Chicago FQHC sustainability
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2025–2030[?]
Cohort selection
Filter with the buttons or check any combination — metrics, charts, map & sensitivity recompute. Subset CIs are approximate.
· dots colored by parent-org fragility, non-selected greyed. Click a site for detail.
Cohort revenue vs. expenses
Solid: actuals from IRS Form 990[?] (2016–2023). Dashed: COVID-controlled projection median; shaded = 80% CI (bootstrap).
Cohort weighted operating margin
Revenue-weighted margin across the cohort. Reference line at 0% (break-even). Grey = COVID years, controlled out in the projection.
Methodology & caveats
- What this is
- 19 Chicago federally qualified health center organizations. Financials from IRS Form 990 (2016–2023, compiled by Third Horizon). Trajectory uses the same engine as the hospital tool: COVID-controlled OLS on operating margin, empirical-Bayes shrinkage across the FQHC cohort, 10,000-draw bootstrap for intervals. Sites + services from a manually-scraped directory (141 sites), HRSA cross-check pending.
- FQHC economics differ from hospitals
- FQHCs run thin, grant-supported margins (not commercial profit). The key vulnerability is grant dependence — government grants as a share of revenue — which exposes a center to the federal Health Center Fund cliff. "Operating-deficit" flags centers already spending more than they take in.
- Limitations
- Org-level 990 financials only (HRSA UDS payer-mix/patients/cost-per-patient layer pending). Two orgs lack a credible trajectory fit (volatile reporting). Site→org rollup matches 119 of 141 sites by name; the rest show as unaffiliated. 990s reflect the whole filing entity, which for multi-service orgs can exceed clinic operations.
Policy sensitivity
Each cut hits every organization in proportion to its own exposure — grant cuts scale by each FQHC's grant dependence, Medicaid cuts by patient revenue. Shocks layer onto the baseline 2025–2030 projection and carry its 80% interval. The measured levers use per-org data; proxy levers ride on national UDS averages[?] (adjustable) until per-center UDS lands.
Scenario impact
Who's hit hardest
Annual revenue/cost impact under the current scenario, by organization — the distributional story a blanket cut can't show. Sorted by dollar impact.
| Organization | Grant dep. | Baseline margin | Scenario margin | Annual $ impact | Status |
|---|---|---|---|---|---|
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FQHC sustainability — per organization
All 19 organizations. Click a row to open its profile. Sorted by latest margin (most distressed first).
| Organization | Latest revenue | Margin | Grant dep. | Trajectory | Proj. margin 2030 | Sites | Fragility |
|---|---|---|---|---|---|---|---|
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