MHA is collecting stories about hospitals’ health improvement efforts. Please share examples of how your hospital or health system is working to implement your community health needs assessment or partnering with local organizations to address health challenges locally.

When you share stories on social media, please use the hashtag #MoHospitalsCare to help us identify and amplify your efforts. In addition to sharing on social media, we’ll include select stories in our multimedia campaign to broaden awareness at MissouriHealthMatters.org.

MHA is collecting stories about hospitals’ health improvement efforts. Please share examples of how your hospital or health system is working to implement your community health needs assessment or partnering with local organizations to address health challenges locally.

When you share stories on social media, please use the hashtag #MoHospitalsCare to help us identify and amplify your efforts. In addition to sharing on social media, we’ll include select stories in our multimedia campaign to broaden awareness at MissouriHealthMatters.org.

MHA is collecting stories about hospitals’ health improvement efforts. Please share examples of how your hospital or health system is working to implement your community health needs assessment or partnering with local organizations to address health challenges locally.

When you share stories on social media, please use the hashtag #MoHospitalsCare to help us identify and amplify your efforts. In addition to sharing on social media, we’ll include select stories in our multimedia campaign to broaden awareness at MissouriHealthMatters.com.

Across Missouri and the nation, hospitals use community health needs assessments as an integral tool to identify local challenges, engage community partners and develop programs that improve health — both inside and beyond the hospital’s walls.

CHNAs identify care opportunities

To be treated as a nonprofit, hospitals must meet additional requirements including conducting a CHNA every three years and adopting an implementation strategy to meet community health needs identified in the assessment.

A CHNA is more than a regulatory requirement, according to Stephen Njenga, director of quality measurement and population health improvement at the Missouri Hospital Association, as these assessments seek to identify care gaps and opportunities that exist within each community, shaping the health and well-being of people.

“Every community is different because those in the community have varying levels of resources,” Njenga said.

CHNAs can be “eye opening” for hospital and health system leaders as they learn about factors outside of their hospital that can impact or interfere with their patients’ health, added Njenga, who works with Missouri hospitals as they develop their CHNAs.

The role of data in CHNAs

CHNAs are driven by both robust data and community engagement. With support from the Hospital Industry Data Institute, MHA’s data company, Missouri hospitals have access to cutting-edge tools that help identify strategies they can implement to close care gaps.

Two of those platforms include the exploreMOhealth.org website, HIDI’s flagship CHNA platform, and health data on MissouriHealthMatters.com , where hospitals can identify differences in the prevalence of diseases among different population segments, said Mat Reidhead, MHA’s vice president of research and analytics.

MHA and HIDI also offer hospital-specific Determinants of Health Dashboards, “where you can drill down to actual patients who experienced X, Y or Z — both in your health care setting and across any hospital setting in the state,” Reidhead said.

This data allow hospitals to determine what health needs and nonmedical factors are most acute in their communities for various segments of their patient population.

Connecting the data to the people who live, work, play and learn in the communities served by hospitals can provide important context, Njenga added.

Community forums with people who are representative of the hospital’s service area are often used in the CHNA process, ensuring different voices are heard, Njenga said. These individuals can offer insight on whether the presented data reflects real issues. Their firsthand knowledge of local challenges, demographics and available resources is essential.

From assessment to action

One example of how data provided by HIDI and a CHNA came together to benefit Missourians occurred at Barnes-Jewish Hospital in St. Louis. The hospital’s emergency department was seeing high rates of usage among patients experiencing severe behavioral health conditions that were exacerbated by housing instability, Reidhead said.

In response, Barnes-Jewish Hospital launched the Hospital to Housing program as a behavioral health priority area in the hospital’s CHNA. When the hospital partnered with St. Patrick Center and Living in Victory Recovery Sober Living to provide transitional housing to these individuals, emergency department utilization fell by half, resulting in a significant drop in overall health care spending.

The program illustrates how addressing nonmedical needs, like housing, can improve health outcomes, reduce hospital utilization, and according to a formal evaluation conducted by MHA, induce significant savings across the health care system.

While the robust return on investment created by the H2H program is critical to demonstrate when engaging payers and policy makers, the crux of the program is in its transformative effects on human lives, and that’s a beautiful thing that’s hard to quantify, Reidhead said.

At smaller hospitals in Missouri, Njenga has seen similar needs, such as food insecurity, being addressed through CHNAs. For instance, when one hospital identified patients who needed help with meals, staff responded by immediately providing food bags to meet patients’ short-term needs. Then, patients were connected with local food pantries and community resources to ensure they received ongoing access to food.

CHNA resources for hospitals

From CHNA templates to guidance and implementation strategies, MHA’s website offers many resources to assist hospitals with these assessments.

The webpage also includes 10 priority health issues commonly found in CHNAs from Missouri hospitals. They include mental health, substance use, obesity, access to care, diabetes, chronic conditions, affordable health care, the COVID-19 pandemic, heart disease and the unhoused.

In addition, Quality Works, a subsidiary of MHA, can provide hospitals with customized services for CHNAs, including primary and secondary data collection and analysis, facilitation of community input, survey design, writing the assessment and development of an implementation plan.

