A Sign of Change in South Madison: Understanding the Wingra/Access Community Health Centers Partnership

On July 1, 2009, the UW Health Wingra Family Medical Center began an innovative partnership with Access Community Health Centers (Access), a Madison-based nonprofit organization that provides affordable health care for low-income and underserved populations.

Patient care continues as before at the clinic. In fact, the biggest sign of change at the clinic is just that: the new sign in front of the building.

But over time, it is hoped that the partnership will result in deeper positive changes, not just at the clinic itself, but potentially for underserved patients throughout South Madison.

How the Affiliation Works

From a patient perspective, the Wingra Clinic operates much as it always has, with the same clinicians, services, location, referral options, hospital affiliations, and insurance programs. It also continues as a major training site for Department of Family Medicine (DFM) residents as well as for medical students and other health professionals. (For more details, see the letter and Frequently Asked Questions document sent to patients in June.)

The organizational changes resulting from the partnership are mostly behind the scenes. For example, while Wingra clinicians and staff remain employees of the UW Health enterprise, they are now technically contracted by Access to provide services at this clinic. Similarly, Wingra Clinic patients are now registered as Access patients, not UW Health patients.

Reasons for the Partnership

According to UW Department of Family Medicine Professor and Vice Chair for Education William Schwab, MD, the partnership has been several years in the making. Dr. Schwab credits DFM Professor and former Chair John Frey, MD, for initiating the first discussions on the subject.

Dr. Schwab outlined three major reasons why the partnership makes sense:

1. Improved care for patients. Wingra and Access both serve a common population, not just by location (Access has another existing clinic in South Madison), but also in terms of health care needs and socioeconomic status.

Dr. Schwab points out that some patients already go back and forth between the Wingra Clinic and the Access South Side Clinic. "Greater communication between the two entities will help us find better, more coordinated ways to care for our patients," he said. "In addition, Wingra will be able to provide a broader array of services."

2. Critical educational experience. One of the DFM's primary educational missions is to train future physicians to meet the needs of underserved communities, an activity amplified by the Access partnership.

A newly published article in the journal Family Medicine supports earlier research findings that residents or students who receive training in community health centers are more likely to practice in them after graduation.

"This kind of training is critical to the future family medicine workforce," said Dr. Schwab, "especially since many of the current policy discussions around health care reform focus on the community health center model."

3. Economic viability. As a result of the Access partnership, Wingra Clinic is now part of what is known as a Federally Qualified Health Center (FQHC), which means there are additional resources to help care for patients.

As critical access primary care sites serving communities in need, FQHCs receive enhanced reimbursement rates for some services and are eligible for supplemental funding from the Federal government. In addition, FQHCs are able to purchase pharmaceuticals at much lower rates, which helps make them more affordable for patients.

This support assures that Wingra can continue to offer quality health care to all patients, regardless of insurance status or ability to pay. It also allows the clinic to provide additional services that might not be possible in a typical practice.

Short- and Long-Term Impact

As a result of the partnership, Wingra Clinic will be able to offer:

• Access to Access' sliding scale payment option for patients who are uninsured or underinsured;
• Behavioral health services to help patients quit smoking, lose weight, cope with stress, and make other healthy lifestyle changes (planned for late 2009); and
• An on-site pharmacy so patients have immediate access to affordable prescriptions (planned for 2010).

But Dr. Schwab anticipates even more changes in the Wingra practice over the coming years. "As we share records, processes, and approaches to care with Access, we're hoping this will result in the development of new models of clinical services, coordination of community resources, and educational innovation," he said.

"Both Access and Wingra have many direct relationships with social service providers throughout the community," he added. "Those relationships are very valuable as we move forward together."

And, because the clinic is an FQHC governed by a community-based board of directors, "any directions and plans for strengthening the clinic in the future will be taken on in more formal partnership with the community," he said.

Dr. Schwab notes that this transition has required substantial contributions from many people. "Wingra Clinic Director Beth Potter, MD, Clinic Manager Michael Seavecki, and their faculty and staff colleagues deserve tremendous credit for their sustained commitment to patients in the community and for their ongoing efforts to assure the success of this partnership," he said.

"In addition, DFM Director of Clinic Operations Susan Kaletka, MS, and all of the other members of the department's administrative team have been integrally involved in the details of this initiative," he added. "Thanks to them and to our partners at Access, health care in South Madison has taken an important step forward."