Douglas Keskula is dean of the Western Carolina University College of Health and Human Sciences.

Expanded, consistent health-care access could be around the corner for Western North Carolina if a formalized partnership between Western Carolina University and Harris Regional Hospital and Swain Community Hospital succeeds.

Announced in mid-October, and known as the Ascent Partnership, the initiative is designed to train additional nurse practitioners and create opportunities to engage the surrounding communities about wellness.

According to Doug Keskula, dean of the WCU College of Health and Human Sciences, the overall goal is to ensure North Carolina’s westernmost countries receive quality health care.

“We want to provide an exceptional educational experience for our students and future health-care professionals,” Keskula said. “We can’t do that without our partners.

“We launched discussions about how to build on our existing partnership to take things to the next level — how to better use the resources and expertise of each partner to improve the health of the community through education, service and research.”

Currently, those communities lack significant health-care services, Keskula said.

Based on Mountain Area Health Education Center data, roughly 20 percent of North Carolinians — nearly 2.2 million people — live in rural counties with limited health-care access. Statewide, 42 counties have physician shortages, meaning they have too few providers to meet patient needs. The shortfall includes all of Western North Carolina’s counties.

To address this need through the Ascent Partnership, Harris Regional and Swain Community Hospitals, which are part of Duke LifePoint Healthcare, will pay the roughly $26,000 cost for three students each to complete WCU’s two-year family nurse practitioner (FNP) program.

One student will receive the award during each of the next three years in return for a commitment to work in an area hospital for a yet-undetermined number of years. The award allows students to graduate debt-free, Keskula said, while having guaranteed employment.

The Ascent Partnership furthers a decades-long relationship, said Steve Heatherly, Harris Regional and Swain Community Hospitals’ chief executive officer. During that time, the WCU-hospital connection has spawned two university-based clinics that provide rehabilitation and primary-care services to area communities, as well as clinical training sites for WCU students.

Steve Heatherly is chief executive officer of Harris Regional and Swain Community hospitals.
Steve Heatherly is chief executive officer of Harris Regional and Swain Community hospitals.

Currently, Heatherly said, the counties immediately surrounding WCU — Jackson, Swain, Graham, and Macon — need six to eight primary-care practitioners. WCU’s nurse practitioner program graduates could fill those roles.

“If it takes two years to be trained, by four years from now, we will have used this investment and partnership with the university to put three, fully-trained primary-care practitioners to work in our communities,” he said.

“They will be able to reduce that provider shortage by one-third within five years.”

Each nurse practitioner, carrying a full patient load, can treat roughly 1,500-to-2,000 patients a year. After all three award recipients graduate, Heatherly said, they could potentially serve 4,500-to-6,000 people who currently don’t have health-care access, accounting for approximately 10 percent of the communities the partnership serves.

But, securing an appointment with a primary-care provider frequently isn’t the problem, said Melissa McKnight, health education specialist with the Jackson County Department of Public Health. Having extra nurse practitioners available to serve the community will be a benefit, she said, but it’s unlikely to address the real issues that limit access to care.

“When we surveyed our communities, we heard it’s not hard to get an appointment to see a provider,” she said.

“What’s difficult is having the transportation or financial resources to get to the provider.”

Additionally, she said, educating extra practitioners won’t reduce the area’s uninsured population. According to public health department data, in 2013, 29 percent of 18-to-65-year-olds in the area were uninsured — a rate higher than WNC and statewide averages.

At this point, specific methods for measuring the partnership’s success haven’t been identified, but Keskula said a key indicator will be whether the initiative bolsters the number of providers in the health-care workforce.

In the long run, Heatherly said, greater primary-care access could create benefits for patients. He anticipates the Ascent Partnership will lead to Western North Carolinians making fewer trips to the emergency room for primary-care services and more people controlling their diabetes.

Keskula said he hopes the program will prompt better eating habits and less smoking among the surrounding population.

“Most importantly, this is a commitment of two major employers in the area to continually seek ways to collaborate for the benefit of our communities,” Heatherly said.

“We both recognize that individually, we play important roles in maximizing the health and well-being of the communities we serve, and collectively, we can make an impact in a much greater way.”

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Whitney L.J. Howell is a contributing reporter to Carolina Public Press. Contact her at

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