Missouri State Flex Profile

Top Flex Activities

Program Area: Support for Quality Improvement: 

In order to achieve the objectives in this area, the 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 will promote MBQIP and utilize the data for quality improvement activities. Each hospital now has the ability to look at aggregate performance, and most current average performance as a state as well as nationally on the dashboard. It also provides information about rates and how each hospital ranks by state for the most current quarter, last four and eight quarters. 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 now also 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: http://web.mhanet.com/mbqip.aspx 

Program Area: Support for Financial and Operational Improvement: 

The Missouri Flex Program has subcontracted to MHA offer technical assistance in this area. The subcontractors utilize 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's (FMT) CAH Financial Indicator Report (CAHFIR). The CAH Chief Executive Officer (CEO) Network meeting helps guide the financial activities to a select cohort of hospitals that need assistance.

Program Area: Support for Population Health Management and Emergency Medical Services Integration: 

The Flex Program is contracting with MHA to conduct population health activities. Together the Flex Program and MHA will conduct an assessment of the population health needs gathering information from the CAHs' community health needs assessments (CHNAs), FMT and the Missouri Department of Health's Missouri Information for community assessment tool. MHA will provide education and health prevention activities by identifying common community health issues and work with participating CAHs to develop and implement strategies. They will also develop and distribute chronic care management toolkits to address common community health issues. 

Please provide information about Collaboration/Shared Services (specifically connected to population health management): 

MHA and the State Office of Rural Health 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 next year.

Program Area: Support for Designation of CAHs: 

The Flex Program will provide technical assistance to rural communities or hospitals seeking CAH status or conversion to CAH status.

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.

Please provide information about network activities in your state to support Flex Program activities (such as financial improvement networks, CAH quality networks, operational improvement with CEOs or EHR workgroups): 

MHA hosts a CAH CEO Network meeting monthly. This forum is used to decide what activities the Flex activities should focus on as well as identifying needs of the CAHs.

From the last Flex Program year, please describe a best practice you would like to share with other states: 

Contracting with the MHA has doubled the capacity of the Missouri Flex Program. The MHA has resources and is aligned to fulfill the activities of the Flex grant. They have a Quality Improvement Unit that has incorporated MBQIP into the rest of the quality improvement initiatives making the use more meaningful and seamless. They have access to the financial and operational data and resources to make the Flex dollars stretch further.

Program Statistics

What type of organization is your Flex office housed in?: 
State Government
What is the number of full time employees (FTE) in your Flex office?: 
How many CAHs are in your state?: 
Do you have any hospitals interested in converting to CAH status?: 

Additional Information

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

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.