Leaders from Missouri’s critical access hospitals gathered April 15 in Jefferson City, Mo., for a Critical Access Hospital Network meeting hosted by the Missouri Hospital Association. During the full-day meeting, attendees learned about updates on several health care initiatives, met for collaborative discussions and visited with their state lawmakers.

Members of MHA’s senior leadership team provided attendees with updates on the Rural Health Transformation Program and workplace safety. Following a legislative briefing, MHA’s governmental relations team and CAH leaders traveled to the Missouri State Capitol to meet with legislators and discuss sustaining access to care in rural communities.

The CAH Network is an MHA engagement group that supports rural hospitals through education, collaboration and advocacy.

“Meetings like this one reinforce MHA’s commitment to strengthening Missouri’s rural health care system and ensuring that critical access hospitals remain positioned to meet the needs of their communities,” said Nate Blackford, MHA’s senior vice president of membership services.

The following Missouri CAH leaders attended the meeting.

• Don Carpenter, CEO, Cedar County Memorial Hospital
• Karla Clubine, CEO, Pershing Health System
• Valerie Davis, administrator, Mercy Hospital Aurora, Mercy Hospital Carthage and Mercy St. Francis Hospital
• Kristen DeHart, CEO, Excelsior Springs Hospital
• Belinda Farmer, administrator, Mercy Hospital Carthage
• Martha Gragg, CEO, Sullivan County Memorial Hospital
• William Hellebusch, administrator, Hermann Area District Hospital
• Nikki Hendren, COO, Harrison County Community Hospital
• Steve Henson, CEO, Ste. Genevieve County Memorial Hospital
• Chris Lang, CEO, Cass Regional Medical Center
• Lisa Lochner, president, Missouri Baptist Sullivan Hospital
• Michele Meyer, CEO, Washington County Memorial Hospital
• Tylie Mills, CEO, Pike County Memorial Hospital
• Blake Riley, COO, Carroll County Memorial Hospital
• Ann Schlueter, CEO, Community Hospital - Fairfax
• Laura Smith, CEO, Ellett Memorial Hospital
• Meagan Weber, CEO, Scotland County Hospital
• Jill Williams, CEO, Samaritan Hospital

“This award reflects a shared commitment to improving health care access and outcomes for rural Missourians. From the start, the state engaged primary care providers, behavioral health organizations and hospitals, among others, as key partners in shaping a plan that works for the communities we jointly serve. That collaboration is Missouri’s strength — and it’s why our state's ToRCH CARE proposal stood out nationally.”

The leaders said this funding will help stabilize rural hospitals, expand primary and behavioral health services, and build a workforce pipeline to meet local needs. It also invests in technology and data tools that connect care across settings — ensuring patients experience seamless, coordinated services.

In addition to Gov. Kehoe, they also commended the state's Department of Social Services, including Director Jess Bax, for Missouri's uniquely collaborative approach. Missouri’s Transformation of Rural Community Health (ToRCH) CARE model brings together a wide variety of stakeholders, including clinics, behavioral health providers, federally qualified health centers, EMS, hospitals, physicians, other providers, public health and social-service organizations through regional networks and community hubs. This structure fosters shared accountability and innovation, making care more accessible and sustainable.

The state is expected to finalize its cooperative agreement with CMS and launch implementation of the ToRCH CARE model features in early 2026.

“We congratulate Gov. Kehoe’s administration on a visionary and successful application that earned Missouri one of the nation’s top‑10 awards,” Jon Doolittle, MHA President and CEO, said. “We’re grateful the state included MHA and our member hospitals as key stakeholders throughout the process. This investment will help rural Missourians receive high‑quality care in strong, connected local systems — the kind of care that improves lives and sustains communities.”

What this means for rural Missourians
This cooperative agreement gives the robust network of providers in Missouri's health care system additional tools to extend care where people live — primary, maternal and behavioral health services; workforce pipelines; and the digital backbone that ties it all together.

How Missouri will put the funding to work
Missouri’s plan — built around Transformation of Rural Community Health (ToRCH Care) — advances five practical priorities hospitals will recognize:

• Regional networks and community hubs. Seven coordinating networks and dozens of multi-county hubs will align local partners — hospitals, behavioral health providers, clinics, EMS, public health and social‑service organizations, physicians and other providers, among more — to close gaps and keep people healthier.
• Payment models that reward collaboration. Alternative payment approaches will support care coordination and prevention, not just volume, strengthening hospital sustainability.
• Digital backbone. Interoperable tech and data tools — including referral platforms — will simplify handoffs, track outcomes and reduce friction for patients and providers.
• Workforce pathways. Targeted rural workforce programs will recruit, train and retain clinicians and caregivers to meet local needs.
• Provider transformation support. Hospitals can receive financial and technical assistance to stabilize and modernize operations and care delivery — with measurable improvements in access, quality and cost.

What’s next
Missouri’s Department of Social Services will finalize cooperative agreement terms with CMS, then sequence funding for hub activation, workforce initiatives and tech procurement. The state will continue formal engagement with hospitals and partners with MHA actively facilitating hospital input so implementation reflects real‑world needs.

MHA will continue to issue updates and guidance to members on participating in hubs, data and referral workflows, workforce opportunities and hospital transformation resources.

Background
CMS announced awards on Dec. 29, 2025, to every state under the $50 billion Rural Health Transformation Program, with first‑year awards averaging $200 million.

Leaders representing more than a dozen of Missouri's critical access and rural emergency hospitals visited with lawmakers at the Missouri State Capitol in Jefferson City, Mo., on April 10. The full group met with Speaker of the House Jon Patterson, R-Blue Springs, to advocate for legislation to reform insurers’ prior authorization systems. 

The legislation would address delays and denials for providers who have a percentage of high percentage of prior authorization approvals upon appeal. In addition to their visit with Speaker Patterson, the hospital leaders met with their respective lawmakers in the Missouri House and Senate. 

Learn more about our prior authorization advocacy and share your thoughts with lawmakers at MissouriHealthMatters.com.

Attending were leaders from the following hospitals.

• Cedar County Memorial Hospital in El Dorado Springs
• Community Hospital – Fairfax
• Excelsior Springs Hospital
• Harrison County Community Hospital in Bethany
• Hedrick Medical Center in Chillicothe
• Hermann Area District Hospital
• Mercy Hospital Aurora
• Mercy Hospital Cassville
• Mercy St. Francis Hospital in Mountain View
• Missouri Baptist Sullivan Hospital
• Parkland Health Center – Farmington
• Parkland Health Center – Bonne Terre
• Pershing Memorial Hospital in Brookfield
• Pike County Memorial Hospital in Louisiana
• Ray County Hospital in Richmond
• Salem Memorial Hospital
• Samaritan Hospital in Macon
• Scotland County Hospital in Memphis
• Sullivan County Memorial Hospital in Milan
• Wright Memorial Hospital in Trenton