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Understanding Health Center Service Area Needs

HRSA has developed quantitative, standardized ways to understand a proposed health center service area and a health center’s existing service area.

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Service Area Needs Assessment Methodology and Unmet Need Score

HRSA developed the Service Area Needs Assessment Methodology (SANAM) to provide a consistent and transparent approach for assessing need for new Health Center Program investments that provide comprehensive primary and preventive care services to address health disparities and advance health equity.

The SANAM uses publicly available data to calculate an Unmet Need Score (UNS) for every ZIP Code within a proposed service area. The SANAM reduces burden for applicants by automating calculations and helps HRSA target resources to high need areas.

We incorporated the SANAM in the fiscal year (FY) 2019 New Access Points (NAP) funding opportunity. We evaluated the use of the UNS in that funding opportunity and adjusted the measures and weights to improve the SANAM for future decision-making resulting in the updated UNS.

The UNS map tool is designed to help applicants evaluate service area needs. Using the map and summary data table, applicants can explore the UNS for a proposed health center service area.

Resources for the SANAM and UNS

Service Area Status

The Service Area Status (SAS), also derived from the SANAM, describes the health, social, and economic status of a health center’s existing service area using a standardized methodology and public data sources described in the UNS and SAS Resource Guide (PDF - 1 MB). SAS scores can be obtained through the SAS Workbook for HRSA-funded health centers and look-alikes and is based on calendar year 2020 Uniform Data System (UDS) patient data. The ZIP Code configurable workbook allows those outside the Health Center Program to obtain SAS scores for ZIP Codes within a proposed service area.

Resources for the SAS

Service Utilization Benchmarks

Health centers deliver comprehensive, culturally competent, high quality primary health care, as well as supportive services such as care coordination, health education, outreach and eligibility assistance, translation, and transportation.

In addition to ensuring access to required services such as well child services, preventive screenings, immunizations, maternal health care, and pharmaceutical services, health centers develop systems of patient-centered and integrated care that expand access to additional services, including mental health, substance use disorder, and oral health services in areas where economic, geographic, or cultural barriers limit access to affordable health care.

In an effort to understand the unmet need for access to these additional services in underserved areas and populations served by health centers, HRSA developed these service utilization benchmarks by conducting literature reviews and quantitative analyses of relevant data from the:

  • National Survey on Drug Use and Health
  • Medical Expenditure Panel Survey
  • Health Center Patient Survey
  • National Health Interview Survey
  • Health center data reported to HRSA’s Uniform Data System (UDS)
Service Category Mental Health Substance Use Disorder Oral Health Vision Interpretation/Translation
Benchmark - Percentage of the Health Center Program patient population that would reasonably be expected to receive mental health, substance use disorder, oral health, vision, or interpretation/translation service in a year.  33% 17% 59% 37% 24%
Current Utilization - Percentage of total Health Center Program patient population who received a service across all health centers based on 2021 UDS data. 9% 1% 19% 3% 9%*
Additional Need Estimate - Difference between the Benchmark and the Current Utilization for the Health Center Program patient population that needs that service. 24% 16%  40%  34% 15% 
Additional Need Patient Estimate - Number of Health Center Program patients that likely need access to a given service. 7.6M 4.7M 12.1M 10.3M 4.7M

* The current utilization for interpretation/translation is based on 2014 Health Center Patient Survey data.


Questions or Suggestions?

Complete the BPHC Contact Form.

  • Under Health Center Program, select Health Center Program (e.g., Unmet Need Score, Advancing Health Center Excellence Framework) 
  • Tell us about your request

Call 877-464-4772 (select option 1) 8 a.m. – 8 p.m. ET, Monday – Friday (except federal holidays).

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