Community clinics are an integral part of California's primary care and safety-net system, especially for uninsured, underinsured, and low-income people. This report captures key measures of clinics' financial health from 2006 to 2009. In addition to examining financial measures, the report looks at staffing and program/service models that may contribute to clinics' financial success.

Key findings include:

• Both revenues and expenses climbed in each year from 2006 to 2009, with expenses growing faster than revenue. While total revenues rose by 20.7%, adjusted for inflation, total expenses went up 24.4%.
• Clinic financial performance remained widely varied. The financially strongest clinics had 7.8% operating margins, while the weakest clinics had -0.7%. However, the bottom tier has improved its operating margin over time.
• There was limited correlation between staffing patterns and financial performance. However, clinics with a higher mid-level-to-physician ratio appeared to have lower financial performance and productivity, which may be attributed to patient mix. Mid-level staff includes nurse practitioners, physician assistants, and certified nurse midwives.

A related issue brief discusses the research findings and the lessons learned from eight case studies and is available through the Related CHCF Page link below.

This Almanac report is available under Document Downloads, along with past editions. The full report is available on the Capital Link site through the External Links below.