Community health centers across the United States saw an expansion of service sites and patient visits from 2013 to 2016. Due to an increase in the insured patient population, health centers were more fully compensated, and therefore, able to improve their financial position to support this growth.

Capital Link’s newly release report, Federally Qualified Health Centers Financial and Operational Performance Analysis, 2013-2016, provides an aggregate profile of financial and operation trends of community health centers, nationally. The report identifies strengths, challenges, and opportunities for performance improvement within these functions, which health centers can then use to develop a framework to review their individual practices and support change. 

The report uncovered interesting findings, including statistics related to growth and expansion, productivity and utilization, financial measures, and quality of care. Most notably:

  • There was significant growth in both patients and visits over the four-year review period. Health centers were busy in 2016, providing services to nearly 26 million patients and conducting over 104 million visits. This was a major increase from 21 million patients and 85 million visits in 2013.

  • There was a substantial shift in insurance coverage over the review period. Uninsured patient rates dropped from 34% of patients in 2013 to 21% in 2016, while Medicaid coverage increased, from 34% of patients in 2013 to nearly 45% in 2016.

  • Patient growth and an improved payer mix were partially responsible for a 47% increase in revenue from 2013-2016, with health centers bringing in $24 billion nationwide in 2016.

  • Productivity declined across several functions over the four-year period, likely due to changes in care models and clinical practices. Physician visits and mental health visits per provider experienced the largest declines at -7% and -6%, respectively.

  • Health centers experienced a 18% increase in cost of care for both patients and visits. Averaging approximately 6% per year, it was slightly higher than the rate of increase in physician and clinical expenditures.

  • An overall look at health center financial stability from 2013-2016 found that 75% of health centers operated in a steady environment, while 25% operate under fragile financial conditions.  

The analysis also looked at health center quartiles to examine strategies of high performers for replication, and areas of improvements for low-performers. The report was developed with support from the Health Resources and Services Administration.   

To access this new resource, please click here.

Capital Link is proud to be participating in the PACE at Community Health Centers program, which is funded by The Retirement Research Foundation, along with our partners National PACE Association, National Association of Community Health Centers, and Galway Group.

The Program for All-Inclusive Care for the Elderly (PACE) is a national program that provides a comprehensive package of services to help enable elders to successfully remain in their homes. There are approximately 120 PACE programs across the nation, and only six are run by community health centers.

Read more about the PACE at Community Health Centers program here on NACHC’s blog.


In the current health care environment where health centers seek to negotiate adequate reimbursement from payers and become as cost-efficient as possible, accurately tracking, comparing, and allocating costs across all service lines is critical. Yet as health centers evolve to provide a broader range of services beyond just medical, these tasks have become more complex.

Capital Link announces the release of two new cost of care resources: Cost of Care Trends for Community Health Centers 2012-2016 and Cost Per Visit – Measuring Health Center Performance. Together, these complementary resources support the ongoing focus on tracking and understanding costs in order to provide a strong foundation for current and future financial and clinical operations at health centers. 

Cost of Care Trends for Community Health Centers 2012-2016 provides median health center cost trends for all services using national data from Uniform Data System (UDS) from 2012 to 2016, providing general comparative data for benchmarking. The report further breaks down the data by separately analyzing direct staff and related costs, and the allocation of facility and non-clinical support costs (overhead) for each service. Results of the analysis show that health center costs have been increasing across all service lines at a relatively rapid pace. However, there is one area where cost increases have risen at a more modest rate: cost per-full time equivalent employee (FTE). This implies that health centers have been broadening the services offered to patients without increasing the cost per-FTE. Download the full report here.

Developed by Capital Link and the National Association of Community Health Centers (NACHC) as an update to NACHC’s original 2003 publication, Cost Per Visit – Measuring Health Center Performance, reviews in detail the process and methodology for calculating the component costs of care with a focus on cost per visit across all service lines — medical, dental, mental health (including substance abuse), and vision services. It also examines methods for reducing health center costs through population health management, global payment methodologies, and tying reimbursements to outcomes. Download the Issue Brief here.

For more information on this topic, attend Capital Link’s upcoming webinar, Managing Your Health Center's Cost of Care on Wednesday, September 26, 2018 2-3 p.m. ET. Click here to learn more and register.

Capital Link will soon be launching two new reports that can be customized using individual health center cost of care data: Cost Comparison Profile and Cost Comparison Snapshot. Details and ordering information will be released in the next month, so keep an eye out.

Sign up to receive our newsletter and email updates.

Sign Up