Community Health Collective

I'm Jill Steeley, and I spent years as an FQHC CEO feeling like I was the only one struggling with impossible choices—mission or margin, staff or budget, growth or sustainability. Until I realized: I wasn't alone. None of us are. That's why I created this podcast—to build the community that community health leaders deserve. Whether you're leading a health center, a rural clinic, a public health program, or any organization putting community care first, you'll find practical wisdom, honest conversations, and a whole lot of "finally, someone gets it" moments here. Each episode tackles the big stuff—financial strategy, workforce challenges, policy changes—and the personal stuff—boundaries, burnout, and what it really takes to sustain yourself while serving others.

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  Episode #40

  Her Two AI Holdouts Were the Youngest Providers in the Building

  Aug 12, 202621 min

  Community Health Collective — AI Resistance Episode (#40) Host: Jill Steeley You cannot answer a values objection with a training session. That's the line Jill keeps coming back to after a story a CEO told in one of her Bootcamp sessions — she rolled ambient scribes out to 50 providers, braced for a fight with her most tenured doctors, and got exactly two holdouts. Neither was over 40. Both were her youngest physicians, and they weren't afraid of the technology or confused by it. They objected on ethics and on environmental cost. In this episode Jill breaks down the three kinds of "no" that look identical from the outside — the capability no ("I can't"), the evidence no ("I don't trust it yet"), and the values no ("I don't think we should") — why only the first two shrink when you throw support at them, why the third one hardens and goes quiet when you ignore it, and the four moves that actually work on a values objection, none of which are another training session. The turn comes at the end: her 62-year-old docs adopted in week one, and the assumption cost that CEO more than the resistance ever did. If you're rolling out AI, a new EHR module, or any change at all right now, this one will save you months of planning aimed at the wrong person. Highlights: Why 48 of 50 providers adopted ambient scribes — and why the two who didn't weren't who anyone expected The three kinds of no: capability, evidence, and values — and how to tell them apart in one conversation Why a capability no gets smaller over time and a values no gets bigger, quieter, and picks up allies What the younger physicians actually argued: patient consent, audio retention, model training, and the environmental cost of the data-center buildout Four moves for a values objection — name it out loud, get real answers from the vendor in writing, offer a real opt-out with a real expiration date, and don't make them the villain The reframe: your loudest ethical objector is a free early-warning system for the questions your board and your patients will ask in six months The bigger lesson — stop predicting who will resist, and go ask Quotes from the episode: "You cannot answer a values objection with a training session." "They weren't afraid of the AI. They weren't confused by it. They understood the technology probably better than anyone else on the team." "A capability no and an evidence no both get smaller over time if you provide added support. A values no can actually get bigger if you ignore it." "The assumption cost her more than the resistance did." Mentioned in This Episode • CEO Bootcamp — Jill & Steve Weinman’s program for health center leaders navigating strategic and financial decisions. www.fqhc-ceo.com • Work with Jill — Email jill@jillsteeley.com or schedule a call at jillsteeley.com to talk through your needs.

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  Episode #39

  One Woman Called Patients All Day for Two Years. Then She Quit - and They Never Replaced Her.

