Health Center Program Strategic Initiatives

HRSA supports special projects to inform the strategic development of the Health Center Program.

Advancing Health Center Excellence Framework

The Advancing Health Center Excellence Framework aims to spur innovation and performance improvement in seven key domains: Access and Affordability; Patient Experience; Quality, Patient Care, and Safety; Population Health and Social Determinants of Health; Financial Sustainability; Workforce; and Governance and Management.

There are four performance levels within each domain. The basic performance level builds on standard Health Center Program requirements and the top level is considered leading. The framework aims to help health centers to:

  • Self-assess their current state of performance across the seven domains;
  • Identify a desired future state of performance.

HRSA is still considering how and when we might implement the framework, but we expect it will help us better target technical assistance and other resources. To ask questions or make suggestions, please use the BPHC Contact Form HRSA BPHC exit disclaimer. Choose “Health Center,” and then the “Strategic Initiatives” sub-category, and then the “Health Center Performance” sub-category. Or call 877-464-4772 Monday – Friday (except federal holidays).

Advancing Health Center Excellence Webinar

Presentation Slides (PDF - 2.7 MB)

Medicare Site Enrollment

Health centers that receive approval from HRSA for new service-delivery sites must enroll with the Centers for Medicare and Medicaid Services (CMS) to get Federally Qualified Health Center (FQHC) Medicare reimbursement. Health centers can enroll sites in Medicare using either the electronic Provider Enrollment, Chain, and Ownership System (PECOS) or the paper enrollment application (e.g., CMS-855A).

CMS encourages all provider types to enroll electronically via PECOS.

Since 2017, we have worked with CMS’s Provider Enrollment & Oversight Group to identify ways to streamline the Medicare enrollment process for health centers. We now share monthly health center site data with CMS to make it easier for grantees to enroll using PECOS.

Medicare Site Enrollment Webinar

HRSA and CMS hosted a webinar to share information about streamlining Medicare site enrollment for health centers and using PECOS.

To ask questions or make suggestions, please use the BPHC Contact Form HRSA BPHC exit disclaimer. Choose “Health Center,” then the “Strategic Initiatives” sub-category, and then the “Medicare Site Enrollment” sub-category. Or call 877-464-4772 Monday – Friday (except federal holidays).

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 SANAM and UNS in that funding opportunity and adjusted the measures and weights to improve the SANAM for future decision-making resulting in UNS 2.0.

Resources for the SANAM and UNS include:

To ask questions or make suggestions, please use the BPHC Contact Form HRSA BPHC exit disclaimer. Choose “Health Center,” then the “Strategic Initiatives” sub-category, and then the “SANAM” sub-category. Or call 877-464-4772 Monday – Friday (except federal holidays).

Service Area Status

The Service Area Status (SAS) describes the health, social, and economic status of a health center’s service area. HRSA developed the SAS by leveraging SANAM and the data used in the calculation of the UNS. HRSA is evaluating the different uses for SAS.

Resources for the SAS include:

To ask questions or make suggestions, please use the BPHC Contact Form HRSA BPHC exit disclaimer. Choose “Health Center,” then the “Strategic Initiatives” sub-category, and then the “Service Area Status” sub-category. Or call 877-464-4772 Monday – Friday (except federal holidays). 

Service Area Considerations

To inform service area-related policy considerations and to solicit additional ideas and suggestions from the public related to these topic areas, HRSA sought public input and feedback through a Request for Information (RFI). To view key takeaways from public feedback visit the Health Center Program Service Area Considerations Request for Information webpage.

Date Last Reviewed:  October 2021