Unto thy maker: The fate of church-based nonprofit clinics in a turbulent health care environment

Despite the explosive growth of the nonprofit sector in recent years, many charitable organizations have closed their doors. Evolution of the health care delivery system in the Minneapolis-St. Paul metropolitan area in Minnesota has favored large, integrated service networks at the expense of small, church-based nonprofit organizations that have long served as a means of neighborhood organizing, social outreach, and the proliferation of community values. Interviews with three defunct church-based health care organizations provide the basis for the authors' observations that relatively sudden and wide-scale changes in the health care environment have legislated against small health care organizations, selecting them out for extinction.