“Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up the other; but woe to one who is alone and falls and does not have another to help.”
A Note From Jon Doolittle
It has been a difficult year. However, hospitals have met challenges head-on, protecting and saving lives, during a period of great uncertainty. We’ve done this together.
I am reminded of a passage from the bible — Ecclesiastes 4:9-12. “Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up the other; but woe to one who is alone and falls and does not have another to help.”
Collaboration is essential to a hospital’s mission. On a good day, we all are virtuosos in the moment of care or our place in the care process. But, in our complex organizations, we never are alone in our work. We always are a care team — from the surgeon and the surgery team, to nurses, imaging and laboratory technicians, dieticians, environmental services staff and auxilians who create spaces for healing to happen.
In 2021, this truth extends not only to our hospitals and health systems; it extends to our entire community of hospitals. COVID-19 has demonstrated our interdependence — we are connected. Moreover, it is true for the connections between hospitals and the Missouri Hospital Association.
I began the year as a small hospital CEO within a larger health system. I am closing the year as the CEO of MHA. From both perspectives, I have seen how MHA helps “lift us up” through connection. MHA leads advocacy efforts in the interest of hospitals, certainly. But it goes far beyond that. MHA helps hospitals manage operations, care for patients and serve our communities.
MHA is both a toolbox and a forum for hospital leaders. It’s a place to connect policies with progress and information with ideas that make a difference.
This report is a reminder that the connections we have with and through MHA matter.
Thank you for your continued support and partnership.
Jon D. Doolittle
MHA President and CEO
A printable PDF of MHA’s 2021 Report of Accomplishments is available.
Approximately one in six Missourians benefit from Medicaid coverage. Our collective efforts to support state funding for Medicaid and build coverage helps improve health statewide.
In 2021, Medicaid policy loomed large during the state legislative session. Although funding for the expansion population was not included in the budget that was adopted by lawmakers, two “stabilization funds” for the Medicaid program — totaling $1 billion — were included in the final budget. Expansion was accomplished mid-year through the courts, and the stabilization funds, federal incentives for nonexpansion states to participate and enhanced federal match, among other factors, are sufficient to cover the state’s share of expansion costs subsidized for the remainder of the decade.
Hospitals will benefit from an additional $258 million in Federal Reimbursement Allowance-supported Medicaid Disproportionate Share Hospital payments in 2022. MHA worked hard to secure this added payment, which ensures that hospitals receive their full measure of federal DSH funds.
Although Medicaid reform, funding and expansion overshadowed other issues, progress was made on various important fronts. COVID-19 liability protections were put in place to shield health care providers and businesses from lawsuits; a statewide prescription drug monitoring program was authorized; and other health care-related legislation on issues such as workplace violence and behavioral health were adopted.
MHA continues to engage with federal lawmakers and the Biden administration to shape COVID-19 response and recovery. MHA also is working with federal partners to ensure relief payment recoupment doesn’t damage vulnerable hospitals’ financials, placing these hospitals and local health access in jeopardy. Without federal support, many hospitals would have incurred a negative operating margin during COVID-19 response.
The association is working with state and federal partners to extend appropriate COVID-19 waivers to allow hospitals agility in responding to the pandemic.
MHA helped hospitals react to COVID-19 dynamically, resulting in improved outcomes and reduced loss of life. This included removing regulatory roadblocks during the public health emergency, and coordination with hospitals and other stakeholders to build momentum toward full recovery through vaccination and large-scale immunity.
Throughout 2021, hospitals continued to care for the communities they serve. Despite the pandemic, many other MHA-supported efforts to produce highly efficient, safe and reliable organizations continued.
MHA is a primary partner with the Alliance for Innovation on Maternal Health and the Maternal-Child Learning and Action Network to reduce the state’s high rate of maternal mortality and pregnancy-related harm. Alongside hospitals, the state and stakeholders, MHA is working to improve adherence to evidence-based care and support to reduce harm during, after and between pregnancies.
MHA partnered with the Missouri Attorney General’s Office to deliver resources for hospitals to identify and reduce human trafficking. Through the partnership, hospitals can utilize a comprehensive toolkit to guide efforts and access web-based video training modules to support hospital workforce education.
Data underpins decision-making. Delivery of high-value, actionable data is an MHA and Hospital Industry Data Institute core competency. Throughout the COVID-19 PHE, HIDI data and analysis informed state and local decisions. Data also supported hospitals operationally as the challenges of reimbursement, disease management, advocacy, and prevention and health improvement intersected.
COVID-19 highlighted the significant structural and cultural barriers to equitable care. In 2021, MHA formed a Health Equity Committee to guide the association’s work to help hospitals provide more equitable and inclusive care to their communities. Part of that work included the release of a suite of four health equity-focused dashboards that offer previously unavailable granularity in health outcomes, health factors and social determinants of health for finite population segments and geographic areas in Missouri. This tool builds on the value of exploreMOhealth.com, an MHA partnership-driven data site, to assist hospitals in connecting community health needs with health equity and community health improvement goals.
For the first time in its 30-year history, the FRA was not reauthorized by the Missouri General Assembly during its regular session. Caught up in legislative debates of abortion policy, the legislation was later enacted in a special session. The FRA underpins the state’s Medicaid program and bonds hospitals together in the cause of coverage. MHA is working to ensure the hospital-to-hospital and MHA-and-state partnerships are strong and sustainable.
The health care workforce — which was facing headwinds before the pandemic — is in jeopardy. MHA continues to provide recruitment and retention tools, including an all-new Missouri Health Careers website. Throughout the pandemic, MHA has continued to collaborate with workforce development stakeholders to encourage investments that expand the pipeline for workers and attract individuals to choose health careers.
COVID-19 forced the health care system to adapt. Throughout the pandemic, telehealth services expanded exponentially. At the same time, the utility of nurse practitioners and other health professionals — working to the full scope of their training — was demonstrated. MHA continues to advocate for normalization of these changes to address the supply and demand gap in health care.
Missouri’s behavioral health and substance use crises have not abated — and likely have worsened — during the pandemic. MHA continues to provide assistance for programs that support and expand access to recovery, and to advocate for investments in a stronger behavioral health system.
MHA is committed to financial stewardship of member resources and value for dues investment. MHA continues to seek opportunities for funding other than dues to support programs that benefit Missouri hospitals and the communities they serve. MHA’s dependence on dues as a percent of total association revenue is among the lowest in the nation. At the same time, the 2020 member-satisfaction scores place MHA among the highest for value.
Strategic investments in the future of the organization continue. MHA is focused on new data products and partnerships, better analytics, support for quality and safety improvement, and unparalleled advocacy for hospitals. The association is committed to ensuring hospitals have both the tools they need to succeed and the policy environment to focus on the efforts that improve not just health care, but health.
MHA’s goal is to help hospitals serve their communities. To achieve this goal, we’re committed to understanding hospitals’ needs, delivering superior value for membership and helping hospitals build the connections to succeed.
Hospitals and health care systems that fulfill their missions,
improve the health of their communities, and are valued
throughout Missouri and the nation.
To create an environment that enables member hospitals
and health care systems to improve the health of their
patients and communities.
The Missouri Hospital Association is committed to
exceptional individual and organizational performance.
The Missouri Hospital Association respects the knowledge,
commitment and diversity of its employees.
The Missouri Hospital Association respects the unique
qualities of its members, their employees and the
communities they serve.
The Missouri Hospital Association strives to understand its
members’ needs and to exceed their expectations.
The Missouri Hospital Association honors the trust of its
members and provides wise stewardship of their resources.