  Aug 5, 202653 min

  Community Health Collective Podcast Episode 39 · Guest: Alison Williams, Vital Interaction Host: Jill Steeley Jill's been saying it for months: the way health centers survive the Medicaid coverage cliff is by helping patients keep the coverage they're still eligible for. In this episode she brings on Alison Williams - 25 years in the health center movement, 10 of them inside a community health center in Upstate New York, another decade leading the national FQHC customer success team at Athena, and a former HRSA grant reviewer - to answer the question every CEO asks next: with what staff? Because HR1 doesn't make most of these patients ineligible. It makes them do paperwork twice a year, forever. Redeterminations move to every six months for expansion adults 19 to 64 starting January 1, 2027. Work requirements of 80 hours a month start the same day. And immigrant eligibility narrows on October 1, 2026, which is right around the corner. Somewhere between 11 and 17 million people are expected to lose coverage - compared to about 4 million when the public health emergency unwound. The difference, as Jill puts it, is that the PHE was a one-time event and this one never stops. Alison walks through how a Patient Management System like Vital Interaction turns that into three different message streams instead of one mass blast, why the first text a patient gets should be "add us as a contact" and not a reminder, how one two-minute provider video becomes dozens through AI, and what actually happens to the person whose entire job was calling patients all day. Jill also flags the funding angle most centers miss: this is exactly the kind of investment the Rural Health Transformation Program was built to pay for. Highlights: The plain-English HR1 breakdown: six-month redeterminations and 80-hour work requirements starting January 1, 2027, immigrant eligibility cuts October 1, 2026 Why 11 to 17 million is a different animal than the 4 million who lost coverage during the PHE unwinding - this one is ongoing, not a single event The trust step before the reminder: "Hi, this is Friendly Family Health Center. Please add us as a contact," plus QR codes at check-in and checkout One two-minute provider video, recorded at a desk, turned into dozens of personalized messages by AI - because patients do what their providers tell them, not what the front desk tells them Three HR1 buckets means three completely different messages - retention, work-hour documentation, and sliding fee for patients who genuinely lose eligibility Two-way texting that's actually multilingual: you text in English, the patient reads and replies in Spanish, and it comes back to you in English Follow-up you can dial: one health center runs 3-day, 5-day, 10-day, and 25-day touches, and patients drop off the list the moment they schedule The labor answer: the woman who called patients all day for two years, quit, and never had to be replaced Why a single retained Medicaid patient's PPS payment starts paying for the technology immediately Rural Health Transformation Program funding maps directly to this - IT modernization and chronic disease management Implementation runs 90 to 120 days after signing, and you need an executive sponsor, operations, and IT at the table or it turns into a struggle bus Quotes from the episode: "When people hear me say 'help your patients stay covered,' they're thinking about 10 years ago when we were stuffing envelopes. We can do this at scale now." - Jill Steeley "Communicating with the right patient at the right time in the right way. It isn't a mass blast - because if it's going to be a mass blast, it's going to be just like another piece of paper they're not going to react to." - Alison Williams "Is there one provider or one nurse or one care manager at your location that the community knows, respects, and trusts? That's the person we want." - Alison Williams "We're not suggesting you take the human out of every engagement. We're saying those manual tasks that will suck the soul out of your employees - why are they doing that now?" - Jill Steeley Guest disclosure: Alison Williams runs Trusted Advisors Consulting Group and states plainly in the episode that Vital Interaction is her partner and client. Jill has a partner relationship with Vital Interaction as well, and gets her clients a ~33% discount. Links: Vital Interaction: www.vitalinteraction.com Schedule a call with Vital Interaction (Community Health Collective listeners get 33% off): https://guidance.vitalinteraction.com/jill-steeley Alison Williams: alisonwilliams@trusted-advisors-consulting.com · LinkedIn Episodes 35 and 36, referenced in this conversation: www.jillsteeley.com/podcast Free HR1 planning worksheet: email jill@jillsteeley.com with "HR1 plan" in the subject line FQHC CEO Connect Bootcamp - next cohort opens in September

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  Episode #38

  Six Leaks, One Hour: What Happens When CEOs Score Their Own Numbers Live

  Jul 28, 202618 min

  Community Health Collective Podcast Six Leaks, One Hour: What Happens When CEOs Score Their Own Numbers Live Host: Jill Steeley In this solo episode, Jill, who was a health center CEO for nearly nine years and describes herself as a business-model thinker rather than a finance person, makes the case that funding instability isn't the real threat to health centers, a fragile business model is, and instability just exposes it faster. She walks through why most health centers are leaving anywhere from $200,000 to a million dollars or more on the table every year, and previews the two free Insiders Sessions she and Steve Weinman are hosting in August: a six-metric revenue leak diagnosis (August 4) and the prescription to fix it (August 20). If you've ever watched your budget sit stuck year after year and couldn't name why, this one's for you. In this episode: Why Jill looks at business models, not just finances, and why that reframe matters for your center Why funding instability exposes a fragile business model rather than causing the problem The $5.98 billion flat funding reality and why grant or Medicaid dependency over 35 percent puts your operation at risk The six metrics that predict a health center's financial health: Days in AR, denial rate, no-show impact, payer mix, 340B, and time-of-service collections How one center recovered $970,000 in six months by finally looking at their 137 days in AR Why high performers keep their no-show rate below 12 percent, and what 200 no-shows a month really costs The revenue opportunities most centers overlook, from payer contract renegotiation to 340B expansion to chronic care management Why "attracting insured patients" funds the mission instead of betraying it What happens in each session and why attending live (with the workbook in hand) is the whole point Quotes: "Funding instability is not your real problem. A fragile business model is. Instability just exposes it faster." "The money you need is almost certainly not in a new grant application. It's in your existing operations, your payer contracts, and your billing system. You just need someone to show you where to look." "Profit is oxygen. No margin, no mission." The two sessions: [ Insider’s Session, Part 1 ] Finding Your Revenue Leaks: The 6-Metric Diagnostic Tuesday, August 4 · 11 AM PT / 2 PM ET We run a 6-metric revenue leak diagnostic on your health center. You'll score your own organization live and leave knowing exactly where you're bleeding. [ Insider's Session: Part 2 ] Revenue Opportunities and Cost Reduction Blindspots Thursday, August 20 · 10 AM PT / 1 PM ET This is what to actually do about it, plus the revenue most centers overlook entirely. Both are free and live, with about 45 minutes of training and 15 minutes of Q&A. Register Insider Session #1 here Register Insider Session #2 here Related episodes: Jill points listeners to her episodes on the HR 1 changes and last week's episode on double-booking on purpose, episodes 35, 36, and 37 www.jillsteeley.com/podcast

