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Missouri Department of Health and Senior Services

Top Flex Activities

Program Area: Support for Quality Improvement

In order to achieve the objectives in this area, the Missouri Flex Program has contracted with the Missouri Hospital Association (MHA) to offer technical assistance. MHA offers technical assistance for the Medicare Beneficiary Quality Improvement Project (MBQIP) utilizing webinars, conference calls, in-person trainings, regional trainings and one statewide training annually.

MHA has built a dashboard for critical access hospitals (CAHs) that promotes MBQIP and utilizes quality data for improvement activities. Each hospital has the ability to look at aggregate performance as well as the most current performance averages for the state and nation on the dashboard. The dashboard also provides information about rates and how each hospital ranks in the most current quarter and the past four and eight quarters, respectively. Lastly, the dashboard provides charts for the rate of each measure against the rate of other hospitals in the state and nationally. The new report will begin including whether or not the change in the measure was statistically significant.

Please share a success story about reporting quality data or using quality data to help Critical Access Hospitals (CAHs) in your state improve patient care

Success stories are shared on the MHA Flex website.

Program Area: Support for Financial and Operational Improvement

The Missouri Flex Program has subcontracted to MHA offer technical assistance in this area. The subcontractor utilizes information from their annual financial report, Stress Test, as a guide to provide technical assistance and training to participating hospitals. The information gathered is from MHA's Management and Productivity Report, Annual Licensing Survey, Cost Report information, a consulting firm's 2014 assessment and the Flex Monitoring Team (FMT) CAH Financial Indicator Report (CAHFIR).

The CAH CEO Network meeting helps guide the financial activities for a select cohort of hospitals that need assistance.

Program Area: Support for Population Health Management and EMS Integration

The Flex Program contracts with MHA to conduct population health activities. Together, the Flex Program and MHA conduct an assessment of the population health needs using information from the CAHs' community health needs assessments (CHNAs), FMT and the Missouri Department of Health's Missouri Information for Community Assessment (MICA) tool. MHA provides education and health prevention activities based on common community health issues identified, including developing and distributing chronic care management toolkits, and works with participating CAHs to develop and implement strategies.

Please provide information about Collaboration/Shared Services

MHA and the State Office of Rural Health (SORH) completed a CHNA assessment which identified gaps in the implementation plans of hospitals as well as some common areas to address for population health activities in the coming year. MHA has been working with the Section for Community Health Services and Initiatives within the Missouri Department of Health and Senior Services in addressing implementation of activities. MHA has also developed a Population Health website to assist hospitals in locating resources for CHNAs and implementation of activities.

Please provide information about any efforts to assist CAHs/communities and partner organizations in the transition to value-based care.

MHA offers a wide variety of training opportunities for the hospitals. The Flex Program supports these training opportunities for the CAHs.

MHA Quality and Health Improvement page

MHA Events Calendar

Please provide information about network activities in your state to support Flex Program activities.

MHA hosts a CAH Chief Executive Officer (CEO) Network meeting monthly. This forum is used to identify needs of the CAHs and decide what activities the Missouri Flex Program should focus on.

Please describe how your state Flex Program has enhanced its use of data in the past year.

Along with utilizing the resources available to all Flex Programs such as the MBQIP Data Reports, FMT and the Critical Acces Hospital Measurement and Performance Assessment System (CAHMPAS), the Missouri Flex Program, through the contract with MHA, has aligned resources with MHA's Quality Improvement Unit which can analyze MBQIP data. MHA has access to the financial and operational data reporting by the hospitals and other resources to make the Flex dollars stretch further. 

Program Statistics

Type of Organization State Government
Staffing 5.0 FTEs
Number of CAHs 36
Website URL

Missouri Department of Health & Senior Services - Rural Community Health

Missouri Hospital Association - Flex Program

Flex Program Staff

Melissa Van Dyne
State Office Director and Flex Coordinator, Missouri
(573) 526-9687

State Office Director and Flex Coordinator since April 2013

Sherry Buschjost
Director of Quality Services, Missouri
(573) 893-3700

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,100,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.