UChicago Medicine Reduces Non-urgent ED Visits by 45% with Patient Advocates

A patient seeking a medication refill visited the emergency department (ED) at UChicago Medicine (UCM), a non-profit academic health system. During the visit, they were connected with the UCM Medical Home and Specialty Care Connection (MHSCC) program. The Urban Health Initiative (UHI) — UCM’s community health department — launched the program about 20 years ago to provide patients who visit the UCM ED in Chicago’s Hyde Park neighborhood for non-urgent reasons with education about primary care resources and help them find medical homes.

The patient communicated during a follow-up call that they were having challenges obtaining the refill through their usual pharmacy. After contacting the ED’s pharmacy and the patient’s regular pharmacy, MHSCC team members resolved the issue and made sure the patient received their medication. They also directed the patient to a primary care physician to manage future refills without relying on the ED.

“Sometimes patients don’t know they can ask questions,” said Melanie Francia, MHSCC patient advocate manager. “We were that voice for that patient.”

That’s just one example of the impact of the MHSCC program. The initiative can serve as a blueprint for providers looking to assist patients who utilize the emergency department for primary care: It succeeded in reducing non-urgent ED visit rates by 45%, preventing approximately 9,487 trips to the ED and saving an estimated $2.9 million during a nine-year period, according to a 2025 study authored by UCM researchers (including Francia).

ED Visits for Non-urgent Issues: A Common Challenge

Low-acuity ED visits are a widespread occurrence for U.S. health care providers: Approximately one-third of ED visits qualify as non-urgent, and those avoidable trips add an estimated $32 billion to annual health care spending, according to a University of Southern Maine policy brief.

Many patients come to the UCM ED for conditions that could be treated better and faster at a community health center, said Laura Markin, executive director of transformation and strategy for the UHI and a co-author of the study on the MHSCC program’s effectiveness. However, she understands why many South Side Chicagoans don’t have another source of care (watch the video).

“It’s generations of residents who, for good reason, have not been able to trust the medical system,” Markin said. “That’s why education is such a huge part of our program, because we want people to understand that there are places in the community that are meant for this, meant for them and will take care of their needs.”

How It Works: Education and Community Effort

Approximately 17% of the patients who visit the UCM ED receive assistance from MHSCC, according to UChicago Medicine. ED providers will ask patients if they have a primary care physician. If the answer is no and the ED provider feels the patient needs support connecting with a primary care provider or specialist for follow-up appointments, they’re referred to the MHSCC program through UCM’s electronic health record (EHR) system, Epic, Francia explained. Patient advocates will then visit the patient's bedside or call to offer help, depending on whether they receive the referral during or after standard business hours.

If the patient accepts assistance, the advocate will ask about their insurance status and social determinants of health such as access to food and transportation.

“We really lean on our community partners to make sure these patients are taken care of outside of the hospital walls,” Francia said.

Advocates educate patients on the importance of establishing a medical “home” for primary care and help make follow-up appointments with primary care physicians and specialists. UCM is part of the South Side Healthy Community Organization (SSHCO), a non-profit funded by the Illinois Department of Healthcare and Family Services. Through the SSHCO, UCM patient advocates can coordinate with other providers (including community hospitals, federally qualified health centers and other health systems) and monitor a patient’s progress as community health workers provide updates via EHR.

Takeaways for Other Providers

For hospitals and health systems that want to similarly reduce low-acuity ED visits, Markin and Francia offered these insights:

• Start small. “It doesn’t have to be a full team,” Markin said. She noted that the MHSCC program expanded to UCM Ingalls Memorial Hospital in Harvey, Illinois, in 2025 and is “making a dent” with just one team member.
• Build trust on common ground. Markin recommends hiring people who understand patient perspectives firsthand. “Our team members often come from the community they serve,” she said. “They understand what the health care system is trying to direct the patient to do, and they understand the barriers the patient is facing.”
• Bridge the gap between clinicians and community members. It helps to have professionally trained advocates who can translate medical terminology. “They can really explain it to the patient in plain language,” Francia said.
• Embrace evolution. “There’s always going to be something that’s shifting,” Markin said. “We have to be flexible and be able to pivot.”

The MHSCC program’s tools and training can also make an impact beyond the ED. For example, UCM is developing a program for pregnant patients at Ingalls Memorial that focuses on establishing a medical home and providing assistance from community health workers.

“We’re using everything we’ve learned through the last 20 years of the program to build out support for other patient populations,” Markin said.