Wisconsin State Flex Profile

Top Flex Activities

Program Area: Support for Quality Improvement: 

Twenty-four critical access hospitals (CAHs) participate in a web-based event reporting project. The project is a patient safety initiative focusing on reducing inpatient falls and medication errors. Participating hospitals subscribe to a web-based patient safety event management system that allows hospitals to collect and analyze data, facilitate internal communication, manage follow-up and foster learning to support risk-quality-safety initiatives. Secondly, Wisconsin Flex is in the process of recruiting 35 CAHs to participate in an emergency department transfer communication (EDTC) collaborative project. For part of this project, each hospital that has struggled with EDTC measures will be matched with a mentor hospital that has proven to be strong with EDTC. Participant hospitals will take part in quality improvement initiatives to improve their communications.

Please share a success story about reporting quality data or using quality data to help Critical Access Hospitals (CAHs) in your state improve patient care: 

Wisconsin Flex used MBQIP data to identify CAHs that struggle with achieving high Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, then issued a request for proposals, asking the identified CAHs to submit a proposal aimed at improving one or more of their HCAHPS scores. Wisconsin Flex was able to fund three CAHs and their proposed projects. They will be required to submit progress reports to Flex. Their HCAHPS scores will be monitored to determine if their efforts have resulted in improvement in their targeted HCAHPS scores.

Program Area: Support for Financial and Operational Improvement: 

Wisconsin Flex identified CAHs that were at the highest level of financial risk in the state. A request for proposals was issued to the identified CAHs, asking them to submit a proposal stating their need, a proposed project to address that need and anticipated outcomes. Wisconsin Flex was able to provide funding for four CAHs and their proposed financial improvement projects. All CAHs have reporting requirements back to the state office. It is likely that change will not be seen immediately after the completion of the proposed project, so follow up will occur not only at the end of the grant period, but also at several points in the future to ascertain if improvements have been made and projected goals achieved.

Program Area: Support for Population Health Management and Emergency Medical Services Integration: 

Wisconsin Flex conducted an assessment of Wisconsin ambulance service management and leadership, and received over 800 responses. The office found significant differences on several factors, including differences in rural/urban service responses. The results will help identify areas where resources and policy changes could improve emergency medical service (EMS) performance. In conjunction with this assessment, Wisconsin Flex contracted to develop a toolkit which serves as a road map for those EMS services who wish to improve their performance in areas covered by the assessment, such as human resources and financial performance. Wisconsin Flex recently completed an assessment of EMS patient care policies and practices, focusing on patients with time-critical diagnoses. The results will help identify those services that could benefit from one-on-one technical assistance to improve their patient care practices.

Please provide information about Collaboration/Shared Services (specifically connected to population health management): 

Wisconsin Flex continues to work with three communities (representing four CAHs) on population health improvement projects. The communities were targeted because of high obesity rates. Wisconsin Flex has provided funding and other resources to assist them in developing and implementing evidence-informed obesity reduction programs. These range from worksite-based programs to programs targeting women and families. Wisconsin Flex will provide these resources over three years, which will enable the community coalitions to track participants over time and identify outcomes.

Please provide information about any efforts to assist CAHs/communities and partner organizations in the transition to value-based care: 

Wisconsin is fortunate to have many strong rural partners, such as the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative. These organizations have expertise in the move to value-based care and provide support, education and resources to rural hospitals in Wisconsin. Wisconsin Flex works with these partners to incorporate activities into the Flex proposal that help support hospitals in the transition. CAHs can seek support and technical assistance from both the Flex office and a number of Wisconsin organizations.

Please provide information about network activities in your state to support Flex Program activities (such as financial improvement networks, CAH quality networks, operational improvement with CEOs or EHR workgroups): 

Wisconsin takes part in the following networks: Wisconsin Rural Health Council (led by the Wisconsin Hospital Association), Wisconsin Stroke Coalition, Wisconsin Coordination of Care Advisory Committee, Wisconsin Health Care Coalition Advisory Board and the Wisconsin Rural Health Development Council.

From the last Flex Program year, please describe a best practice you would like to share with other states: 

The Flex Program office designed and implemented a Microsoft Access database that tracks all Flex Program objectives and activities, including project milestones, outputs, Performance Improvement Measurement System (PIMS) measures and program outcomes. The database also serves as their directory of hospitals and clinics, including names and contact information for all key hospital/clinic staff.

Program Statistics

What type of organization is your Flex office housed in?: 
What is the number of full time employees (FTE) in your Flex office?: 
How many CAHs are in your state?: 
Do you have any hospitals interested in converting to CAH status?: 

Additional Information

Flex Program Staff

John Eich
State Office Director, Wisconsin
(608) 261-1890

Specialty Areas / Background

  • Strategic planning
  • Marketing
  • Evaluation

State Office Director since January 2006 

Kathryn Miller
Flex Coordinator, Wisconsin
(608) 261-1891

Specialty Areas / Background

  • Grant writing
  • Long-term care
  • Conference planning

Flex Coordinator since September 2008 

Penny Black
Rural Health Epidemiologist, Wisconsin
(608) 261-1887

Specialty Areas / Background


Rural Health Epidemiologist since July 2014

Kevin Jacobson
Rural Communities Program Manager, Wisconsin
(608) 261-1888

Specialty Areas / Background

  • Grant writing
  • Community health
  • Loan assistance programs

Rural Communities Program Manager since April 2007 

Kye Richards
Program Assistant, Wisconsin
(608) 261-1883

Program Assistant since September 2014

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,100,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.