The 5 Essential Pillars of Health Center Business Planning

Are you just copying last year's plan and calling it done? In this comprehensive solo episode, Jill Steeley breaks down the five essential pillars every health center needs in their annual business plan—whether your fiscal year runs January to December or any other cycle. Moving beyond day-to-day firefighting, this episode provides a strategic framework for positioning your health center for success in an ever-changing healthcare landscape.

Key Topics Discussed

Why Business Planning Matters

Moving beyond day-to-day firefighting to strategic thinking
How healthcare landscape changes demand annual strategic review
The difference between compliance planning and strategic planning
Why copying last year's plan sets you up to merely survive, not thrive

The 5 Essential Pillars

Pillar 1: Financial Sustainability and Revenue Diversification

Analyzing your revenue streams and dependencies
The danger of relying too heavily on Medicaid or 330 grant funding
Grant diversification strategies (federal, state, foundation, corporate)
Value-based care contracts and quality incentive programs
Cost optimization without compromising care quality
Vendor contract renegotiations and supply chain waste reduction
Why you can't have all your eggs in one basket

Pillar 2: Workforce Planning and Retention

Why your staff are your number one customers
Current workforce assessment and turnover analysis
Recruitment strategies in a competitive market (loan repayment, relocation assistance, clinical rotations)
The honest truth: retention is cheaper than recruitment
Professional development as the #1 retention and #2 recruitment strategy
Creating clear career pathways and mentorship opportunities
Leadership development pipeline for succession planning
Addressing healthcare worker burnout and exhaustion
Technology investments that make staff lives easier

Pillar 3: Service Lines and Community Needs

Moving beyond "checking the box" on community health needs assessments
Service line analysis: which are thriving vs. struggling
Identifying expansion opportunities based on data
Care integration strategies (medical-dental, behavioral health, specialist coordination)
Optimizing telehealth strategy and ensuring equitable access
Population health initiatives with measurable goals
Strategic vs. reactive service planning

Pillar 4: Quality Improvement and Clinical Outcomes

Establishing baseline on key quality measures
Setting realistic but ambitious targets based on UDS benchmarks
Selecting 2-4 focused quality improvement projects
Patient safety initiatives and measuring success
Patient experience beyond clinical outcomes (wait times, convenience, communication)
Moving beyond HRSA-required measures to what matters to patients

Pillar 5: Infrastructure, Technology, and Facility Planning

Why facilities matter more than you think for patient attraction
Comprehensive facility condition assessments
Space planning for current operations and future expansion
Technology refresh cycles (internet bandwidth, computers, servers)
EHR evaluation and replacement considerations
Cybersecurity as risk management
Capital investment planning and funding sources

Key Timestamps

[00:01:00] - Introduction: Moving from day-to-day to strategic planning
[00:03:00] - Pillar 1: Financial Sustainability and Revenue Diversification
[00:08:00] - Pillar 2: Workforce Planning and Retention begins
[00:12:00] - Retention strategies and professional development
[00:15:00] - Addressing burnout and technology support
[00:17:00] - Pillar 3: Service Lines and Community Needs
[00:22:00] - Telehealth strategy and population health
[00:24:00] - Pillar 4: Quality Improvement and Clinical Outcomes
[00:28:00] - Pillar 5: Infrastructure, Technology, and Facility Planning
[00:33:00] - How the five pillars interconnect
[00:35:00] - Final advice: involvement, realism, flexibility, accountability

Critical Questions to Ask Yourself

Financial Sustainability:

What happens if one of your major revenue streams dries up or decreases?
What percentage of your total budget comes from your top 2 revenue sources?
Where are your largest expense categories and efficiency opportunities?

Workforce:

What is your turnover rate by position over the last 12-24 months?
How are you attracting talent when you can't compete on salary alone?
Who's going to lead your health center in 5-10 years?

Service Lines:

Are you addressing your community's most pressing health issues?
Which service lines are thriving vs. struggling (impact, not just revenue)?
How many patients get internal referrals to your other services?

Quality:

Where are your biggest gaps in HRSA performance measures?
What do patients complain about most in satisfaction scores?
How many patient safety issues occurred in the last 12 months?

Infrastructure:

When was your last comprehensive facility condition assessment?
Is your technology helping or hindering your staff's productivity?
Do you have adequate space for current operations and expansion plans?

The 5 Pillars Framework Summary

Financial Sustainability & Revenue Diversification - Building a foundation that can weather uncertainty
Workforce Planning & Retention - Attracting, developing, and keeping great people
Service Line Expansion & Community Health Needs - Strategically serving evolving needs
Quality Improvement & Clinical Outcomes - Delivering exceptional care
Infrastructure, Technology & Facility Planning - Maintaining the foundation that supports everything

Key Takeaways

✓ These five pillars aren't isolated silos—they're interconnected and must work together

✓ The most effective business plans tell a story of where you're going and how you'll get there

✓ Professional development is the #1 retention strategy and #2 recruitment strategy

✓ It's cheaper to keep good employees than constantly recruit new ones

✓ Your service planning should be strategic and aligned with actual community needs, not reactive observations

✓ Patients want clean, state-of-the-art environments—facility planning affects patient attraction

✓ Technology issues are often staff's #1 complaint but get the least attention in planning

✓ Business planning shouldn't be something that just happens in the C-Suite

✓ Your business plan should be a living document reviewed monthly or quarterly, not annually

✓ Every element must connect back to your fundamental mission of improving health equity and access

Jill's Final Advice for Effective Planning

Involve Your Team

Get input from frontline staff, providers, and community members—they'll give insights you might otherwise miss

Be Realistic

Don't create a plan so aggressive it's doomed to fail; ambitious is good, but achievable is essential

Build in Flexibility

Your business plan should be a living document that adapts to unexpected circumstances (pandemics, natural disasters, policy changes)

Establish Clear Accountability

Every goal needs an owner and a regular review rhythm (monthly or quarterly, not just year-end)

Don't Forget Your Mission

Every element should connect back to improving health equity and access for those facing barriers to care

Memorable Quotes

"Your business plan shouldn't be reactive all the time. It should be strategic and aligned with both the community needs that actually exist and not just an observation and the capacity of your health center."

"Your staff is your number one customer."

"The most effective business plans weave these elements together into a coherent strategic plan. They tell the story of where your health center is going and how you are going to get there."

"One of the biggest mistakes I see health centers make in their business planning is just copying last year's services and calling it done."

"My IT guy has a funny joke: What's the best EHR out there? It's the one your health center doesn't have."

"Infrastructure is not the sexiest thing to be saving for and planning for, but it is absolutely essential."

"At the end of the day, we exist. Health centers exist to serve our communities, particularly those who face barriers to care."

Resources Mentioned

CEO Connect Bootcamp Topics:

Month 1: Diversifying and increasing revenue
Month 2: Optimizing staffing levels, reviewing contracts, automation and standardization

Key Planning Tools:

Revenue stream analysis