Capital Plans and Needs of Health Centers: A National Perspective

Supported by a Cooperative Agreement with the Health Resources and Services Administration, Bureau of Primary Health Care, this 2015 study was conducted to determine the capital plans and needs of health centers across the United States. The assessment also gathered information on funding sources and interest in collaborative projects addressing the social determinants of health.

Access the report hereor click on the image at left to download.

(Released in October, 2015)

Infographic: Health Center Capital Project Plans and Funding Needs

This infographic illustrates the key findings from our analysis "Capital Plans and Needs of Health Centers: A National Perspective". Click on the image at left to download or access a PDF from the link below.

Access our Infographic here.

(Released in October, 2015)

Issue 1 Financial and Operational Ratios and Trends of Community Health Centers, 2008-2011: A Guide for Health Centers

Developed by Capital Link and Community Health Center Capital Fund (Capital Fund), Issue 1 of the Community Health Center Financial Perspectivesseries provides health centers with the national financial and operational trends of community health centers from 2008-2011. This resource also provides data for peer benchmarking and recommended ranges for achieving strong financial performance. The first in a series, this publication is sponsored by Citi Foundation.

Access the complete report here.

(Released in August 2013)

Issue 1 Infographic: Financial, and Operational Ratios and Trends, 2008-2011

This infographic illustrates key findings from "Community Health Center Financial Perspectives (Issue 1)," a new resource that provides health centers with the national financial and operational trends of community health centers from 2008-2011.

Access the infographic here.

(Released in August 2013)

Issue 2 Financial and Operational Ratios and Trends of Community Health Centers, 2008-2011: A Guide for Lenders and Investors

Developed by Capital Link and Community Health Center Capital Fund (Capital Fund), "Community Health Center Financial Perspectives (Issue 2)," provides insight into multi-year financial trends for community health centers on a national basis for a lender audience. Very little data about health centers is available on a consistent basis to lenders and investors, who will play an increasingly important role in fueling the industry’s growth as it continues to mature in an environment of health reform. This analysis is a starting point to fill a knowledge gap, providing metrics not previously available on the financial and operational performance of health centers. The second in a series, this publication was sponsored by Citi Foundation.

Access the complete report here.

(Released in March 2014)

The findings were also published as part of the special report series of the Center for Community Investments, Federal Reserve Bank of San Francisco, available at www.frbsf.org/community-development/publications/special/financial-operational-ratios-trends-community-health-centers/.

Issue 2 Infographic: Financial and Operational Ratios and Trends, 2008-2011

This infographic illustrates key findings from "Community Health Center Financial Perspectives (Issue 2),a new resource that provides lenders and investors with the national financial and operational trends of community health centers from 2008-2011

Access the infographic here.

(Released in March 2014)

Issue 3 Impact of Capital Projects on Health Centers: Growth, Financial Trends, and Operational Transformation: A Guide for Health Centers

Developed by Capital Link and Community Health Center Capital Fund (Capital Fund), "Community Health Center Financial Perspectives (Issue 3)" provides insights such as: How fast do health centers grow after a capital project? What are the potential pitfalls? How large should cash reserves be to mitigate possible losses as a new facility ramps up? How fast do other health centers add staff and how does that affect the bottom line? How much debt do other health centers support when they take on a capital project and how much equity do they usually raise? The analysis also addressed the issue of project size, and how this factor may affect health center finances and operations.

The third in a series, this publication was sponsored by Citi Foundation.

Access the complete report here.

(Released in April 2014)

Issue 4 Impact of Capital Projects on Health Centers: Growth, Financial Trends, and Operational Transformation: A Guide for Lenders

Developed by Capital Link and Community Health Center Capital Fund (Capital Fund), "Community Health Center Financial Perspectives (Issue 4)" offers a data-informed analysis to guide lenders as they underwrite health center capital projects, answering questions such as: How quickly do health centers usually grow after a capital project? How do their financial trends change as a result? Are there typically losses in the early years? How long does the “high-risk” period last before operations stabilize? How many health centers utilize debt as a funding source, and how much do they use? Background information on health centers, how they differ from other healthcare providers, and their current operating environment is also included.

The fourth in a series, this publication was sponsored by Citi Foundation.

Access the complete report here.

(Released in May 2014)

Issues 3 and 4 Infographic: Impact of Capital Projects on Health Centers

This infographic illustrates key findings from "Community Health Center Financial Perspectives (Issues 3 and 4),new resources that illustrate the impact of capital projects based on a a study of 118 health centers over a five year period.

Access the infographic here.

(Released in April 2014)

Issue 5 Identifying the Risks of Health Center Failure: A Guide for Health Centers

Developed by Capital Link and Community Health Center Capital Fund (Capital Fund), "Community Health Center Financial Perspectives (Issue 5)" examines the differences between failed or failing health centers and their more successful counterparts offering health centers a better understanding of what operational and financial issues have resulted in financial stress for other centers and impacted their ability to stay in business. The report is based on an analysis of the financial and operational performance of 29 health centers over a four-year period leading up to the centers’ demise.

