Date of Conferral







Aridaman K. Jain


Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The conceptual framework was the systems thinking model. Along with data from the literature review, reviews of the organization's archived data containing employee feedback and feedback from unstructured interviews of four of the 14 FQHC chief executive officers in Alabama were used to develop the profitability model. No employees were interviewed or surveyed during this study, however, a review of archived documents revealed information provided by employees that was helpful in developing the profitability model. To help determine the subject organization's performance, data from independent auditors, technical assistants, FQHC performance reports, the organization's electronic health record system, accounting system, meeting minutes and performance reports were coded, classified, and analyzed. Data from these sources was compared to the profitability model and a gap analysis was used to identify the areas and causes of poor performance. The results indicated that the rural environment impacted the organization's financial performance. The subject FQHC organization may be able to use the results of this study to improve profitability. This study contributes to positive social change by providing a profitability model that other FQHC organizations may use to improve their financial viability and expand services to underserved patients throughout the United States.