The Program to Strengthen Primary Care Health Centers supported improvements in operating systems and the development of good business practices at participant centers. This article provides an overview of the Program. Participant centers were small, community-based organizations that served high-need populations and offered a sliding fee scale for uninsured patients. Grants supported activities to increase patient revenues, serve more patients, promote general stability of center operations, expand the kinds of services provided, and enhance nonpatient revenues. Successful organizations needed to take a step back and analyze their options and also to have a good management team.