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Doing More with Less: Operational and Financial Strategies of Eight Community Clinics

Capital Link

For community clinics, financial stability can vary tremendously. This study finds a continuing divide between "have" and "have-not" clinics in California.

California's community clinics will experience greater demands on their services as health reform makes more people eligible for insurance coverage. This study examined clinic financial indicators, staffing and utilization patterns, and service models to determine if they correlated with performance. Eight case studies were also part of the research.

The study covered the period from 2006 to 2009. Key findings included:

  • Both revenues and expenses climbed each year from 2006 to 2009, with expenses growing faster than revenue, 24.4% versus 20.7%.
  • The divide between the "have" and "have-not" clinics continued. The financially strongest clinics had operating margins of 7.8%, and the weakest clinics, while improving, had -0.7% margins.
  • Few clinics have much debt, which may not be a healthy sign.
  • 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.

The issue brief examining the strategies and lessons learned from the case studies is available as a Document Download. The snapshot of financial and productivity indicators is available through the Related CHCF Page link below. The full report is available on the Capital Link website through the External Link below.

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