JEFFERSON CITY, Mo. — Missouri’s hospitals provided more than $1.6 billion in uncompensated care in 2021, according to new data from the Missouri Hospital Association. Uncompensated care is the combined total of charity care and bad debt reported by hospitals at cost. In 2021, hospitals’ charity care was more than $1 billion. At the same time, bad debt decreased nearly $90 million to a level not seen since 2018. This is an important indicator, as it demonstrates hospitals’ commitment to identify individuals eligible for no-cost or reduced-cost care, and cover them under charity care policies.
PullquoteHospitals also benefit their communities by absorbing unpaid costs of Medicare and Medicaid beneficiaries, educating and training the workforce, and donating to local causes. When combined with uncompensated care, these investments are known as community benefit. In 2021, Missouri hospitals provided $3.1 billion in total community benefit.
A full update of hospitals’ statewide and individual community investment data is available on www.focusonhospitals.com.
These safety net and health-focused investments are part of how hospitals produce value for the communities they serve. However, they don’t fully define the ways that hospitals are investing in improved health. Investments that improve health upstream of the hospitals or health care system are more difficult to represent using traditional community-benefit reporting tools — there are few metrics for health dollars not spent, quality of life improved, illness avoided or opportunities created. However, this work can be transformational for individuals and communities.
“Hospitals are ‘in and of’ the communities they serve,” said Jon D. Doolittle, MHA President and CEO. “They are open 24-7 and serve all Missourians needing care — without regard to their ability to pay. They also have an important role in improving health communitywide. That work requires thinking, acting and investing differently.”
While care is delivered in hospitals’ inpatient and outpatient departments, health happens in the places Missourians live, work, learn and play. Communities in close proximity to one another can have very different access to the factors that contribute to health. These include strong and connected community support systems; access to healthy food, housing and transportation; and the availability of local health care services. An individual’s social determinants of health have significant influence on wellness.
Hospitals throughout the state are engaged in community-specific programs to improve health and well-being. These mission-driven programs often are difficult to illustrate with traditional benefit reporting as they focus on prevention of poor health and improvement of quality of life. This year’s report includes three stories highlighting hospitals’ and health systems’ work that are emblematic of these efforts:
Mercy Hospital Aurora
Mercy Hospital Aurora provides resources and financial support to Project RISE, a curriculum- based program that helps families who are living paycheck to paycheck improve their mental, physical and financial well-being.
BJC HealthCare
In St. Louis, BJC HealthCare created the Community Health Improvement initiative, leveraging its position as an anchor institution to make investments and connections that support community and economic development to improve health.
North Kansas City Hospital
North Kansas City Hospital formed the Reduce Opioid Deaths Community Task Force, collaborating with emergency fire and rescue, and mental health and education partners, to implement harm reduction strategies related to opioid misuse.
All Missouri hospitals are committed to improving access to quality care and health communitywide. How these benefits are designed is shaped by local needs.
“Missouri’s hospitals are home to caregivers who want to do what’s best for their patients and communities,” Doolittle said. “These professionals understand the complexities of life and health, and are determined to make a difference. Our hospitals provide them with support, structure and resources to provide those life-improving and life-saving services.”
Hospitals also increase economic health, locally and statewide. In 2021, Missouri hospitals employed more than 163,000 workers, investing nearly $13 billion in payroll and benefits statewide. They also invested nearly $1.6 billion in various capital improvement projects. These investments ripple throughout the economy, creating household income, opportunities to support and build businesses, and increasing revenue for state and local governments.
“In 2021, hospitals served communities through two waves of COVID-19, while continuing to provide a safety net for Missourians and expanding investments in local programs that improved individual and community health,” Doolittle said. “These statewide and local commitments are how hospitals demonstrate both their value and values.”