Patient Target Frequently Asked Questions & Calculation Overview Table

HRSA’s nearly 1,400 Health Center Program award recipients provide comprehensive primary health care services in nearly 1,400 service areas to more than 28 million patients annually. This document details how HRSA annually calculates patient targets for these service areas in the Patient Target Calculation Overview table and provides frequently asked questions and answers.

Calculations

1. What is the difference between a patient projection and a patient target?

A patient projection is the number of new, unduplicated Health Center Program patients an applicant commits to serving, typically on Form 1A: General Information Worksheet (Service Area Competition (SAC) or New Access Point (NAP) applications) or the Patient Impact Form (supplemental operational funding applications). A patient target is the sum of patient projections from awarded applications.

2. What should I do in response to my patient target notification EHBs email?

If you will complete a BPR for FY 2021, no action is required. Most health centers will complete a BPR in FY 2021 because health centers whose current 2-year or 3-year project period ends in FY 2021 will receive a 12-month extension with funds.

If you will complete a SAC for FY 2021, the Project Director (PD) and Authorizing Official (AO) should review the patient target calculation, consulting with the governing board or other staff, as appropriate, that develop, review, and approve Health Center Program applications to ensure:

  • Accuracy of the application projections used to calculate the patient target.
  • Understanding of the measurement period and achievement date.

If the patient target and calculation are correct, follow the instructions to confirm the patient target in EHBs. If you have questions, contact the Patient Target team using the BPHC Contact Form HRSA BPHC exit disclaimer.

3. How does HRSA calculate patient targets?

Each patient target includes a base value, plus patient projections from funded supplemental applications. See the Patient Target Calculation Overview table for details.

4. How can I view the patient target in EHBs?

Only the PD and AO associated with the Health Center Program (H80) grant in EHBs can view the patient target, including its calculation values (see the Patient Target Calculation Overview table). The PD and AO can access the patient target from a link in the patient target EHBs notification email or in the H80 grant folder through the Patient Target Management link under the “Others” heading.

Adjustments

5. How can I adjust the patient target?

There are two ways to adjust the patient target, as delineated in the graphic below. Raise any questions or concerns related to either adjustment method with the Patient Target team using the BPHC Contact form HRSA BPHC exit disclaimer.

Patient Target Adjustment Factors and Methods

SAC Application Process

Reduce patient volume

Provider shortage

Site closure

Contract or agreement changes

EHBs Adjustment Process

Lower patient projection noted in application

Relinquished award

Successor in interest/merger/transfer

 

6. How can I lower the patient target through SAC?

You can lower the patient target up to 25 percent through the SAC application process by making a patient projection that is at least 75 percent of the patient target in the Service Area Announcement Table (SAAT).

If the SAC application patient projection is lower than 95 percent of the patient target, reduce the federal request for funding according to the table below.

Patient Projection Compared to Patient Target (%) Maximum Funding Request
95-100% of Patient Target No funding reduction
90-94.9% of Patient Target 0.5% funding reduction
85-89.9% of Patient Target 1% funding reduction
80-84.9% of Patient Target 1.5% funding reduction
75-79.9% of Patient Target 2% funding reduction
Less than 75% of Patient Target Ineligible application

 

7. What should I consider when making an application patient projection?

Relevant factors may include:

  • Patient, clinical, and financial data.
  • Service area and target population needs.
  • Local and state trends (e.g., reimbursement changes, population shifts).
  • The current patient target (do not duplicate projected new patients across applications).
  • The achievement date (ensure a realistic and achievable projection in the calendar year referenced in each NOFO).

Primary Care Associations (PCAs) may serve as a useful resource in developing patient projections. Additional information regarding the impact of patient projections on patient targets will typically be included in the Notice of Award (NoA) for funded applications.

Achievement

8. What is the measurement period for assessing patient target achievement?

The measurement period for achievement is the calendar year following the SAC project period start date, and the achievement date is December 31 of that year. HRSA uses the Uniform Data System (UDS) report (number of patients served) to measure progress and achievement. For example, for health centers awarded a 3-year project period through the FY 2021 SAC, the measurement period is calendar year 2022 and the achievement date is December 31, 2022.

9. How does HRSA quantify achievement of the patient target?

HRSA has not quantified achievement of the patient target. Note that the SAC application patient projection minimum of 75 percent is specific to SAC application eligibility and is not related to patient target achievement.

10. What happens if my health center does not achieve the patient target by the required date?

HRSA will monitor achievement of the patient target through the methodology outlined in question 8.

11. How does HRSA use the patient target?

HRSA uses the patient target to:

  • Ensure awareness of the patient commitment for each service area.
  • Support fair competition and continued provision of comprehensive primary health care services within funded service areas.
  • Assess health center progress toward serving the number of patients for which funding was awarded. HRSA may tie future funding for a service area to that progress. See questions 8-10 for additional information.

Patient Target Calculation Overview

If the next SAC for your service area is the: FY 2021 SAC FY 2022 SAC
(FY 2019 NAP new start former LALs with 12-month extension)
FY 2022 SAC FY 2023 SAC
Your Patient Target is the following Base Value:
  • FY 2020 SAC/SAC-AA patient projection
  • FY 2019 NAP patient projection
  • FY 2018 or 2019 SAC/SAC-AA patient projection
  • FY 2020 SAC/SAC-AA patient projection
Plus Patient Projections from:
  • 2019/2020 SAC/SAC-AA supplemental
  • 2019 NAP satellite
  • 2019 IBHS
  • 2020 SAC/SAC-AA supplemental
  • 2017 AIMS
  • 2018 SUD-MH
  • 2019/2020 SAC/SAC-AA supplemental
  • 2019 NAP satellite
  • 2019 IBHS
  • 2019/2020 SAC/SAC-AA supplemental
  • 2019 NAP satellite
  • 2019 IBHS
Patient Target Achievement Date (based on FY 2019 – 2021 SAC) December 31, 2022 December 31, 2020 December 31, 2020 December 31, 2021

Acronyms

  • AIMS – Access Increases in Mental Health and Substance Abuse Services (HRSA-17-118)
  • IBHS – Integrated Behavioral Health Services (HRSA-19-100)
  • NAP – New Access Points (HRSA-19-080)
  • SAC – Service Area Competition
  • SAC-AA – Service Area Competition-Additional Areas
  • SUD-MH – Expanding Access to Quality Substance Use Disorder and Mental Health Services (HRSA-18-118)
Date Last Reviewed:  May 2020