In Kenya, government-owned health facilities could retain the revenue they collected from user fees, health insurance reimbursements, and government transfers prior to devolution in 2013. Facilities would spend these funds to address their immediate needs, including sourcing for commodities, hiring casual workers, and paying for other operating costs. After devolution, their ability to retain and use own-source revenue became dependent on how the newly formed county governments interpreted the 2012 Public Finance Management Act. Most counties started requiring facilities to transfer all own-source revenue to the county treasury. Some have since put in place arrangements to grant financial autonomy to health facilities. Under the Strategic Purchasing for Primary Health Care (SP4PHC) project, ThinkWell reviewed facility financing arrangements in Kenya’s 47 counties. This brief summarizes the findings and offers reflections on potential implications for service readiness.