Click for 2 page PDF of summary 
The Mission of Rural Wisconsin Health Cooperative’s (RWHC) is that rural Wisconsin communities will be the healthiest in America. We believe that rural hospitals can help make healthy lifestyles a trademark of their communities–improving health status, reducing avoidable health care utilization and helping to attract and retain jobs. Rural has an extra challenge. Rural counties are typically the least healthy in a state, particularly compared to suburban communities and small cities. We believe that hospitals, clinics, public health agencies and employers working together in rural communities can help employees, their families and their communities become healthier.
The RWHC Vision is that we are a strong and innovative cooperative of diversified rural hospitals; it is the “rural advocate of choice” for its members as well as developing and managing a variety of products and services. We believe that our ability to meet our vision depends on acting in accordance with these Core Values: Trust, Collaboration, Creativity, Excellence, Joy, Openness, Personal Development, Productivity and Responsibility.
Incorporated in 1979 as the Rural Wisconsin Hospital Cooperative, RWHC has received national recognition as one of the country's earliest and most successful models for networking among rural hospitals. The National Rural Health Association, the National Cooperative of Health Networks and the Wisconsin Hospital Association have given RWHC their top award available to an organization or program. Today, the work continues as the renamed Rural Wisconsin Health Cooperative responds to rural hospitals’ increasingly diverse role in their communities.
RWHC serves as a catalyst for statewide collaboration and as a creative force on behalf of all rural health constituencies. Owned and operated by 35 non-profit rural acute, general medical-surgical hospitals, RWHC’s charge is twofold: shared service development for cooperative hospitals and external customers as well as advocacy for rural health at the State and Federal levels.
The tenants of shared service and advocacy have benefited one another over the years. Advocacy is more credible as RWHC is seen not just as a “mouth piece” but as a mission driven group–not just talking but adding “real” value. Shared services and advocacy require pretty much the same infrastructure so a cooperative of rural hospitals organized for shared services forms a natural critical mass for advocacy and vice versa.
A central service available to members is RWHC roundtables. RWHC directly addresses the geographic isolation associated with rural health by sponsoring over three dozen professional roundtables, representing a wide range of clinical and non-clinical disciplines. Most of these roundtables meet 4-6 times per year, typically for 2-4 hours per meeting; participation is in person, by phone and increasingly via videoconference.
RWHC’s shared services, like our roundtables, have been a major source of advocacy initiatives. Examples include: (a) the Quality Roundtable’s work related to rural relevant public reporting, (b) the RWHC Network’s promotion of rural access standards and (c) the CFO Roundtable leading to action on multiple Medicare and Medicaid reforms.
Since its inception, RWHC has maintained a philosophy of “together, we are better”, working collaboratively to represent smaller rural hospitals as an important stakeholder at the policy maker’s table. Initiatives as diverse as facilitating Critical Access Hospital conversions and developing shared rural HIT systems have energized RWHC’s expertise in crafting rural health policy. Today, that expertise continues to help shape the landscape of rural health services in America.
RWHC’s internal monthly newsletter, Eye On Health, began to be shared externally in 1995. Since then it has attracted a national readership among key rural health leaders. It is known for its eclectic mix of original articles and abstracts from a diverse array of news items, editorials and published research. Some readers appreciate Eye On Health for having the country’s longest lasting rural health cartoon series.
Shared services have grown through collaborative efforts, and continue to provide sound quality programs to our rural partners in Wisconsin and around the country. At the heart of RWHC service line development is the desire to be an affordable and effective option for rural health organizations. Our focus includes quality (core measures, noncore measures and patient satisfaction), finance, HIT, credentialing, and reporting capabilities to regulatory agencies. RWHC’s business model gives us the opportunity to deliver services that are innovative and reliable, yet affordable for the smaller hospital. With more than 30 years of experience, RWHC continues to be recognized as a leader providing shared services to smaller hospitals.
Continued growth has lead RWHC to establish three additional standalone business entities. Early in 1997, RWHC incorporated RWHC Network as a mechanism for its rural members to talk with each other and jointly negotiate with health insurance companies without violating antitrust laws. This critical step forward was made possible by notification from the Federal Department of Justice that they had accepted RWHC's request for a Business Advisory Letter. This decision was based on the demonstration that RWHC rural hospitals don't compete with each other but with the problem of patients leaving the local community for care in large, regional medical centers. Consequently, RWHC hospitals can now work together within the parameters of the Business Advisory Letter to negotiate with health plans and others with less concern of violating strict federal antitrust laws.
Working together through the RWHC Network led some members to create RWHC, LLC a Physician Hospital Organization (PHO), formed to negotiate and execute Medicare Advantage contracts on behalf of its members. Membership in the PHO does not require membership in RWHC, and is thus open to physicians, non-RWHC member hospitals, and other providers. The PHO offers a service to members so that they do not need to spend time and other resources on these contracts, and it offers a benefit to Medicare Advantage plans in providing a single contracting source for multiple providers.
In 2007, RWHC and member hospitals founded the RWHC Information Technology Network, a 501(c) 3 organization dedicated to providing member hospitals with shared HIS/EHR services. Four RWHC facilities signed on as founding members. Helping to support the initiative, three grants were awarded to RWHC: (1) HRSA’s CAHHIT Network grant for $1.6 million; (2) FCC’s Rural Healthcare Pilot Program for up to $1.5 million; and (3) a federal appropriation through Senator Herb Kohl’s office for $181,000.
RWHC’s Executive Director, among other appointments, has served twice on the U.S. Department of Health and Human Service’s National Advisory Committee on Rural Health and Human Services. He is a past president of the National Rural Health Association and was a member of the Institute of Medicine Committee that wrote Quality Through Collaboration: The Future of Rural Health.