Community Health Collective

Jill Steeley
  • 5.0 (2)
  • Management

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.

  1. 6d ago

    Twelve Months Analyzing a Weight-Loss Program. A Competitor Launched It in Six.

    Community Health Collective Podcast Host: Jill Steeley Indecisiveness has a cost, and Jill Steeley paid it. When she was a health center CEO, her team spent 12 months analyzing whether to start a weight-loss program while a competitor in the community simply launched one. The cost: roughly 500 patients and $900,000 in revenue. In this solo episode, Jill tells that story, owns her part in it, and does the math most leaders never see, about $75,000 for every month the decision sat on the agenda. She explains why clinically trained leaders are especially likely to get stuck here, then walks through the three things she does now: decide at 80% of the information, put a deadline on the decision itself, and ask the regret question. The flip is the part that stays with you. Waiting is a decision too, and it's the one mistake nobody will ever call a mistake. This one is for health center CEOs and senior leaders with an item on the agenda that keeps rolling to next month. Highlights: The story: 12 months of market analysis, a competitor who went first, and about 500 patients lostThe math: roughly $900,000, about $1,800 a patient, and about $75,000 for every month of waitingWhy waiting feels safe, and why it's still a decision with a priceWhy a business decision is not a diagnosis, and what that means for clinically trained leadersThe 80% rule, and the one question that tells you when you have enoughHow to put a deadline on a decision, and how a three-month pilot makes a big decision smallerThe regret question: a year from now, which will you regret more, acting now or waiting for more data?Homework: find the oldest item on your leadership agenda, price it, and pick a date Quotes from the episode: "It's not like a direct cost that is glaringly staring at you in a budget line item, but it is a real cost, and I did pay it." "Waiting is also a decision. It just doesn't feel like one." "It's the one mistake you can make over and over that no one will ever call an actual mistake." "A business decision is not a diagnosis. In a diagnosis, the answer already exists, and your job is to find it." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    Twelve Months Analyzing a Weight-Loss Program. A Competitor Launched It in Six.

  2. Sep 30

    I Just Paid $3,500 for a Conference (and I'm Still Going)

    Community Health Collective - The Monday Morning Problem Episode Host: Jill Steeley Jill Steeley just registered for a November conference, added up the bill, and landed at about $3,500 before she'd learned a thing. And that's only half the receipt. The other half is what she calls the Monday morning problem: the conference ends, you go home, and on Monday morning you're alone with all those ideas and none of the help to do them. In this episode, Jill runs the full math on a conference versus the FQHC CEO Connect Bootcamp, walking through the direct costs, the time costs that never show up on an expense report, and the three things you don't come home with: implementation tools, someone to call, and content built for your health center. Then she flips it. Jill is still going to her conference, and she explains why the mistake isn't going, it's asking a conference to do a cohort's job. This one is for health center CEOs and senior leaders deciding how to spend a professional development budget in a year when the coverage cliff is on the calendar. Highlights: The full receipt on one conference, one person: about $3,500 direct and roughly $7,000 once you count timeA quick formula for pricing a day of your own time (annual salary divided by 260)The five hidden line items: days out, the catch-up, no tools to implement, no one to call, and content that isn't built for your health centerThe same math run on the fully virtual Bootcamp, including the surprise that the learning hours are about the sameWhy conferences are great at connection and terrible at implementationThe one question to ask about your budget this year: which option changes my numbers by April?Homework: find your last conference receipt and name one thing you changed because of it Quotes from the episode: "The conference ends, you go home, and on Monday morning you're alone with all of those ideas and none of the help to actually do them." "The mistake isn't going to a conference. The mistake is expecting a conference to do the job of a cohort." "I don't go expecting to come home with a plan, because I know I won't, and I've stopped being disappointed about that." "It's not the content. It's whether you're by yourself with it afterward." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    I Just Paid $3,500 for a Conference (and I'm Still Going)

