State Flex Profile Navigation

Wisconsin Office of Rural Health

Top Flex Activities

Program Area: Support for Quality Improvement

The Wisconsin Office of Rural Health (WI-ORH) uses Medicare Beneficiary Quality Improvement Project (MBQIP) data to identify hospitals with low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. In 2018, five critical access hospitals (CAHs) were selected to work with a contractor to assess customer service practices, identify strengths and areas for improvement, and develop a work plan for each hospital to improve HCAHPS scores. In 2019, the contractor will continue to work with these five hospitals to implement and monitor their improvement plans. The revised contract adds three additional hospitals for a total of eight CAHs.

WI-ORH sponsored two provider training workshops in September: Infection Prevention Bootcamp to reduce the incidence of Hospital Acquired Infections (HAIs) and Just Culture training to improve communication and promote accountability for hospital staff.

Program Area: Support for Financial and Operational Improvement

The Wisconsin Flex Program 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 their identified need with a proposed project to address that need and anticipated outcomes. The Wisconsin Flex Program has provided funding for 10 CAHs and their proposed financial improvement projects. All CAHs have reporting requirements that are submitted to the Wisconsin 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

WI-ORH developed an Emergency Medical Services (EMS) Patient Care Assessment that focused on stroke, ST-elevated myocardial infarction (STEMI), trauma, and cardiac arrest patient care policies and practices. Each survey respondent was asked whether their service has time-critical diagnosis (TCD) protocols and quality assurance policies, as well as whether they work with receiving hospitals on quality assurance. The response rate was over 70%. WI-ORH enlisted the services of a contractor to provide one-on-one technical assistance to several EMS services that rated themselves low on the assessment. The contractor has worked with nine services thus far to identify areas for improvement, including the development and implementation of an improvement plan for each EMS service.

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. The Wisconsin Flex Program 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.

Wisconsin takes part in the following networks: Wisconsin Rural Health Council (led by the Wisconsin Hospital Association), Wisconsin Stroke Coalition, Wisconsin STEMI Coalition, the Wisconsin Healthcare Coalition Advisory Group, and the Wisconsin Rural Health Development Council.

Please describe how your state Flex Program has enhanced its use of data in the past year.

In the past year, WI-ORH has developed a protocol for workshop evaluations. Implementation of this protocol creates consistency in evaluation practices so that the WI-ORH can more effectively compare workshops and evaluate their impact on CAH performance. As the WI-ORH accumulates data from more workshops, they will be able to better understand how CAHs use the information to change practices in their organizations. Workshops will then be crafted to increase their impact.

Do you have any hospitals interested in converting to CAH status?:


Program Statistics

Type of Organization University
Staffing 3.4 FTEs
Number of CAHs 58
Website URL Organization Website

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
Data and Evaluation Program Manager, Wisconsin
(608) 261-1887

Data and Evaluation Program Manager


Data and Evaluation Program Manager 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.