Capital Link's Blog

The nation’s highest performing health centers can be classified as having strong clinical quality as well as financial health, but are there lessons to be learned about their workforce models? Capital Link and the Association of Clinicians for the Underserved (ACU) explored this question in a study examining the workforce and financial characteristics of high-performing health centers to begin to understand the success factors among a variety of staffing models for potential replication.

Developed with support from the Health Resources and Services Administration, Identifying Workforce and Financial Characteristics of High-Performing Health Centers is a report of findings comparing financial and workforce metrics of High Performers against Non-High Performers and median results of Federally Qualified Health Centers nationally to identify effective models for potential replication and areas for further research.

The report highlights the following findings:

• High-performing health centers demonstrated operating margins approximately three times higher than national and non-high performing health centers

• High Performers had nearly three times the cash reserves of Non-High Performers and national health centers, at the median

• Provider mix at the high-performing health centers was comprised of approximately 60% physicians and 40% non-physicians

• A 2 to 1 ratio of primary care support staff to providers for High Performers was higher than peer groups, a finding that supports research on effective team models

• The average tenure for CEOs for High Performers was over 10 years, approximately 60% higher than both peer groups

Further analysis on the influence of workforce models on financial and operational performance would provide additional insight on replicable models. To learn more about the findings, access this new resource here.

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.