2026, what are some of
8:08
the big priorities and headwinds that you're focused
8:10
on?
8:11
Oh, 2026.
8:17
I think the biggest for us I I'm
8:19
I refer to our payer mix being heavy
8:21
heavily Medicaid.
8:23
And so for us, I think the headwind
8:25
and the priority
8:26
is really
8:29
working through the upcoming Medicaid changes.
8:32
Knowing that the, community engagement aspect was added
8:35
to Medicaid,
8:37
and
8:38
is basically effective 01/01/2027,
8:41
we're gonna spend a good portion of 2026
8:44
preparing for what that looks like. We need
8:46
to be prepared for less people to be
8:48
on Medicaid
8:49
come 2027,
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either because they can't meet the requirements
8:53
or,
8:54
maybe they don't know about them. We know
8:56
that a lot of times patients can be
8:58
transient. They move a lot. Are they being
9:00
notified? Are they educated? Do they know how
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to submit the forms,
9:04
and the process that will be established by
9:06
the respective states?
9:08
That's something that is an unknown quantity right
9:11
now.
9:12
And so I think for us, we're spending
9:15
a good chunk of 2026
9:17
preparing for those changes,
9:19
when it comes to education and communication around
9:21
the changes, as well as we need to
9:23
be prepared financially
9:25
for what may come if we have a
9:27
significant drop,
9:28
of,
9:29
our Medicaid patients who might then become uninsured.
9:33
That makes a lot of sense. And, you
9:34
know, I I know that, that's a particular
9:37
worry for a lot of hospitals and systems,
9:39
but particularly
9:40
for those situated like yourself with just such
9:43
a high, percentage of the payer mix, you
9:45
know, currently being in the Medicaid process.
9:48
And so when you look at, you know,
9:49
making those preparations financially,
9:51
you know, assuming that everything goes through
9:55
effective 01/01/2027,
9:57
some of the cuts and reductions happen that
10:00
are currently,
10:01
expected to happen.
10:03
You know, what what ways are you looking
10:05
at that from the executive level to make
10:07
sure, I think, first and foremost, that people
10:09
have access to care, and then secondly,
10:12
preparing the organization for, you know, the financial
10:16
challenges that may come from it?
10:19
I will say in Illinois, we've had a
10:21
little bit of a a dry run, we
10:23
might say,
10:24
because we were one of the handful of
10:26
states that implemented,
10:29
Medicaid for undocumented persons a few years back.
10:32
And due to state funding issues,
10:35
that program was ended
10:37
in 2025,
10:39
because we were the state was no longer
10:41
able to afford it. So for a good
10:43
chunk of our patients that were undocumented,
10:46
immigrants,
10:48
that were in kind of the middle age
10:50
stage, if you will. The program was specific.
10:52
It topped out,
10:53
it was, like, mid forties to, early sixties,
10:57
but it was still a huge significant portion
10:59
of the population.
11:01
When that program ended,
11:03
we, along with all the other hospitals in
11:04
the state of Illinois, had to make adjustments,
11:07
in terms of both financially
11:08
and, again, education,
11:10
making sure that people understood what was going
11:12
to happen with their Medicaid,
11:14
making sure they understood what other programs might
11:17
be available to them,
11:18
Medicaid, making sure they're linked with FQHCs,
11:21
that that type of thing.
11:23
And so
11:25
I look at that as being a little
11:26
bit of our our our dry run, our
11:28
practice. This is gonna be on a larger
11:30
scale, of course, but we've experienced it. And
11:33
so we we kinda know how to
11:36
navigate it. It's just going to be understanding
11:39
what the full impact is. And right now,
11:41
it's a little murky,
11:43
in terms of we don't the state and
11:45
we don't have a full understanding of how
11:47
many of our patients are put
11:49
in particular going to be impacted
11:51
when all the other aspects, you know, are
11:53
are taken into account. Right? You have disabilities.
11:55
You have people who kids under age 14.
11:57
Like, there's all these caveats to it. So
11:59
I think for us, it's gonna be
12:02
we we've got a little bit of practice
12:04
in in how to do the education and
12:05
how to make sure people understand
12:07
and can get them, you know, into
12:10
that whether it's back on Medicaid or into
12:12
another program. But I I think we are
12:15
a little bit of a disadvantage,
12:16
until we get a little bit clearer on
12:19
what our impacted patients will look like for
12:21
our organization in particular.