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  Episode #37

  Double Book on Purpose: The $150K-Per-Provider Leak Hiding in Your Schedule

  Jul 22, 202616 min

  Double Book on Purpose: The $150K - per - Provider Leak Hiding in Your Schedule Host: Jill Steeley www.jillsteeley.com An empty chair in your clinic is not a neutral event — it's a loss you already paid for. In this episode, Jill starts in the airport. On a recent trip to Connecticut she got a text asking if she'd give up her overbooked seat, and it clicked: airlines sell that seat twice on purpose, because they know a predictable slice of people won't show, and once the doors close that seat is money they never get back. Your 9:00 no-show and your 9:40 no-show are the same math — two providers, two rooms, two empty chairs you already paid for, and a patient on your waitlist who didn't get care. Jill walks through the exact low-tech strategy her dental director ran at her health center: a 15-minute Monday-morning schedule scrub where the team, who knew their patients and their no-show patterns cold, double-booked with intention in only the slots they could predict. She lays out the math (about three empty chairs a day per provider, roughly $150,000 a year), the flex plan for the rare day everyone shows up, and the reframe that keeps it mission-aligned: no margin, no mission. Recovering an empty seat isn't choosing money over patients — it's turning wasted capacity into more care. This one's for the health center leader who's been absorbing empty chairs for years and calling it normal. Highlights: Why an empty chair is a loss you've already paid for — provider, room, chair, assistants, front desk — and the only thing missing is the patient The airline mindset: a certain share of no-shows is predictable, not random, so you can treat it like a math problem The 15-minute Monday scrub: how a dental team that knew its patients double-booked only the slots they could predict The math that makes the case: ~3 empty chairs a day per provider, ~$150,000 a year, compounding across every service line Overbooking based on predictable behavior — never on who someone is or what insurance they carry The flex plan for the rare double-show, decided on a calm Monday, not at a chaotic front desk The reframe: no margin, no mission — recovered capacity funds the visits nobody pays for Quotes from the episode: "Airlines know something we don't give them credit for. They sold that seat twice on purpose." "An empty chair is not neutral for you. It's a loss you've already paid for. The only thing missing is the patient." "You recover it by seeing more patients, not fewer. You're filling seats that were going to sit empty anyway." "We'd been absorbing those empty chairs for years and calling it normal. What's new is deciding to do something about the part we could actually predict." Coming up: Insiders Session, Part 1: Finding Your Revenue Leaks Tuesday, August 4 at 11:00 AM PT / 2:00 PM ET This is the diagnosis. We’ll walk you through the 6-metric diagnostic that predicts a health center’s financial health. You'll score your own organization live and leave knowing exactly where your money is leaking. One center we worked with used this to recover $970,000 in six months. Not from a grant. From revenue they'd already earned. Register for Part 1 Insiders Session, Part 2: Revenue Opportunities and Cost Reduction Blindspots Thursday, August 20 at 10:00 AM PT / 1:00 PM ET This is the prescription. We’ll show you the revenue most health centers overlook and the cost cuts that make you stronger instead of weaker. One of our CEO Bootcamp participants used what's in this session to negotiate an 18 percent rate increase worth $800,000 a year, from a single conversation. Register for Part 2 Here's how they run. 45 minutes of real training, then 15 minutes of live Q&A where you can ask Jill and Steve Weinman anything about your own situation. And when you register, we'll send you the same workbook, so you can score your own numbers right alongside us.

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  Episode #36

  HR1 is About to Double Your Medicaid Churn - Here's the Plan

  Jul 15, 202630 minS0

  <h1>Community Health Collective — HR1 & Retroactive Medicaid Episode</h1><p>Host Jill Steeley & Guest Howard Archer</p><p>HR1 isn't a someday threat - it's in implementation now, and it's about to make Medicaid billing harder than most health centers are ready for. In this episode Jill sits down again with Howard Archer, CEO of Fix Healthcare Technology and the creator of RetroCAID, to name the real problem: HR1 won't mainly make your patients ineligible, it'll make them lose coverage over paperwork - twice as often as before. Jill and Howard walk through the exact timeline coming at you (six-month re...

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