CASE STUDIES
Representative Leadership Outcomes
The case studies below reflect the leadership outcomes David Hughes has delivered across his career in community health. In each environment, David held senior executive responsibility and was accountable for financial performance, compliance posture, operational execution, and organizational stability.
Leadership Proven Where It Matters
From community-based clinics to large, multi-site FQHC systems, in both rural and urban environments, David Hughes has stepped into executive leadership roles to lead execution, align teams, and deliver measurable results across scale, geography, and organizational complexity.
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At a large, multi-site Midwest FQHC experiencing rapid growth, liquidity had tightened to a level that threatened payroll stability and long-term operating confidence. David led financial stabilization efforts while serving in an executive role with responsibility for financial strategy, cash flow management, and board-level reporting. The focus was restoring financial discipline and visibility without reducing access or destabilizing staffing.
Results delivered:
- Increased liquidity from 15 to 124 days of cash on hand in under two years
- Stabilized payroll and operating cash flow during sustained growth
- Rebuilt board confidence through consistent financial reporting and controls
A community health center transitioning from Look-Alike status had experienced repeated HRSA funding denials, limiting growth and long-term sustainability. David stepped into the CEO role and led organizational realignment, grant execution, and governance engagement to reposition the organization for success.
Results delivered:
- Secured $650K in annual HRSA base funding, now exceeding $2M
- Achieved PPS reimbursement eligibility, FTCA coverage, and 340B participation
- Enabled site expansion and strengthened long-term financial viability
Within a multi-site FQHC system facing execution variability across locations, David led efforts to strengthen operating discipline and provider productivity. The work focused on aligning expectations, restoring consistency, and improving performance without expanding the cost structure.
Results delivered:
- Increased provider productivity by 500 visits per FTE
- Generated an estimated $17M in incremental revenue with minimal added cost
- Improved consistency, morale, and patient access across multiple sites
In several FQHC environments, reimbursement performance had not kept pace with growth due to misalignment between operations, documentation, and PPS strategy. David led reimbursement and operating model redesign efforts to restore financial leverage and long-term sustainability.
Results delivered:
- Delivered recurring revenue improvements of $1M to $3M annually for small to mid-sized health centers
- In one large environment, PPS optimization yielded an estimated $30M in increased revenue
- Strengthened margin performance without increasing fixed cost structure
David has led 340B strategy design and execution to strengthen reinvestable income while expanding patient access to affordable medications. The focus was disciplined oversight, compliance alignment, and long-term sustainability.
Results delivered:
- Produced $1M to $10M in annual 340B revenue, depending on organizational scale
- Expanded patient access to affordable prescriptions
- Created durable funding streams to support service expansion and care delivery
Communities seeking to establish an FQHC often face delays when HRSA New Access Point (NAP) funding is not immediately available. David partnered with community leaders to launch operations as FQHC Look-Alikes, establishing the governance, compliance, and operating discipline needed to begin serving patients while building a strong foundation for future funding success.
Results delivered:
- Successfully launched community health centers under FQHC Look-Alike designation
- Established HRSA-compliant governance, policies, and operational infrastructure
- Enabled access to enhanced Medicaid and Medicare reimbursement methodologies
- Strengthened NAP competitiveness through demonstrated readiness and compliance