  3. Sep 23

    Hire an 18-Year-Old at $17 an Hour to Run Your Lobby

    Community Health Collective Podcast Host: Jill Steeley Jill calls it the Self-Checkout Hire - and it started with her 18-year-old son, who makes $17 an hour at Lowe's mostly helping people through self-checkout. Meanwhile, health centers are paying nurses, MAs, and front-desk staff to do the same kind of work by phone: portal signups, check-in, password resets, and rescheduling. In this solo episode, Jill makes the case for putting one young, tech-fluent person in your lobby and exam rooms whose whole job is getting patients onto the portal and scheduling themselves, walks through the five jobs of that role, runs the math on what it frees up, and names the prerequisite most centers skip - templated provider schedules. Then she flips the conversation: online scheduling isn't a nice-to-have anymore, and the belief that patients don't have a choice is a myth health centers can't afford. This one's for CEOs, COOs, and practice managers who are tired of watching licensed staff play phone tag. Highlights: Why Lowe's puts a $17-an-hour employee next to the self-checkout - and what health centers can learn from itThe hidden cost of licensed staff doing portal signups, password resets, and rescheduling by phoneThe 5 jobs of the Self-Checkout Hire: greet and enroll, teach self-scheduling, be the help desk, speed up check-in, and track the numberThe rough math: about $44K a year, fully loaded, versus the licensed hours you get backWhy templated schedules are the gate to patient self-schedulingThe captive-patient myth - and why patients who want to book at 7:30 at night will go somewhere that lets them Quotes from the episode: "Here's the thing, none of those tasks requires a professional license to help with." "When your most expensive people spend their day on ten dollar tasks, you end up paying for it twice... because nobody went to nursing school to reset passwords." "I call it the captive patient myth, the belief that patients will put up with whatever we offer because they have nowhere else to go." "This work is really hard, but some of the best fixes are simpler than we think. Sometimes it's just a friendly person standing next to a machine helping a patient." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    Hire an 18-Year-Old at $17 an Hour to Run Your Lobby

  4. Sep 15

    Your Levers Have a Lead Time. The Cliff Doesn't.

    Community Health Collective Podcast Host: Jill Steeley Jill has been getting the same question three different ways, always at the end of a call: "I hear you on the four levers, but if I can only focus on one right now, which should I pull first?" In this episode she says plainly that she's been answering it wrong - not wrong exactly, just answering the question people asked instead of the one that matters. The right question is which lever pays out when you actually need the money, because every lever has a lead time, and those lead times run from 30 days on one end to four years on the other. She opens with a correction she hears constantly and has made herself: January 1st is not the day the money disappears. The redetermination clock runs from each patient's own original application date, so there is no single deadline - patients roll through renewals a few hundred at a time and the losses accumulate across all of 2027. Which means replacement revenue has to land in 2027, which means the 12-to-18-month levers had to start in Q3 of 2026. Then she ranks all four by speed: cost and productivity at 30 to 90 days, patient retention at 6 to 9 months, revenue diversification at 6 to 18 months, and market presence at two to four years. The flip lands near the end and it's the opposite of what logic suggests. The fast lever is still there in January and in June - cost reduction doesn't expire. The slow lever is the only one with an expiring start date. So you pull two, and the fast one doesn't just fund the slow one, it shortens it: money freed up from vendor contracts or a renegotiated commercial rate gets reinvested in market presence, and that four-year lead time starts shrinking. Jill closes with what she got wrong in her own turnaround - she rebranded in year one but didn't start the real market presence work until year two, and because that's the lever underneath the other three, the delay pushed everything downstream. If you're building a Q4 budget and wondering whether a revenue line that pays out in 2029 is a luxury you can't afford this week, this one is for you. Highlights: Why "which lever should I pull first?" is the wrong question, and the one to ask insteadThe correction on January 1st - there is no single redetermination date, it runs from each patient's own application dateWhat actually changes: expansion adults 19 to 64, six-month renewals, 80 hours a month of work requirements verified at application and renewalLever two, reduce costs and increase productivity: 30 to 90 days, and why the money is already yoursLever four, retain patients: 6 to 9 months, and the COO who recovered $700,000 in eight months without adding a single serviceLever one, increase and diversify revenue: 6 to 18 months, including what Jill learned about payer contracts from sitting on the Blue Cross Blue Shield side of the tableLever three, build market presence: two to four years, a 700-person community survey, and 27% brand recognition to 94%The flip: the fast lever never expires, the slow one does - so pull two on the same dayWhy the fast lever doesn't just fund the slow lever, it shortens itThe mistake Jill made in her own turnaround, and the years she thinks it cost herTwo pieces of homework you can start this week, one fast and one slow Quotes from the episode: "January first is not the day the money disappears.""No one tells you that, so people pick the lever that sounds best, they pull on it, and then wonder in March why the needle hasn't moved.""The fast lever is available to you in January. It's available in June. Cost reduction doesn't expire. The slow lever is the only one with an expiring start date.""The fast levers saved the health center. The slow lever is what made it unkillable.""That was my mistake. I sequenced them. I should have just started stacking them.""The best day to pull the slow lever was four years ago. The second-best day is today."Mentioned in this episode: The free live webinar with Steve Weinman on Friday, September 18th at 10:00 AM Pacific / 1:00 PM Eastern - a repeat of the September 11th session, same registration link. All four levers in detail, four health centers doing this now, and how to pick yours. Live attendees get the HR 1 exposure worksheet, the HR 1 90-day action plan, and the offense playbook, plus a birthday trivia giveaway. Replay goes to everyone who registers. Register: webinar.fqhc-ceo.com/register FQHC CEO Connect Bootcamp. An executive-level, 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    Your Levers Have a Lead Time. The Cliff Doesn't.

