Southeast Missouri is comprised of 18 rural counties. The region is bordered to the east by rural communities of southern Illinois, western Kentucky, and western Tennessee and to the south by northeast Arkansas. Cape Girardeau is the largest community in southeast Missouri, with a population of nearly 40,000 people and serves as medical hub for the region. The population of the five-state region totals 713,000 residents.
The residents of the rural counties of southeast Missouri have higher rates of chronic disease when compared to the state of Missouri as a whole. According to the 2015 Rural Health Report published by the Missouri Department of Health and Senior Services, the leading causes of death in southeast Missouri are heart disease, cancer, stroke, and lower respiratory tract disease. Additionally, the rate of death from these causes is 10% higher than the rate in Missouri’s urban communities. Rural residents are noted to have higher poverty and teen pregnancy rates and lower education levels and life expectancy. Chronic diseases are prevalent in southeast Missouri with 32% of the population suffering from obesity and 11% suffering from diabetes. Emergency department usage is 7% higher in rural counties in Missouri when compared to urban counties.
In 2016 Saint Francis Healthcare System (Saint Francis) conducted a Community Health Needs Assessment for the 18 counties of Southeast Missouri. The results of this assessment indicated five priorities for population health: obesity, cancer, chronic disease, substance abuse/mental health, and healthcare affordability. To address these critical health needs of the region, Saint Francis established Care Management of Southeast Missouri, LLC (Care Management) in 2018. Care Management is a Missouri limited liability company. Care Management currently has one member, Saint Francis; and one participant, Saint Francis Medical Partners. Membership is available to new participants that meet the qualifications for membership described in the Care Management operating agreement. Independent physician groups, rural health clinics and federally qualified health centers providing care in the 18 county area will be added as participants over the next 12-24 months. The Care Management governing body consists of five physicians, an advanced practice provider and a Medicare beneficiary. Additional participant representatives will be added to the governing body as new participants join Care Management.
Care Management is a network of providers formed to coordinate high quality care for its patients across the full care continuum (home, hospital, post-acute care, office, etc.). As a part of the Saint Francis Healthcare System, it is the mission of Care Management to provide a ministry of healing, wellness, quality and love inspired by faith in Jesus Christ. This mission of Care Management specifically includes:
- The promotion of evidence-based medicine and patient engagement, reporting on quality and cost metrics, and the coordination of care;
- Participation in the Medicare Shared Savings Program, and other governmental and commercial value-based programs;
- The promotion of accountability for the quality, cost and overall care of the Medicare and other beneficiaries assigned to Care Management;
- Enabling Care Management participants to work together to manage and coordinate care for Medicare and other beneficiaries in the 18 county region;
- Encouraging investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients of the participants located in the 18 county region;
- Fulfilling the functions of an accountable care organization, as defined and described in the Medicare Shared Savings Program; and
- Improving the health of the population of the 18 county area.