Missouri Department of Health and Senior Services - Office of Rural Health
Top Flex Activities
CAH Quality Improvement
In order to achieve the critical access hospitals (CAHs) quality improvement objectives, the Missouri Medicare Rural Hospital Flexibility (Flex) Program utilizes a contractor to provide technical assistance for the Medicare Beneficiary Quality Improvement Project (MBQIP), utilizing webinars, conference calls, site visits, in-person training, regional training, and one statewide training annually.
Missouri CAHs have access to a dashboard that promotes MBQIP and utilizes quality data for improvement activities. Each hospital has the ability to view aggregate performance as well as the most current performance averages for the state and nation on the dashboard. The data collected is used to drive performance improvement in a variety of ways. The Missouri Flex Program contacts and assists low performing hospitals in regards to the identified gaps and addresses best practice strategies. A swing bed benchmarking project provides CAHs with access to a web-based application supporting national CAH Swing Bed performance improvement. Through facilitated peer to peer discussions, CAH participants foster relationships and share best practices on Core MBQIP measures. Additionally, regional meetings are hosted and attendees actively participate and network with others who might be struggling in the same areas. The main focus is increased reporting for MBQIP measures and continuous improvement has helped increase the number of hospitals reporting on such measures.
CAH Operational and Financial Improvement
The Missouri Flex Program utilizes a contractor to offer operational and financial technical assistance. Utilizing the Flex Monitoring Team Financial Indicator Report, struggling CAHs are identified and provided targeted technical assistance. Trainings and webinars are provided on new payment and care delivery models, how to improve revenue management and processes, and board education and leadership. Billing and coding education is provided to improve the understanding, compliance, and identify areas of improvement and increased productivity.
CAH Population Health Improvement
The Missouri Flex Program utilizes a contractor to conduct population health activities, such as providing education and health prevention activities based on common community health issues identified and working with participating CAHs to develop and implement strategies. In 2020, a comprehensive population health assessment survey was conducted with all Missouri hospitals. The survey covered nine categories: leadership, patients and community, workforce, finance, data and technology, operations, legal/regulatory, outcomes, and policy/advocacy. The results were tabulated and mapped to a maturity scale comprised of five categories: Pre-Foundational 1, Pre-Foundational 2, Foundational, Proficient, and Transformational. Furthermore, additional individualized reports were developed indicating overall performance for each of the nine categories and identified each CAH’s position on the maturity scale.
Results were shared with each hospital's leadership to help them better understand the necessary tools and resources, interventions, and targeted support that is needed to close the gaps identified. Key strategies were also developed to deploy, in relation to the category, where they landed on the population health maturity scale.
Innovative Model Development
The Missouri Flex Program utilized a contractor to offer technical assistance to CAHs to develop and test innovative models. An innovative model for transportation has been developed. The Telemedicine Innovative Model cohort has been established for the 2020-2021 grant year.
Please provide information about network activities in your state to support Flex Program activities.
The Missouri Flex Program hosts a CAH CEO network meeting annually. This forum is used to identify the needs of the CAHs and decide what activities the Missouri Flex Program should focus on. Additionally, three regional meetings are hosted in the spring and fall, and CAHs are also encouraged to attend the Annual Flex Meeting in August, which encompasses a variety of topics that include quality and financial improvement.
|Type of Organization||State Government|
|Number of CAHs||35|