What is Advancing Financial & Operational Strength?

Advancing Financial & Operational Strength (AFOS) is a new technical assistance program from Capital Link that provides health center staff from all levels of the organization with financial and operational benchmarking assistance, tools, and training with the goal of improving health center business operations and financial health.

How Does AFOS Work?

At the start of the program, participants are provided with a Performance Evaluation Profile (PEP), a customized diagnostic tool to help them to better understand their own financial and operational performance as well as how they compare to other health centers in the region and state. Participants then attend a series of trainings, described below, which serve as a platform for sharing best practices and building knowledge. In the final phase of AFOS, participants may receive customized technical assistance in implementing changes for performace improvement. 


100 Series - Understand

Informed by the PEP report, this first set of trainings introduces financial and operational benchmarking based on Capital Link's databse of financial audits and UDS information from over 1,000 FQHCs. The sessions include a review of  key metrics for tracking organizational performance and of comparative national and statewide trends. 


200 Series - Develop Action Plans

This second set of trainings focuses on how to interpret and respond to the findings in the PEP report in order to develop an action plan. Trainings are based on the topic areas participants are most interested in, which may include:

  • Preparing for Value-Based Reimbursement

  • Drivers of Health Center Performance and Productivity

  • Planning for Growth: Forecasting, Benchmarking, and Accessing Capital 

  • Team-Based Care/Integrated Care Delivery 

  • Change Management Ideas and Strategies

  • Managing Revenue Cycle/Billing and Collections

  • Strategic Planning


300 Series - Implement & Monitor

This final set of trainings and technical assistance is designed to help participants implement changes and share best practices for financial and operational performance improvement. Training in small groups or for the cohort and one-on-one coaching on a variety of topics can be provided either on-site or remotely, including:

  • Revenue Cycle Optimization

  • Team-Based Integration/Staff and Patient Engagement/Facility Optimization

  • Capital Expansion Planning/Scenario Planning/Financial Forecasting

  • Operational Efficiencies/Productivity

  • Improvements/Reducing No Shows

Program Results

In pilot programs conducted in 2016 and 2017, AFOS participants accomplished the following:

  • Implemented changes and best practices around financial systems, revenue cycle management and billing, alignment with new reimbursement methods, team-based care, and patient and staff satisfaction

  • Incorporated billing and financial performance metrics/measures based on benchmarking

  • Made strategic changes to optimize performance processes that will strengthen health center finances

  • Outsourced revenue cycle management function to focus on core business

  • Implemented work flow improvements to improve team dynamics and care coordination

  • Transitioned to shared services options to reduce costs and increase efficiencies

  • Increased access to care through implementation of improved scheduling models


To learn more the AFOS program, please contact Jonathan Chapman, Chief Project Officer, at This email address is being protected from spambots. You need JavaScript enabled to view it. or 970-833-8513.


Sign up to receive our newsletter and email updates.

Sign Up