  5. Sep 8

    They Held a Closed-Door Session at CHI Called "Protecting the CEO"

    Community Health Collective Podcast Host: Jill Steeley Guest Host: Steve Weinman Steve Weinman came back from NACHC's Community Health Institute in Las Vegas with one observation that says more than any policy briefing: they held a closed-door session called Protecting the CEO, and you had to prove you were a health center CEO before they'd let you in the room. In this episode Jill and Steve unpack what that room means, and what everyone outside it was talking about. The number that dominated the hallways was 375,000 - the touchpoints a 25,000-patient Medicaid panel generates once you stack monthly work-requirement verification on top of doubled redeterminations. Steve walks through the panel math so you can run it for your own center: panel size, times a 30% procedural loss rate, times $650 per member per year. For a 25,000-member panel that's $4.9 million at risk, and not one dollar of it comes from a patient who actually became ineligible. Jill and Steve also cover the mergers-and-acquisitions conversations happening all over the conference and what those really signal, why a three-day coverage lapse can change your reimbursement, the 340B and retroactive Medicaid plays that put cash in the door fast, and why your enrollment team just became your retention team. Then Steve says the thing that reframes the whole episode: after 42 years inside health centers, he doesn't think this is a funding problem at all. It's a business model problem. Which is actually good news, because a business model is something you control. If you're a health center leader looking at January 1st and doing quiet math about what happens to your budget, this one is for you. Highlights: What Steve heard in every hallway conversation at CHI - and the closed-door CEO session that tells you how the room really feels375,000 touchpoints a year: what doubled redeterminations plus monthly work-requirement verification actually creates on a 25,000-member panelThe panel math, step by step: panel size × 30% procedural loss × $650 per member per year = your numberWhy a three-day coverage lapse isn't a rounding error - new plan, new benefits, new startup friction, different reimbursementWhy the mergers and acquisitions conversations at CHI are a symptom, not a strategyWhat's actually changing January 1st, and why 50 states doing it 50 ways is the part nobody can plan around yetYour enrollment team just became your retention team - and how to repurpose the people already in your buildingFast cash right now: 340B lines of business, retroactive Medicaid recovery, and commercial payer contracts you haven't renegotiated in yearsThe four levers Jill pulled to take a health center from 62.5% federal dependency to 17% - with a 42% uninsured rateSteve's first move for anyone with four months on the clock: get with your CFO, run your number, and take it to your board before they're surprised Quotes from the episode: "It was sort of this secret CEO session that you actually had to prove that you were a health center CEO before they would let you in the room." "It's not from actual loss of eligibility, but just having them throw so many barriers in front of the patients that they don't make it to the finish line." "Every touch point that gets missed is a lapsed record, and it's basically money walking out the door." "It is definitely not a funding problem. It is a business model problem." "If you put one hand in the oven and one hand in the ice box, the average temperature is a nice, comfortable 70 degrees, but one of them is frozen and the other one's on fire." Mentioned in this episode: Steve Weinman, principal at FQHC Associates and Jill's co-lead on the CEO Connect Bootcamp, with 42 years inside community health centers. NACHC's Community Health Institute (CHI), including the governance workshop on mergers and acquisitions and the closed-door "Protecting the CEO" session. The free live webinar on Friday, September 11th at 10:00 AM Pacific / 1:00 PM Eastern - "I've Already Run a Health Center at 42% Uninsured: Here's Why the Medicaid Cliff Doesn't Scare Me." Register: webinar.fqhc-ceo.com/register Episode #43, where Jill tells her own turnaround story in detail: www.jillsteeley.com/podcast RetroCAID, from Howard Archer at Fix Healthcare Technology - retroactive Medicaid recovery on a pure contingency basis. Schedule a call with their CEO: https://fixht.com/meeting/retrocaid-qa-jsteeley/ Vital Interaction, the patient engagement platform Jill and Steve have hosted in Bootcamp sessions on managing redetermination outreach at scale. To schedule a call with VI and get a 33% discount go to: https://guidance.vitalinteraction.com/jill-steeley FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    They Held a Closed-Door Session at CHI Called "Protecting the CEO"