Access our report here.

(Released in October, 2014)

Issue 6 Identifying the Risks of Health Center Lending: A Guide for Lenders

Developed by Capital Link and Community Health Center Capital Fund (Capital Fund), "Community Health Center Financial Perspectives (Issue 6)"examines the factors that may contribute to default and demise in the health center sector. Based on an analysis of the financial and operational performance of 29 health centers over a four-year period leading up to the centers’ failure, this report provides lenders and investors with the insight necessary to determine potential early warning signs of future financial distress when underwriting health center loan requests—whether for capital project financing, working capital, or growth capital.

Access our report here.

(Released in October, 2014)

Issues 5 and 6 Infographic: Identifying the Risks of Health Center Failure

This infographic illustrates key findings from "Community Health Center Financial Perspectives (Issues 5 and 6)",new resources that examine the differences between failed or failing health centers and their more successful counterparts. The reports are based on an analysis of the financial and operational performance of 29 health centers over a four-year period leading up to the centers’ demise.

Access our infographic here.

(Released in October, 2014)

Infographic: Health Centers Have a Powerful National Impact

Using an integrated economic modeling and planning tool called IMPLAN and the latest Uniform Data Systems data (2014), Capital Link updated our analysis capturing the economic impact and job growth of health centers nationally. Click on the image at left to download or access a PDF from the link below.

Access our Infographic here.

(Released in January, 2016)

California Community Health Centers: Financial & Operational Performance Analysis, 2011-2014

Supported by Blue Shield of California Foundation, this analysis provides an updated statewide, multi-year financial and operational profile. Access the complete report here or click on the image to download. Also access California Community Health Centers: Financial & Operational Performance Analysis, 2010-2013,for analyses on select trends for rural health centers and the operational characteristics of a subgroup of financially high-performing health centers.

(Released in 2016)

Performance Benchmarking Toolkit for California Health Centers

Supported by Blue Shield of California Foundation, this toolkit helps health centers more effectively track performance, understand key drivers and incorporate operational insights for sustainability.

Access the toolkit here or click on the image to download.

(Released in 2015, updated in 2017)

Analysis of the Financial Sustainability of Rural Health Centers in Northeastern California

Supported by Blue Shield of California Foundation, this analysis highlights the unique challenges confronting frontier and rural health centers and offers ideas for strengthening operations. Access the complete report hereor click on the image to download.

(Released in 2016)

Capital Plans and Needs of California Community Health Centers

Supported by The California Endowment, this study was conducted by Capital Link to determine the capital plans and needs of California community clinics and assess the extent to which any funding gaps exist. The resulting data will be used to inform development of a capital financing program for health centers, in collaboration with a variety of statewide and national funders.

Access the complete report here or click on the image to download.

(Released in 2013)

California Community Clinics: A Financial and Operational Profile, 2008-2011

Capital Link completed this study, sponsored by Blue Shield of California Foundation and the California HealthCare Foundation, examining California clinic financial trends and highlighting strengths and weaknesses in their overall performance. The purpose of the research was to better understand the financial health of the California clinic safety net as well as those critical factors that may positively influence the development of high performing health centers.

Access the complete report here.

(Released in September 2013)

Infographic:California Community Clinics: Organizational Factors Impacting Performance

This infographic supports the study "California Community Clinics: A Financial and Operational Profile, 2008-2011" available above. It illustrates selected performance highlights of Federally Qualified Health Centers and Look-Alike Clinics in California.

Access the infographic here.

(Released in September 2013)

California Community Clinics: Financial and Staffing Analysis, FY2006-2009

Prepared for the California HealthCare Foundation (CHCF), this report updates the financial trends of California community clinics and provides a deeper analysis of financial status, efficiency and performance with case studies of eight clinics. CHCF has released an issue brief entitled "Doing More with Less: Operational and Financial Strategies of Eight Community Clinics" as well as a companion publication, "Snapshot: Financial Health of Community Clinics. Click on the image at left to download the complete report and the link here for the CHCF publications: Access the complete report here.

(Released in November 2011)

California Community Clinics, A Financial Profile, 2005-2008

Prepared for the California HealthCare Foundation, this report analyzes the financial trends of California community clinics.

Click on the image at left to download.

(Released in September 2010)

California Community Clinics, A Cohort Analysis Report, 2005-2008

Prepared for the California HealthCare Foundation, this report is a companion report to "California Community Clinics, A Financial Profile, 2005-2008".

Click on the image at left to download.

(Released in September 2010)

Checklist: Sustainable Community Health Center Renovations

Developed by a team assembled by Perkins+Will, this document provides a checklist of sustainable building and renovation practices. Click on the image at left to download.

(Released in December 2010)

Tips for Managing Facility Development Risk

Developed for the National Association of Community Health Center's Risk Management Series, this information bulletin describes the major areas of risk and identifies action steps so health centers can reduce exposure to liabilities related to facilities development.

Click on the image at left to download.

(Released in August 2010)