Managing the Mother-Baby Dyad Affected by Substance Disorder: A Statewide Quality Collaborative Initiative.

Neonatal abstinence syndrome (NAS)/Neonatal opioid withdrawal syndrome (NOWS) and substance abuse disorder (SUD) rates are undeniably linked with the outcomes of mothers and babies. This essential relationship emphasizes the importance of quality improvement work done jointly, treating mother and infant as a dyad, not as separate entities. In 2020 the Missouri Hospital Association (MHA) partnered with Show-Me ECHO, a state-funded telehealth project, to initiate a state-wide quality improvement (QI) project to improve and standardize care delivery to the mother-baby dyad affected by SUD.

Supporting the Resilience and Mental Health of Missouri Healthcare Workers Through COVID-19 and Beyond: the Gateway2Wellness Program.

The COVID-19 pandemic is over, but US healthcare workers (HCWs) continue to report high levels of work-related exhaustion and burnout but are unlikely to seek help. Digital tools offer a scalable solution. Between February and June 2022, we surveyed Missouri hospital administrators to assess HCW mental health and identify related evidence-based or evidence-informed resources.

Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates.

Background: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts.

Methods: We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates.

Understanding Drivers of Coronavirus Disease 2019 (COVID-19) Racial Disparities: A Population-Level Analysis of COVID-19 Testing Among Black and White Populations.

Background: Disparities in coronavirus disease 2019 (COVID-19) testing-the pandemic's most critical but limited resource-may be an important but modifiable driver of COVID-19 inequities.

Methods: We analyzed data from the Missouri State Department of Health and Senior Services on all COVID-19 tests conducted in the St Louis and Kansas City regions. We adapted a well-established tool for measuring inequity-the Lorenz curve-to compare COVID-19 testing rates per diagnosed case among Black and White populations.

Utilization of Social Determinants of Health ICD-10 Z-Codes Among Hospitalized Patients in the United States, 2016-2017.

Background: The inclusion of Z-codes for social determinants of health (SDOH) in the 10th revision of the International Classification of Diseases (ICD-10) may offer an opportunity to improve data collection of SDOH, but no characterization of their utilization exists on a national all-payer level.

Objective: To examine the prevalence of SDOH Z-codes and compare characteristics of patients with and without Z-codes and hospitals that do and do not use Z-codes.

Research Design: Retrospective cohort study using 2016 and 2017 National Inpatient Sample.

Generating Subcounty Health Data Products: Methods and Recommendations From a Multistate Pilot Initiative.

Background: County Health Rankings & Roadmaps (CHR&R) makes data on health determinants and outcomes available at the county level, but health data at subcounty levels are needed. Three pilot projects in California, Missouri, and New York explored multiple approaches for defining measures and producing data at subcounty geographic and demographic levels based on the CHR&R model. This article summarizes the collective technical and implementation considerations from the projects, challenges inherent in analyzing subcounty health data, and lessons learned to inform future subcounty health data projects.

Association of Stratification by Dual Enrollment Status With Financial Penalties in the Hospital Readmissions Reduction Program.

Importance: Beginning in fiscal year 2019, Medicare's Hospital Readmissions Reduction Program (HRRP) stratifies hospitals into 5 peer groups based on the proportion of each hospital's patient population that is dually enrolled in Medicare and Medicaid. The effect of this policy change is largely unknown.

Objective: To identify hospital and state characteristics associated with changes in HRRP-related performance and penalties after stratification.

Adjusting for social risk factors impacts performance and penalties in the hospital readmissions reduction program.

Objective: Medicare's Hospital Readmissions Reduction Program (HRRP) does not account for social risk factors in risk adjustment, and this may lead the program to unfairly penalize safety-net hospitals. Our objective was to determine the impact of adjusting for social risk factors on HRRP penalties.

Study Design: Retrospective cohort study.

Measuring Subcounty Differences in Population Health Using Hospital and Census-Derived Data Sets: The Missouri ZIP Health Rankings Project.

Context: Measures of population health at the subcounty level are needed to identify areas for focused interventions and to support local health improvement activities.

Objective: To extend the County Health Rankings population health measurement model to the ZIP code level using widely available hospital and census-derived data sources.

Design: Retrospective administrative data study.

For the common good.

Hospital leaders are called not just to lead and advocate for hospitals or even health care, but for the total society of which we are members.