Tuesday, May 15, 2018

New Report Measures Health Center Reporting of Social Determinants of Health Interventions

While increasing access to health care and transforming the health care delivery system are important, there has been growing interest in the impact of social, economic, and environmental factors to health and well-being. Community health centers have long served both the clinical and non-clinical needs of their patients and collaborated with community and social support services. A natural extension of this commitment is to track their patients’ social determinants of health requirements, such as The Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE), in order to begin to inform care plans and connect patients to community and social services.

As health centers begin to offer non-health related services to address the social determinants of health (SDOH), they should also collect data on (1) what services are being offered; (2) the scope and reach of these services; and (3) which SDOH interventions hold the most promise for improving health outcomes. A new baseline analysis by Capital Link, sponsored by Blue Shield of California Foundation, provides a start to measuring health center efforts to impact the non-clinical dimensions of the SDOH.

The analysis documents SDOH interventions offered by health centers as reported to the Health Resources and Services Administration’s Uniform Data System (UDS) during 2015 and 2016, the most recent data available, in California and nationwide. SDOH interventions seek to link patients with programs that provide social and economic opportunities that promote good health but are not part of the listed medical, dental, behavioral, and other health services. They are distinct from clinically-focused enabling services which facilitate access to care, and include services such as: Women, Infant and Children (WIC) programs, job training, head start programs, shelters, housing programs, child care, frail elderly support, adult day health care programs, fitness programs, and public/retail pharmacies. Prior to this review, no substantive research had been conducted on these services, although multiple studies have been undertaken on clinically-focused enabling services.

Click here for a free download of Tracking Social Determinants of Health Interventions: Health Center Reporting of Non-Health Related Services in the Uniform Data System

Over our long history of working with health centers, Capital Link has amassed a database of financial and operational information to develop field-building resources on the factors affecting health center performance, impact, and growth. For more information, visit www.caplink.org.

New Report Examines the Financial and Operational Trends of California Health Centers

Capital Link announces the release of an updated statewide financial and operational profile of California health centers. This resource, sponsored by Blue Shield of California Foundation, presents multi-year trends as well as comparative data for health centers nationally, offering a framework for identifying the financial strengths, challenges, and benchmarks that support opportunities for performance improvement.

Covering the four-year period of 2013 to 2016, this analysis focuses on the following trends for California Federally Qualified Health Centers (FQHCs) and FQHC Look-Alikes (LALs):

  • Growth and expansion of the patient population and service provision
  • Financial performance as shown by revenue growth and operating margins
  • Financial health as measured by liquidity and revenue collections 
  • Operational measures such as patient utilization and practice mix
  • Productivity metrics and quality of care indicators

Click here for a free download of California Community Health Centers: Financial & Operational Performance Analysis.

Over our long history of working with health centers, Capital Link has amassed a database of financial and operational information to develop field-building resources on the factors affecting health center performance, impact, and growth. For more information, visit www.caplink.org.

Wednesday, February 14, 2018

New Markets Tax Credit Program Allocation Awards Announced: Capital Fund Receives $40 Million


The U.S. Department of the Treasury’s Community Development Financial Institutions Fund announced the awardees for the 2017 round of New Markets Tax Credit (NMTC) allocations. The $3.5 billion in awards are aimed at revitalizing low-income communities and increasing economic opportunity nationwide. Community Health Center Capital Fund (Capital Fund), Capital Link’s lending affiliate, was awarded a $40 million NMTC allocation.

While NMTC financing is a critical source of low-cost capital and equity for health center facility projects—often securing approximately 20-22% of total project costs—obtaining tax credits is a competitive and complex process. Interested health centers must demonstrate a high level of project readiness and be able to communicate the merits of their projects to Community Development Entities (CDEs) with allocation. Furthermore, the process of structuring and closing an NMTC transaction is complicated and the terms, benefits, and fees offered to borrowers vary widely.

Capital Link has extensive knowledge of the NMTC financing process and has strong connections with Capital Fund and other CDEs interested in working with health centers. Of the nearly $1 billion in financing obtained by health centers through the NMTC program, approximately 60% was raised with Capital Link and/or Capital Fund assistance. We’ve also assisted many health centers with combining NMTC financing with HRSA capital grants—an excellent option, especially for projects of $5 million or more.

For help in determining whether NMTC financing could be a good fit for your health center, please contact
us here.


To learn more about the NMTC program and how it works, click here.


Wednesday, December 20, 2017

New Resource on Capital Project Planning

Federally Qualified Health Centers needing to build new facilities, renovate existing space, or purchase new equipment quickly discover that capital development is a complex endeavor. The capital development process requires careful planning and clear objectives, as it can take years from project conception to completion. Without proper planning, health centers can experience unexpected pitfalls, financial destabilization, or lack of interest to get the project off the ground. Capital projects become more manageable when a methodical process is followed.

