The critical access hospital (CAH), as a new provider category is an important step in modernizing the concept of rural health care delivery. The CAH--an acute care hospital for short time periods when needed--offers a practical direction for preserving access to health services, while providing opportunities to safeguard and strengthen the small town milieu. Wisconsin, like other Midwestern states, is dotted with many rural communities, usually 25 to 35 miles distant from the next small town--quite different than the vast and isolated expanses of the frontier states. Wisconsins rural communities, in large part, derive their characteristics and economic viability from the presence of the towns small hospitals. The challenges these facilities face is how to adapt to ever-changing reimbursement configurations of health care and how to continue offering needed services. A freestanding critical access hospital--or a CAH as part of a rural medical center--allows a measured transition toward an integrated multi-service health care facility. These new types of facilities present opportunities to preserve local health services and the unique qualities of the small town.
