Health leaders urge more primary care, warn Medicaid cuts could shift costs to Springfield

At a Citizens Club of Springfield forum, health-system leaders said expanding primary and urgent-care options and strengthening community programs are central to reducing avoidable emergency-department use and addressing stark health disparities in Springfield.

The panelists — Dr. Mandy Easton, president and CEO of Memorial Health; Brian Brennan, president and CEO of HSHS Saint John's Hospital; Rebecca Berenbaum, chief executive of Springfield Clinic; and Dr. Christopher McDowell, executive assistant dean for clinical affairs at SIU School of Medicine — appeared after Jen DeYoung of the Community Foundation announced a $20,000 gift to the Citizens Club to support programming.

Why it matters: Panelists warned recent federal Medicaid policy changes will not reduce need but will shift costs onto providers and local communities, forcing difficult operational decisions. "Those policy changes like Medicaid cuts are not actually a cost cutting measure, they're a cost shifting measure," Dr. Mandy Easton said, adding that such changes "force us to have to start making much tougher decisions." She urged civic advocacy and holding elected officials accountable for policy choices that affect local health systems.

Reducing avoidable ER visits: The panel outlined steps to move lower-acuity care out of emergency departments. Rebecca Berenbaum described Springfield Clinic's new "urgent care plus," which offers IVs and imaging services at select urgent-care sites so patients can receive more advanced diagnostics without visiting an ER. Brian Brennan said HSHS places community health workers in emergency departments to connect frequent users with follow-up care and community resources, a program he credited with reducing repeat ER visits. Dr. McDowell stressed the emergency department's unique diagnostic capabilities and the need to build reliable alternatives so the ED can focus on true emergencies.

Price transparency and patient navigation: Panelists acknowledged wide price variability driven by payer contracts and government reimbursement differences. Brian Brennan said hospitals are required to provide best-cost estimates and that organizations are increasing education and online information to help patients understand likely bills. Rebecca Berenbaum and other panelists said staff and community programs help patients identify programs and discounts that may reduce out-of-pocket costs.

Health equity and life-expectancy gaps: The moderator cited data showing a citywide average life expectancy of 77.2 years and neighborhood gaps ranging from about 64 years on the North and East sides to 87 years in other areas. Dr. Easton called the roughly 20-year gap "staggering" and said social determinants — transportation, housing, education and nutrition — drive those disparities. Memorial has joined the Healthcare Anchor Network to study and adapt interventions that other communities have used successfully.

Workforce and training pipeline: Dr. McDowell urged pipeline programs that begin in high school and move students into health careers; he noted roughly one-third of Springfield Clinic physicians trained through SIU programs. Panelists said coordinated workforce planning and shared training resources can help address shortages in nurses and specialty clinicians.

Audience questions and local purchasing: Audience members asked about records sharing, clinician-to-clinician communication and using local suppliers. Panelists said investments in health IT, stronger professional relationships and procurement conversations with system teams are ongoing priorities.

Closing: The event ended with the panel thanking the audience; the Citizens Club noted its next program is scheduled for May 22 at the Hoagland and invited attendees to return.

The panel did not take formal votes; the discussion focused on programmatic strategies, advocacy and collaboration.