Health systems are trying to steer clear of the Trump administration as it targets diversity, equity and inclusion initiatives.
Some providers are removing DEI language from their annual reports, rethinking titles for leaders and updating programs. Others are still assessing their response.
There may not be one right answer, particularly for healthcare, which finds itself particularly reliant on federal funding.
Related: Inside insurer annual reports: DEI is out, publicity worries are in
Like in other industries, DEI leaders in healthcare already were feeling pressure from a lack of resources and support — especially in Republican-led states — and it increased after President Donald Trump took office in January. Trump quickly signed executive orders to end DEI-related mandates, policies and programs at government agencies. One order directed federal leaders to motivate the private sector to make similar changes.
Earlier this month, the Health and Human Services Department said it was investigating four unnamed medical schools and hospitals on allegations of discrimination. And on Wednesday, the federal government published guidelines on what constitutes DEI-related discrimination and how employees should respond to it.
“Industries and companies are reevaluating their programs and saying, ‘OK, obviously we want everybody to have a fair shot. How can we reword or revamp our programs and policies, so that we’re not incurring the wrath of the presidential administration,’” said Jared Slater, partner at law firm Ervin Cohen & Jessup.
Finding the right approach is a balancing act.
Hospitals have intensified efforts in recent years to promote health equity, in part by recruiting a diverse workforce because research has shown a difference in patient outcomes. But health systems, most of which operate on thin margins, rely heavily on federal funds through the Medicare and Medicaid programs as well as for medical research.
Federal support is already in limbo with proposed Medicaid cuts and mass layoffs across healthcare agencies. Last week, Johns Hopkins University said it plans to lay off more than 200 employees due to federal funding cuts.
To avoid being caught in the crosshairs, many healthcare providers have decided silence is the way to go, at least publicly. More than 15 health systems across the country, in addition to the American Hospital Association, the Federation of American Hospitals and the American Medical Association, contacted for this article declined comment or did not respond to requests for comment on their DEI programs.
Large for-profit health systems, which are required to file annual reports with the Securities and Exchange Commission, have changed DEI language or deleted those references altogether, similar to what large health insurers have done.
Franklin, Tennessee-based Community Health Systems changed a “diversity, equity and inclusion” section in the 2023 annual report to “workforce diversity and competency” for the 2024 report. The system kept language about recruiting and retaining a diverse workforce but removed references to its diversity leadership committee and programs to build diverse talent pipelines.
A CHS spokesperson said the system often updates its disclosures with the most up-to-date and clear information for investors. “These updates may reflect changes in strategy and/or the operating environment or reflect an evolution of our programs,” the spokesperson said.
Health systems and companies are looking at the language they use through a risk management lens, meaning they are reassessing what is important to stakeholders, said Miriam Wrobel, who leads FTI Consulting's environmental, social, governance and sustainability practice.
Nashville, Tennessee-based HCA Healthcare, for example, removed a “diversity, equity and inclusion” section that was in the 2023 annual report, which had outlined commitments to an inclusive culture, diverse hires, employee resource groups and an executive DEI council.
Instead, HCA included a “culture and values” section in its latest report to reflect a newly renamed team that pledges to “foster a culture of compassion and respect.” HCA also changed Sherri Neal’s title from chief diversity officer to chief culture and values officer.
“These changes reflect our ongoing commitment to promoting an environment where everyone feels valued, while also supporting a broader vision of teamwork, respect and shared purpose across all areas of our organization,” a HCA spokesperson said.
Dallas-based Tenet Healthcare also removed a “diversity and inclusion” section that outlined a commitment to hiring from underrepresented populations and the demographic breakdown of its workforce, plus references to the system’s diversity council and resource groups for women, Black, LGBTQ+ and other employees. It did include a "culture" section that referenced a community healthcare engagement council that supports recruitment and talent development.
Tenet did not respond to requests for comment on the changes.
King of Prussia, Pennsylvania-based Universal Health Services kept consistent language from the 2023 annual report, although it did remove a “diversity and inclusion” subheading.
Some health systems are changing titles for DEI leadership. In addition to HCA, Houston Methodist in Texas changed Arianne Dowdell's title from chief DEI officer to chief culture and engagement officer in February. There was no change in her job description or to her team, a spokesperson said.
“Recently, DEI has taken on a new meaning, and we need to rise above that noise and move forward. To do this, we changed the name of our program to better reflect our mission. … Our mission is not changing,” the spokesperson said.
Rush University Medical Center in Chicago categorizes its efforts as DEI and health equity has been a priority for years, a spokesperson said. One example is Rush's work with the American Medical Association's MAP Hypertension program to improve the accuracy and frequency of blood pressure checks on patients in Chicago's West Side.
Rush has not made changes to its programs in response to the executive orders, though it is reviewing the orders to ensure compliance, the spokesperson said.
Renton, Washington-based Providence and Cleveland-based MetroHealth said they are assessing how recent developments under the Trump administration will affect their policies.
Wrobel said clients have found there is no one solution to the current environment.
"There is a variety of what is actually changing and what isn't," Wrobel said. "We're not seeing a lot of companies say that what they were doing before they no longer believe in, so we're not seeing an abrupt change in philosophy. What we're seeing is some tactical changes for the most part aimed at decreasing that political and legal risk."
Dru Bhattacharya, research director with digital health company Canopy Innovations and former chief DEI officer at Banner Health, said he questions senior healthcare leaders' commitment to and understanding of DEI. The people trying to actually implement change have felt isolated for some time, Bhattacharya said.
"Who is really holding folks accountable?" Bhattacharya said. "Ultimately, it boils down to how you value differences and translate that into robust policies and procedures that ensure you have equitable, inclusive environments, and that does not exist right now."
Correction: An earlier version of the story incorrectly said Rush Medical Center does not categorize its efforts as DEI.