  6. Sep 3

    From 62.5% to 17%: The Four Levers That Turned My Health Center Around

    Community Health Collective — Four Levers Turnaround Episode (Ep. 43)Host: Jill Steeley Jill takes you inside the health center she inherited in Helena, Montana - nearly a million dollars in the red, a 42% uninsured rate, 37% staff turnover, a dental clinic shuttered for years, and no new provider recruited in five. The board gave her 12 months to turn it around or they were closing the doors. This episode is the story of what actually moved the needle, and it wasn't more grants. It was a question. Jill stopped asking "how do we get more funding?" and started asking "why is our business model built to need it?" From there she walks through the four levers she now teaches in every framework - increase and diversify recurring revenue, reduce costs while increasing productivity, build market presence, and retain patients through exceptional care - and the guilt that sits underneath all of it: the belief that profit is greed and that serving the poor means staying poor. The turnaround took grant dependency from 62.5% of the budget down to 17%, grew the insured patient line 20% year after year, and put millions in reserves after a near-million-dollar deficit. And it expanded access for everyone, insured and uninsured. If you're a health center leader who's been cutting staff, services, and sites because there's nothing left to cut, this one is for you. Highlights: What Jill walked into: a near-million-dollar deficit, 42% uninsured, 37% turnover, a closed dental clinic, and five years without a successful provider recruitmentWhy the board's 12-month ultimatum changed how she thought about the problemThe epiphany - swapping "how do we get more funding?" for "why does our model need it?"The mindset that keeps health centers stuck: profit is greed, we serve the poor so we must be poorLever 1: increase and diversify revenue - specifically recurring revenue you controlLever 2: reduce costs while increasing productivity, without asking providers to do more with lessLever 3: build a real market presence, not "hey, can the front desk run our Instagram?"Lever 4: retain patients through exceptional care, because retention is cheaper than acquisitionThe results: 62.5% grant dependency down to 17%, 20% annual growth in insured patients, millions in reservesOne CEO who opened an in-house pharmacy and added over $2 million in annual revenue Quotes from the episode: "This is a very slow-turning ship, but it is a ship that can course correct.""We can't make a profit, we're a nonprofit. We serve the underserved. We have to be poor because we serve the poor.""My argument has always been no margin, no mission. If your doors are closed, we couldn't serve anyone.""I'm not really a financial person, I'm a business model person.""Why is our business model built to need those federal programs and those federal grants?" Mentioned in this episode: Free webinar with Steve Weinman - Friday, September 11 at 10:00 a.m. Pacific / 1:00 p.m. Eastern. Jill and Steve go deeper on the turnaround story and walk through how to pull all four levers at your own health center. https://webinar.fqhc-ceo.com/register FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    From 62.5% to 17%: The Four Levers That Turned My Health Center Around

  7. Aug 26

    You Didn't Lose Control. You Lost Line of Sight.