Capital Link’s newly released publication, Steps to Success: A Toolkit for Community Health Centers Navigating a Capital Development Venture, provides community health centers with a broad overview of the capital development process. This resource highlights eight fundamental planning activities that create a foundation for smoother completion, eliminating most of the guesswork, and allowing health centers to understand opportunities and risks. Each action step provides guidance and related resources to help successfully direct a health center capital project and keep it on track. Steps include: developing a strategic plan, analyzing financial strength, achieving operational and clinical excellence, defining market opportunity, developing a comprehensive business plan, creating strong leadership team with project planning expertise, identifying capital sources, and benchmarking objectives for continuous improvement. 


Monday, October 23, 2017

New Report Highlights Financial and Operational Trends of Health Centers


The four-year period of 2012-2015 was a time of high growth for community health centers across the United States. The implementation of the Affordable Care Act resulted in the expansion of Medicaid and increased patient demand, but also a need for health centers to effectively manage their operations by better understanding their financial and operational performance.

Capital Link’s newly released report, Federally Qualified Health Centers Financial and Operational Performance Analysis, 2012-2015, highlights multi-year financial and operational trends of community health centers on a national basis. The analysis provides a framework for identifying the financial strengths, challenges, and opportunities for performance improvement.  

The report uncovered interesting findings across several financial and operational functions, including statistics related to growth and expansion, productivity and utilization, and financial measures. Most notably:

·         There was significant growth in both patients and visits over the four-year review period. Health centers were busy in 2015, providing services to over 24 million patients and conducting nearly 97 million visits. This was a major increase from 21 million patients and 84 million visits in 2012.

·         There was a substantial shift in insurance coverage over the review period. Uninsured patient rates dropped from 36% of patients in 2012 to 24% in 2015, while Medicaid coverage increased, from 39% of patients in 2012 to nearly 49% in 2015.

·         Patient growth and an improved payer mix were partially responsible for a 40% increase in revenue from 2012-2015, with health centers bringing in $21 billion nationwide in 2015.

·         Productivity declined across several functions over the four-year period, including medical visits, which decreased 12% by 2015. This decline was largely associated with health reform initiatives, including the implementation of medical records.

·         Health centers experienced a 17% increase in cost of care for both patients and visits, exceeding the U.S. medical care inflation rate.

·         An overall look at health center financial stability from 2012-2015 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.



Monday, September 18, 2017

Capital Link Resource Offers Guidance to Health Centers Recovering from Hurricane Damage

Community health centers located in the wake of recent hurricanes may be in the process of assessing damage and making plans to rebuild. Determining where to start and how to finance repairs, replacements, or even relocation can be overwhelming, but health centers should be aware that they may be eligible for funding and assistance through the Federal Emergency Management Agency (FEMA). Capital Link’s new resource, Hurricane Recovery Resources for Health Centers, provides guidance to health centers in need of disaster aid.

Capital Link’s resource has links to the necessary FEMA application documents, handbooks, and helpful websites, including updates from the state of Texas on public assistance process. It highlights, step by step, what to expect while working with FEMA, and what health centers can do to make the process easier. The document also reviews what FEMA may cover regarding cleanup, repairs, or replacement of facilities and equipment. Intended to help health centers through a difficult recovery process, the resource will be continuously updated as new information becomes available. As FEMA and the state of Florida assess damages and announce the disaster aid process, this document will be revised to reflect resources for health centers affected by Hurricane Irma, as well.

To access this new resource, please click here.

The Department of Health and Human Services has also issued draft guidance to help healthcare facilities with disaster planning and recovery. To learn more, please click here.

Friday, March 3, 2017

Communicating the Value+Impact of Health Centers

For more than 50 years, Federally Qualified Health Centers (FQHCs) have delivered comprehensive, high-quality preventive and primary health care services to patients regardless of their ability to pay. With revenues exceeding $21 billion in 2015, FQHCs constitute the largest network of primary care providers in the US and the second largest nonprofit health system, behind only Kaiser Foundation Hospitals. If FQHCs were listed on the Fortune 500, they collectively would rank #133, on a par with Staples and ahead of Whirlpool, Starbucks, Kraft Heinz and Facebook. However, as independently operated, locally-controlled nonprofit organizations, FQHCs focus on providing excellent care at the local level to their 24 million patients in the 9,800 urban and rural communities they serve.

The story of what health centers bring to their communities can be told along the following domains:

  1. Employment and Economic Impacts, using economic modeling software
  2. Savings to the Health Care System
  3. Access to Care
  4. Comprehensive Coordinated Care
  5. Preventive Care and Chronic Disease Management

Health centers are facing the prospect of a changing financial landscape. Now more than ever, there is a need to demonstrate the value health centers have on the communities they serve and communicate this impact. To illustrate the value and impact of health centers nationally, Capital Link has created the Value + Impact of Health Centers, an updated version of our Economic Impact Analysis. Click on the image below to view a sample of the infographic and supporting data report.



Capital Link’s customized Value + Impact of Health Centers is available for $2,000, discounted from $2,500. Order by March 17th for use at the NACHC Policy & Issues Forum.

To assist PCAs in advocacy efforts, we are also offering customized statewide and congressional district Value + Impact of Health Centers infographics and supporting data reports. Click here to view a sample of a statewide report. Interested PCAs should contact Steve Rubman, Director of Data & Information Systems, at srubman@caplink.org or 617-422-0350 for more information.