12:24
But we're planning as best as we can.
12:25
We're really focusing on education and communication. We're
12:28
really focusing on
12:29
looking at our finances, you know, and being,
12:32
as cost efficient as possible while still delivering
12:35
excellent health care.
12:36
That makes a lot of sense. And thank
12:38
you so much for, that kind of broader
12:40
explanation. I I think it's so helpful just
12:43
to connect and hear, how you're thinking about
12:45
it. Now what do you think the hardest
12:47
thing you'll have to do in the coming
12:48
year will be?
12:49
Kind of a continuation of that. Right? So,
12:52
if you heard of my introduction, a lot
12:54
of the areas I'm I am responsible for
12:57
are not revenue generating.
13:00
They are really about addressing
13:01
social determinants of health, health equity,
13:04
the things that, you know, cause our patients
13:07
to come into our doors but aren't necessarily
13:10
billable, right,
13:12
when you address them. And so I think
13:14
from my perspective,
13:16
it's going to be hard to continue to
13:18
make a case for addressing those needs,
13:22
when we are in a resource restrained environment,
13:25
when social determinants of health and the vulnerabilities
13:28
our patients are experiencing have kind of been
13:30
deprioritized
13:31
at a a national level,
13:34
it's hard to, continue to make that case.
13:36
I'm fortunate that I I work at a
13:38
organization that, again, is
13:41
very much aware of of health equity and
13:43
the importance,
13:45
of addressing health disparities and addressing SDOH.
13:48
So
13:49
I, you know, my team are in a
13:51
better position than most, but
13:53
it still becomes,
13:55
an equation. Right?
13:57
And so,
13:58
that's gonna be the hardest thing to do
14:00
is make sure that we can continue to
14:01
show ROI around addressing social determinants of health,
14:05
whether it's reducing length of stay because we're
14:07
addressing something, whether it's,
14:09
improving someone's quality of life, how do we
14:11
quantify that,
14:13
whether it's, you know, how do we leverage
14:15
this program to reduce no show rates. So
14:18
continuing to deliver an ROI
14:20
around whatever we can when it comes to
14:23
addressing these areas,
14:25
in a resource restrained environment so that we
14:27
aren't,
14:28
at risk of having to lose anything that's
14:31
so important to our patients and getting them
14:32
here and getting them and keeping them in
14:35
care.
14:36
That's such an excellent point. And, you know,
14:38
being able to find that value, I know
14:41
the soft and hard ROI can,
14:43
be a challenge, but, you know, you outlined
14:45
so clearly how, you've been able to do
14:48
that and started to think through,
14:50
some of those outcomes in in knowing that
14:52
not only this is this right thing to
14:54
do for the patients and the community, but
14:55
then it it actually has an impact on
14:58
the organization and a financial one as well.
15:00
When you're talking through that with your, colleagues
15:03
at the c suite level,
15:05
is there anything that, you know, you wanna
15:07
make sure that you message so that they
15:09
truly understand the impact of the work that
15:11
you're doing?
15:12
Well, we've been really trying to quantify that.
15:14
Right? So I just shared with you some
15:15
of our numbers around the domestic violence program.
15:17
I'm sharing those numbers. I actually was in
15:19
a meeting,
15:20
today with my colleagues and, some local,
15:23
politicians
15:24
sharing the information, sharing that our outpatient transportation
15:27
program for those that were enrolled in it,
15:29
it reduced their no show rate by thirty
15:31
percent. That's significant.
15:33
Right? So that's impact, and we are currently
15:36
evaluating
15:37
actually what the outpatient transportation's impact is, in
15:40
terms of,
15:42
visits,
15:43
and the reduction on no show,
15:45
and what visits and the relative cost of
15:48
the visits that they did make it to.
15:49
How does that align with what we actually
15:52
spent on that individual's transportation?
15:54
So we're doing those calculations and trying to
15:56
make sure that we can show and demonstrate
15:59
value,
16:00
where we can. Sometimes it'll be, you know,
16:02
kind of easy, like, with outpatient transportation.
16:05
Sometimes Sometimes it's gonna be a little bit
16:06
more challenging. Like, with our DV,
16:09
can I draw a straight line from DV
16:12
intervention
16:13
to save dollars or, you know, or something
16:15
along those lines? Not necessarily.