To learn more, listen to this episode of MHA’s PolicyHuddle podcast as Njenga and Reidhead discuss the tools and processes of successful CHNAs.

MHA embarked on a campaign to share hospitals’ community health-related stories from throughout the state.

Today, MHA launched the first — a video spotlighting the Hospital to Housing program supported by BJC HealthCare and Barnes-Jewish Hospital in St. Louis, and St. Louis social services agencies St. Patrick Center and LIV Recovery Sober Living. The program employs a long-range, multipronged approach designed to help people with complex, interrelated needs find housing and achieve better health.

To reach more Missourians and connect them to the good work going on in your community and throughout the state, MHA needs your community benefit stories. Please share examples of how your hospital or health system is working to implement your community health needs assessment or partnering with local organizations to address health challenges locally.

When you share stories on social media, please use the hashtag #MoHospitalsCare to help us identify and amplify your efforts. In addition to sharing on social media, we’ll include select stories in our multimedia campaign to broaden awareness at MissouriHealthMatters.com.

Missourians benefited from more than $2.25 billion in unpaid care in 2023 thanks to the charitable service commitments of Missouri’s hospitals and health systems. New data released by the Missouri Hospital Association underscores these hospitals’ commitment to individual and community health improvement and demonstrates their foundational service as a health care safety net for all Missourians. The data, which aggregates community benefit totals statewide and includes individual hospitals’ contributions to their communities, is available on MHA’s consumer-focused website, FocusOnHospitals.com.

In 2023, the 128 reporting  hospitals provided $677 million in care to individuals who could not afford their care and $389 million in billed services that were never paid. These costs, known as uncompensated care, represented $1.06 billion in unpaid care costs provided to Missourians.

In addition, 82 reporting hospitals absorbed more than $1.2 billion in unreimbursed costs for care provided to enrollees in Medicare and Medicaid — more than $811 million in Medicaid and $440 million in Medicare. That’s because Medicare and Medicaid represent a significant share of patient coverage in Missouri. Medicare beneficiaries account for half of all care provided in hospitals, and an additional 18% of care is provided to those covered by Medicaid. Medicaid covers approximately 40% of births and children in Missouri. However, both programs reimburse hospitals for services at less than the actual cost of providing care. According to the federal Medicare Payment Advisory Commission, for each dollar of cost incurred to care for a Medicare beneficiary, Medicare pays 87 cents while Medicaid pays even less.

These data demonstrate hospitals’ commitment to providing a health care safety net for Missourians. Missourians are served every day through hospitals’ delivery of no- and low-cost care. Ongoing federal policy discussions related to the nation’s health care system — specifically funding cuts to Medicare and Medicaid — could result in shifting even greater cost portions for care under the programs to hospitals. Cuts to these programs could harm all Missourians’ access to care and influence the number of hospitals and providers available to serve them.

“The state’s hospitals are mission focused,” said Jon D. Doolittle, MHA president and CEO. “Providing care for individuals who don’t have insurance, or the ability to pay for their care, is a significant component of how hospitals serve their communities.”

Hospitals benefit their patients and communities beyond care costs. In 2023, hospitals contributed more than $413 million to the education and training of the health care workforce and donated $32 million to local causes. 

When combined with uncompensated care and absorbed costs above reimbursement rates in the Medicaid and Medicare programs, hospitals’ investments are known as community benefit. In 2023, hospitals provided more than $2.7 billion in total community benefit.

According to Doolittle, the numbers only demonstrate a part of the value of hospitals’ work. Hospitals engage in significant community-specific health improvement efforts that don’t fit neatly into an IRS reporting category.

“Health improvement activities are upstream of hospital care,” Doolittle said. “That means Missouri’s hospitals invest in prevention and chronic disease management to reduce the need for care. In addition, they assess community health to identify systems and projects that support wellness communitywide. This work reduces poor health and its associated costs, while — most importantly — improving lives.”

Hospitals Add Economic Value

The value of hospitals extends beyond their role in care delivery. From the state’s largest cities to its small towns, hospitals and health systems often are the largest employers. Locally and statewide, hospitals and hospital employees provide a ripple of economic activity that contributes to economic stability, and both supports and attracts jobs and businesses.

Doolittle noted our state’s hospitals provide a measurable economic boost in the communities they serve — through payroll and benefits, capital investments and community leadership.

In 2023, Missouri hospitals employed more than 152,000 workers and invested nearly $1.7 billion in various capital improvement projects in their communities. These community investments help strengthen the health care system. They also create household income, opportunities to support and build businesses, and revenue for state and local governments.

“Hospitals are essential, community-focused organizations. Again this year, hospitals improved the physical and economic health of the people and communities they served,” Doolittle said. “Producing these numbers are 150,000-plus hospital team members committed to delivering lifesaving care, improving health and making their communities better. We all should celebrate and thank them for their work.”

In 2023, Missouri’s hospitals provided more than $1 billion in uncompensated care and $2.7 billion in total community benefit, according to new data available on MHA’s public transparency site, FocusOnHospitals.com. Missourians can review the contributions of 128 hospitals and access statewide community benefit and investment totals on the site. 