    The Community Health Collective Podcast Have you ever felt like you lost line of sight on something in your health center? Not that anything is wrong, exactly - you couldn't point at a problem if someone asked you to. It's quieter than that. There's a part of your organization you used to watch closely, and somewhere along the way you stopped, and you can't remember the day that changed. In this episode Jill names that feeling and gives it a diagnosis: a closed loop, where the only person who can see the work is the person doing the work. She walks through the four signs you've got one, the two doors closed loops form through (tenure and relief, and neither one is malice), what they actually cost in dollars and in time-to-detection, and the two fixes that don't require you to confront anybody. The counter-intuitive part lands near the end - a closed loop doesn't just hide information from you, it makes asking about the information feel like an accusation, and that's what keeps it closed. If you've ever caught yourself rehearsing how to ask your own team a question you're entitled to ask, this one is for you. Highlights: The four signs you've quietly lost line of sight on part of your organizationWhy "everything looks fine" is not evidence of anythingThe two doors a closed loop forms through - tenure and relief - and why neither one is anybody's faultWhy your HRSA site visit, your annual financial audit, and your monthly financials are not the oversight you think they areDelegation versus abdication, and how to tell them apart before month 18Time to detection: the number nobody counts, and why it's the one that decides what a problem costs youThe two-part fix - outside eyes on a schedule, and a line-of-sight floor you set for every functionWhat to ask your team this week, and the sentence to finish on a blank page by yourself Quotes from the episode: "A closed loop always reports that everything is fine. Not because anyone is being nefarious or anyone is lying, but because that's structurally the only report it's capable of producing.""You don't have oversight. You have a very well-designed window with a view somebody else selected.""Delegation is handing off the work. Abdication is handing off the visibility. Those look identical for six, twelve, eighteen months, but then they stop, and it's usually at a very bad moment.""It doesn't just hide the information, it makes asking about the information feel like an accusation.""You can't read the label if you're in the bottle."Mentioned in this episode: Matt Stevens, an attorney who does outside general counsel work for health centers and a guest presenter in the FQHC CEO Connect Bootcamp. FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    You Didn't Lose Control. You Lost Line of Sight.

  8. Aug 19

    A CFO Told a Room Full of Health Centers That Every Visit Should Be 30 Minutes

    A FQHC CEO Bootcamp member came back from a CFO training with a story that wouldn't leave Jill alone. Another CFO in the room - a peer, from a health center just like hers - told the whole group that every single visit should be 30 minutes. No caveats. And a room full of leaders who came to that training eager to learn "best practices." That's how a bad standard gets laundered into a best practice: somebody says it with confidence, with a title next to their name, and 18 months later it's just how we've always done it and nobody can tell you where it came from. In this solo episode Jill takes the whole thing apart - starting with the math nobody in that room ran (a 7.5-hour clinic day holds 15 patients at 30 minutes and 22 at 20, which is roughly $300,000 of capacity per provider per year), moving through the two places a universal 30-minute template actually comes from, and landing on the reframe that changes the conversation: shorter doesn't mean more rushed, shorter means better supported. She's clear that some visits genuinely need 40 minutes, and equally clear that those should be a slot type, not the entire template. If your standard slot is 30 minutes and your visits per day are sitting in the teens, this one is for you - because you don't have a provider problem, you have a template problem, and it's the cheapest problem on your whole list. Highlights: Why a 30-minute standard is a capacity decision, not a clinical one - and what it quietly capsThe math on one full-time provider: 15 visits versus 22, seven a day, ~1,500 visits and ~$300,000 of capacity a yearThe federal productivity standard (4,200 visits per physician, 2,100 per mid-level) that a 30-minute template mathematically guarantees you'll missThe two places a universal 30-minute template actually comes from, and why both feel reasonableSteve Weinman on the "my panel is sicker than everybody else's" problem - and why they can't all be rightNine minutes in the EHR for every 15 minutes with a patient, plus the hour and a half of pajama timeWhy the order matters: build the support first, then shorten the slotThe three visit types that genuinely earn 40 minutesThree things to look for when you pull up your appointment templateThe one-thing homework: count your slot lengths, then put your visits-per-day number next to it Quotes from the episode: "A 30-minute standard is not a clinical decision. It's a capacity decision, and most of the people making that decision haven't really done the math on what it costs." "Shorter doesn't mean more rushed. Shorter means better supported." "The long visit should be a slot type. It should not be the entire template." "Somebody says it at a training, it gets repeated in a hallway, then in a leadership meeting back home, and by the time it reaches your actual scheduling template, it carries the weight of a best practice. But it was just what one health center is doing." Mentioned in this episode: FQHC CEO Connect Bootcamp. A 5-month program that helps you build a profitable, reputable health center easier and FASTER than figuring it out alone. Enrollment is now open: www.fqhc-ceo.com Get in touch with Jill: jill@jillsteeley.com or schedule a call with her here.

    A CFO Told a Room Full of Health Centers That Every Visit Should Be 30 Minutes
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Ratings & Reviews

5
out of 5
2 Ratings

About

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.

Information

  • Creator
    Jill Steeley
  • Years Active
    2025 - 2026
  • Episodes
    49
  • Rating
    Clean
  • Copyright
    © Copyright 2026 Jill Steeley
  • Show Website
    Community Health Collective

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