Missouri's new rural health program addresses upstream factors of health

The Missouri Department of Social Services has approved the implementation of a new pilot project targeting rural health care.

The Transformation of Rural Community Health program aims to go beyond treating patients when they get sick, but to address social challenges that make it difficult for people to maintain their health or manage chronic conditions, according to a news release from the department. It has been in development since 2021.

Six rural hospitals will lead the way in joining this new program. These health care facilities include Salem Memorial District Hospital in Salem, Golden Valley Memorial Healthcare in Clinton, Bothwell Regional Health Center in Sedalia, Phelps Health in Rolla, Citizens Memorial Hospital in Bolivar and Ray County Memorial Hospital in Richmond, according to the news release.

These hospitals will act as community hubs, where they will collaborate with other community organizations and partners to address health-related social needs and other social determinants of health, the news release added. These partners include primary care and behavioral health clinics, as well as other social service providers in those counties.

Social determinants of health comprise of the environment in which individuals are born, grow, learn, work, play, worship and age. The news release listed examples such as safe housing, transportation, access to nutritious food and opportunities for physical activity.

"For too long, our payment systems have failed to reward hospitals for efforts to address some of the root causes of poor health," the department's MO HealthNet Division Chief Transformation Officer Kirk Mathews stated in the news release, adding that this project "allows hospitals to receive payment for proactively addressing issues that contribute to poor health outcomes."

Under this initiative, hospitals and their partners will be able to share resources, send referrals and ensure completion of referrals on an online platform. With that software, program participants can provide services like transportation and meal delivery to patients. Missouri Medicaid money will help finance the participants' staff, monitor data and convene a local hospital leadership board to oversee the initiative's operations.

The release added the pilot initiative's goals are to lower the rates of avoidable hospitalization, decrease rates of avoidable emergency department visits and reduce hospital utilizations of Medicaid recipients. The department hopes that as a result, the program will help rural hospitals save costs and sustain operations.

Rural hospitals in Missouri have been closing down because of insufficient funding, Missouri Rural Health Association's Executive Director Heidi Lucas said in February. Around 40 percent of all such facilities are at risk of closing, according to a report from the association released this year.

"This (Transformation of Rural Community Health) model perfectly aligns with our overarching goals for the Medicaid program. We believe this innovative approach will empower our partner communities to focus on improving health outcomes, and in doing so it will lower overall costs to the (Medicaid) program," Todd Richardson, the department's Director, stated in the release.