The combined totals of $677 million in charity care and $389 million in bad debt equaled just more than $1 billion in total uncompensated care in 2023. In addition, 82 hospitals reported absorbed unreimbursed costs of more than $811 million in Medicaid and $440 million in Medicare, contributed more than $413 million to the education and training of the health care workforce, and donated $32 million to local causes. When combined with uncompensated care, these investments totaled more than $2.7 billion.

“These data are an important part of demonstrating the significant value of the state’s hospitals,” said Jon D. Doolittle, MHA President and CEO. “They should reinforce people’s correct intuition that hospitals provide extraordinary care and great careers while also providing a wide variety of additional community contributions.”

MHA is collecting stories that demonstrate how hospitals are essential to improving health in the communities they serve. Please share examples of how you are working to implement your community health needs assessments or partnering with local organizations to address health challenges locally. When you are sharing good news on social media, please use #MoHospitals to join the conversation and help us identify stories to amplify your reach.

A background document on the data is available.  

The more stakeholders know about the factors that influence health, the better hospitals and health systems — and their partners in public health and community-based organizations — can identify, manage and mitigate them.  

Resources for health improvement are often constrained. Data, including the robust ZIP code-level access to community health insights available on exploremohealth.org, can shape stakeholders’ investments and maximize the value of community and public health initiatives.  

In concert with National Public Health Week, the Missouri Hospital Association refreshed exploreMOhealth as of April 8. 

What is exploreMOhealth? 

Launched in 2018 with support from MHA, exploreMOhealth is a community data platform created to provide ZIP code-level rankings across major health behaviors and health outcomes to illuminate high-risk communities at the subcounty level.  

The platform features demographic data from the U.S. census and hospital discharge data specific to Missouri. The county-level health indicators are provided by County Health Rankings & Roadmaps. The ZIP code-level data are provided by the Hospital Industry Data Institute and Washington University School of Medicine through the Missouri ZIP Health Rankings Project. 

The ZIP code-level data included in the most recent updates on the exploreMOhealth platform are based on hospital discharges that occurred between fiscal years 2022 and 2024 (Oct. 1, 2021, through Sept. 30, 2024), and the 2023 American Community Survey of the U.S. census. 

These free, publicly available resources on exploreMOhealth are intended to help communities, hospitals, public health officials and other stakeholders identify local health needs by ZIP code or county, and to develop health needs assessments and actionable plans to improve public health. Data is the key to diagnosing and addressing the most pressing health issues. 

How hospitals can use exploreMOhealth 

With the detailed data available on the exploreMOhealth platform, hospital and health care leaders and providers can make informed decisions about serving their communities. 

The platform allows hospitals to develop comprehensive and customized community health needs assessments and offers summaries of leading health factors in different-sized communities through reports, such as the Chronic Condition Explorer, Missouri Health Atlas and Spotlight on ZIP Health. 

“Most of the hospitals that use exploreMOhealth are able to identify where gaps exist at a ZIP code level in the communities they serve and opportunities to close those gaps, using the power of data,” said Stephen Njenga, MHA’s director of quality measurement and population health improvement. 

Njenga added that this detailed level of information helps care providers target scarce resources where they are needed the most as opposed to implementing a blanket approach, hoping that it will work for the entire service area. 

Changes to exploreMOhealth for 2025 

In addition to new data, the site also has a refreshed look, along with some notable changes made to this year’s measurements and methodologies. 

The 2025 update to the Zip Health Rankings includes changes that improve accuracy and align with national standards. 

• Health Factor Domain, Clinical Care Subdomain: The Agency for Healthcare Research and Quality’s five Prevention Quality Indicators for emergency department settings replaced an outdated New York University algorithm for defining potentially avoidable emergency department utilization. 
• Health Outcome Domain, Quality of Life Subdomain: Anemia; anxiety disorders; atrial fibrillation; depression, bipolar or other depressive mood disorders; fibromyalgia and chronic pain and fatigue; hyperlipidemia; and hypothyroidism were added to the 20 most prevalent conditions in Missouri defined using the Centers for Medicare and Medicaid Services Chronic Condition Warehouse, as well as two standalone cancers — endometrial and prostate cancers — not previously included. Additionally, a new measure combines visits for anxiety, depression and inpatient mental health diagnoses. 
• Multiple Domains and Subdomains: Many measures were updated to align with CMS Chronic Condition Warehouse  and Agency for Healthcare Research and Quality Clinical Classifications Software-Refined, replacing older definitions. 

In addition, County Health Rankings & Roadmaps switched from a county rankings approach to a grouping approach in 2024. Counties now are assigned to one of 10 groups for the health outcome and health factors domains.  

The exploreMOhealth platform is available to anyone with an interest in community health at no cost thanks to funding from HIDI and the MHA Health Institute. Setting up an optional account allows users to customize their experience by saving geographic areas, health indicators, customized reports and other features. 

To learn more about exploreMOhealth, visit the FAQ page, or you can email questions to exploreMOhealth@mohospitals.org.