16:17
Can I tell a story about, improved quality
16:20
of life and safety?
16:22
I can. So it's really picking, you know,
16:25
from the different areas what we can what
16:27
we can prove with data and what we
16:29
can show with stories. And that's where we
16:31
have to continue to be creative around,
16:34
and make sure that we're sharing it at
16:35
every turn. And, again, I shared some of
16:37
this information yesterday in a meeting, and, my
16:40
colleague it was a great reminder to them
16:42
of all the things that we do that
16:44
aren't necessarily out in front. Right? It's not
16:46
gonna result in a new building that with
16:49
a beautiful atrium like we have, but it
16:51
is gonna result in patients who are connected
16:53
to our organization
16:54
and can come here for care and feel
16:57
safe and feel taken care of and, ideally,
17:00
have a better outcome than if we hadn't
17:02
offered that particular service.
17:04
That's amazing to hear. Thank you for going
17:06
through some of those details with us, Ronnie.
17:08
Now,
17:09
I'm curious. Before we wrap up here, I
17:11
wanted to ask, where do you see some
17:13
of the best opportunities for organizational growth?
17:16
I think for
17:18
us, I the biggest opportunities are really how
17:21
creative are we gonna be.
17:23
Changing environment, again, resource restraints,
17:26
I think that,
17:28
we continue to grow our ambulatory
17:31
footprint.
17:32
We have a a lot of ambulatory services
17:34
and specialties and subspecialties here on our immediate
17:36
campus in the Illinois Medical District. We're continuing
17:39
to look at how we can grow that
17:41
around the city of Chicago and even outside
17:43
of the city of Chicago so that we
17:45
can connect more people with care.
17:47
We need to continue to be creative around
17:49
things such as telehealth and behavioral health and
17:52
how we're delivering that and the patient population.
17:54
We have some great ideas,
17:56
in that regard about some new programs, in
17:58
the behavioral health space. So really excited about
18:02
those types of thing.
18:03
Expanding the advanced practice,
18:06
workforce,
18:08
really looking at, you know, what are we
18:09
doing with our APRNs?
18:12
What are we doing with our physician's assistance?
18:14
How are we leveraging them within our organization,
18:17
within the ambulatory space to,
18:20
to grow, especially in areas where,
18:23
there oftentimes
18:24
might be,
18:26
a significant strain when it comes to access.
18:29
So how can we be creative,
18:30
around that using our APPs?
18:33
And then I'll say finally, and I am
18:35
not an early adopter, but I am I'm
18:37
having to admit,
18:38
AI is here.
18:40
It is something that we definitely
18:43
have to continue to adopt and be thoughtful
18:45
around. I think tech adoption and AI, efficiencies
18:49
are really, how we can position ourselves well
18:52
for growth. Looking at how we can save
18:55
time, how we can communicate better, how we
18:57
can make more intelligent decisions using technology and
19:00
AI are gonna be really key,
19:02
again, in a resource restrained environment.
19:04
And so I'm excited about those possibilities. Still
19:07
cautious,
19:08
but excited
19:09
about the possibilities for growth that come out
19:11
of those areas.
19:13
I love that. Ronnie, thank you so much
19:15
for joining us on our podcast today. This
19:16
has been such a fun conversation,
19:18
and, you know, I really appreciate your time
19:21
and effort. It's cool to hear about all
19:23
the things that you're doing, and,
19:25
you know, I am looking forward to seeing
19:26
you as well at our annual meeting. I
19:27
know you'll be speaking on one of our
19:29
panels, and so it'll be just a ton
19:31
of fun to see you in person and
19:32
catch up.
19:33
Yeah. Absolutely. I will be there. I enjoy
19:36
a Becker Daniel meeting every year. I'm I've
19:38
been there and been a speaker multiple times.
19:40
Welcome to Chicago, everybody.
19:43
Hopefully, the snow will be gone by April.
19:46
Fingers crossed.
19:49
Absolutely. Yeah. I'm looking forward to thank you
19:51
for the opportunity to share kind of what
19:52
we have going on. I I always love
19:54
the opportunity to share.
19:56
We do so much,
19:58
and I I I'm really
20:00
connected to UI Health, and I'm very proud
20:03
of the work that we do,
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despite, you know, again, the headwinds and all
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the things coming at us.
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We are very committed to serving our patients
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and lifting health equity in Chicago and throughout
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the state of Illinois.