Health Center Program Strategic Initiatives

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

Health Center Performance Management

The Health Center Performance Management effort aims to advance approaches to managing health center performance based on value, clinical quality, and community health outcomes while ensuring the financial stability of health centers. The project will identify, define, and test potential approaches to value-based grantee performance management for the Health Center Program.

At the conclusion of this undertaking in September 2020, HRSA aims to:

  • Support the timely, evidence-based management of the Health Center Program;
  • Understand and identify the return on investment of all funding provided to health centers;
  • Explore models for targeting
    • existing funding to incentivize key priority areas; and
    • new or additional Health Center Program funding to achieve desired outcomes.

To ask questions or provide feedback, please email

Health Center Performance Management Webinar

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 obtain Federally Qualified Health Center (FQHC) Medicare reimbursement. They can enroll sites in Medicare using either the electronic Provider Enrollment, Chain, and Ownership System (PECOS) or the paper enrollment application process (e.g., CMS-855A).

CMS encourages all provider types to register in PECOS, relatively few health centers sites do so.

Since 2017, we have worked with CMS’s Provider Enrollment & Oversight Group to identify ways to streamline the Medicare enrollment process for health centers. HRSA now shares health center site data with CMS to prepopulate in PECOS to reduce the time and burden associated with the paper application process. CMS launched this PECOS upgrade in April 2019.

Medicare Site Enrollment Webinar

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

To ask questions or provide feedback, please email

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 to assessing unmet need to support Health Center Program decision-making.

The SANAM uses publicly available data to automatically calculate an Unmet Need Score (UNS) for every zip code within a proposed service area. The SANAM reduces burden for applicants by automating calculations of unmet need and standardizes the assessment of unmet need across different service areas to assist the Health Center Program in targeting its resources to areas of unmet need.

Resources for the SANAM and UNS include:

The SANAM was initially incorporated in the fiscal year (FY) 2019 New Access Points (NAP) funding opportunity. HRSA will evaluate the use of the SANAM and UNS in the FY 2019 NAP funding opportunity, and will continue to explore ways in which the SANAM and UNS can be adjusted and improved for future use through the Health Center Program.

To ask questions or provide feedback, please email

Date Last Reviewed:  December 2019