Healthcare organizations need to make money. That may sound like an unusual way to begin a conversation about nonprofit healthcare, but it’s an important distinction.
It takes money to recruit great physicians and employees:
- To invest in technology.
- To open new locations.
- To add services.
- To improve infrastructure.
- To reach more patients.
No healthcare organization can accomplish its mission for long if it isn’t financially healthy.But there is a difference between making money and existing to make money.
And that difference can shape the decisions an organization makes.
Profit can be a result without being the purpose
In a traditional for-profit business, generating returns for owners or investors is part of the fundamental purpose of the organization. Capital is invested with the expectation that it will ultimately produce a financial return.
A nonprofit operates differently.
There are no shareholders receiving dividends and no owners whose equity increases in value as the organization grows. Financial success can instead be reinvested in advancing the organization’s mission.
That doesn’t make financial performance less important. It changes what financial performance is for. For a healthcare organization, that distinction creates an interesting question:
If the value you create doesn’t ultimately need to leave the organization, what else can you do with it?
Put it back to work
Financial success can become fuel for the next thing healthcare needs.
- It can help bring care to a community that needs greater access.
- It can support a new service that fills a gap for patients.
- It can give physicians better technology, infrastructure, and operational support.
- It can help recruit talented people and give them the resources to do their best work.
- It can create capacity to try something new, improve something that isn’t working or build something that’s missing.
That’s the opportunity behind the nonprofit model at One Health. One Health Founder Ali Karim has a simple way of putting it: “Mo’ Money, Mo’ Mission.” It may not sound like the typical nonprofit mantra, but that’s exactly the point.
Being a nonprofit doesn’t mean financial performance matters less. If we want to make a bigger difference in healthcare, we need strong, sustainable businesses capable of generating resources to do it.
The difference is what happens to those resources.
There isn’t an investor waiting for an exit or a shareholder expecting a dividend. The value we create can be put back to work: expanding care, supporting physicians, investing in our people, building new capabilities, and reaching more communities.
The better our businesses perform, the more we’re able to invest in the reason they exist in the first place.
More resources. More impact. More mission. Or, as Ali would say: Mo’ Money, Mo’ Mission.
Structure influences decisions
Organizational structure can feel abstract until a difficult decision has to be made. Imagine two opportunities:
- One offers the greatest potential financial return.
- The other may produce a smaller return but addresses an important gap in care, strengthens another part of the organization or allows more people to access a service they need.
Which one should a healthcare organization pursue? There isn’t always an obvious answer. Healthcare decisions involve competing priorities, limited resources and real financial constraints.
But who ultimately benefits from the decision matters.
Without shareholders or outside investors expecting a return on their capital, a nonprofit has greater ability to evaluate opportunities through the lens of its mission and long-term impact.
That doesn’t mean every worthwhile idea gets funded or every community can be served. It means financial return doesn’t have to be the final answer to every question.
Nonprofit doesn't mean undisciplined
There is sometimes an assumption that nonprofit organizations can afford to think less about efficiency, growth or financial performance. The opposite should be true:
- Every dollar spent inefficiently is a dollar that can’t be invested somewhere it could have greater impact.
- Every process that creates unnecessary cost limits what the organization can do next.
- Every business that isn’t sustainable eventually loses its ability to serve anyone.
Financial discipline matters because the mission matters. The goal isn’t simply to generate resources. It’s to use them well.
A longer view of growth
The nonprofit structure can also change how an organization thinks about time.
Some investments take years to reach their potential. Some capabilities become more valuable when they connect with other parts of an organization. Some opportunities matter because of what they make possible next.
When there isn’t an investor exit driving the timeline, leaders can take a longer view of what they’re building and why. For One Health, growth isn’t simply about getting bigger.
It’s about creating the scale, capabilities, and connections that allow us to build healthcare around people rather than individual places, businesses or transactions.
The more we build, the more we can put back to work.
So, what changes when profit isn't the point?
- Financial performance still matters.
- Accountability still matters.
- Growth still matters.
- What changes is why they matter.
- Efficiency still matters.
Financial success gives a nonprofit healthcare organization the ability to invest again. To solve another problem. Reach another community. Support another physician. Build another capability. Help another patient.
Healthcare is a business. It has to be. But financial return doesn’t have to be the reason the business exists.
Profit isn’t the purpose. It’s a resource we can put back to work.
