the access to, and quality of, rural health care.
The Wisconsin Office of Rural Health (WORH) was established in 1975 by the U.W. Center for Health Sciences Vice Chancellor Robert Cooke, M.D. The original mission of the Office was to address shortages of health services in rural Wisconsin by developing rural clinical sites, using university resources. During the first 18 months of operation, the WORH was involved in a variety of activities to identify areas of shortage, organize programs to address the unique requirements of each area, and enlist university resources to implement the programs.
WORH, working closely with the Department of Family Medicine and the School of Nursing, helped establish two nurse practitioner clinics with physician participation, one located in Tigerton.
One of the most visible roles of the WORH was its development of a physician recruitment and retention program, called New Physicians for Wisconsin (NPW). This program began operating in 1979 and has developed into a nationally recognized resource, which has placed more than 500 physicians in community practices throughout the state. NPW provides a full range of services including practice and community profile development; a reference library of community resource materials; finding qualified candidates, matching them with appropriate practice opportunities, and promoting those opportunities; development of pertinent personal background information on candidates; newsletter articles and other materials on recruitment and retention; and consultation on issues, trends, and available resources in the recruitment marketplace. NPW’s primary source of financial support is through fee-for-service contract arrangements with communities, clinics, and hospitals.
As WORH matured, it became clear that the emphasis for rural health at the university was located in the Department of Family Medicine (DFM). Consequently, it was relocated to DFM offices in September 1979, where it stayed until early 1986. During this period WORH became closely associated with family medicine and many of its activities were developed to support the rural practice of family medicine.
The Medicare Rural Hospital Flexibility Program (Flex Program) was created by the Balanced Budget Act of 1997 and is intended to strengthen rural health care by encouraging states to take a holistic approach. The federal Flex legislation created the Critical Access Hospital (CAH) designation. CAH designation allows the hospital to be reimbursed on a reasonable cost basis for inpatient and outpatient services provided to Medicare patients. In 1999, the WORH applied for and was successful in starting the Wisconsin Flex Program. We have assisted 59 small rural hospitals in achieving CAH designation, with Ministry Eagle River Memorial Hospital being the first to designate in October 1999. The last hospital to receive CAH designation was Memorial Medical Center in Ashland in October 2007.
Each year, the WORH applies for Flex Program funding from the Health Resources and Services Administration (HRSA) to provide continued support and assistance to Wisconsin’s Critical Access Hospitals, Rural Health Clinics, and rural emergency service providers. Now that CAH designation in Wisconsin is complete, Flex grant dollars are utilized to assist with quality and performance improvement initiatives, encourage the development of rural health networks, and improve rural emergency medical services, all in an effort to enhance and ensure health care access to rural American.
WORH helped formulate legislation that created the Wisconsin Health Professions Loan Assistance Program (HPLAP). This initiative provides educational loan repayment to primary care physicians, psychiatrists, nurse practitioners, physician assistants, and certified nurse midwives who agree to practice in medical shortage areas of Wisconsin. Dentists and Dental Hygienists were added to the program in 2001.
In 2005, in partnership with the Wisconsin Primary Health Care Association, a Dentist Placement Program (DPP) was created, focusing on clinics serving underserved populations around the state. To date, the DPP has placed over 90 dentists at 30 locations in the state, a majority in the federally qualified community health centers that are the safety net for the large number of people in Wisconsin without dental insurance.
In 2017, WORH recognized as the first in the nation in Medicare Beneficiary Quality Improvement Project (MBQIP) performance.
Wisconsin’s Critical Access Hospitals ranked fourth in the nation for their quality reporting and improvement rates over the past year.
In 2020, WORH is being recognized as third in the nation in Medicare Beneficiary Quality Improvement Project (MBQIP) performance. This honor continues a trend of Wisconsin’s rural hospitals leading the nation in top quality improvement measures.
As COVID-19 sweeps across the country, WORH distributes federal pandemic funding to local rural hospitals. The funds support rural hospitals in an extremely challenging time.