Skip Navigation HRSA - U.S Department of Health and Human Services, Health Resources and Service Administration U.S. Department of Health & Human Services
Home
Questions
Order Publications
 
Grants Find Help Service Delivery Data Health Care Concerns About HRSA

The Health Center Program: Health Care and Business Plan Performance Measures

Outreach / Quality of Care

Performance Measure: Percentage of pregnant women beginning prenatal care in the first trimester 

Numerator: All female patients who received perinatal care during the program year (regardless of when they began care) who initiated care in the first trimester either at the grantee's service delivery location or with another provider.

Denominator (Universe): Number of female patients who received prenatal care during the program year (regardless of when they began care), either at the grantee's service delivery location or with another provider. Initiation of care means the first visit with a clinical provider (MD, NP, CNM) where the initial physical exam was done and does not include a visit at which pregnancy was diagnosed or one where initial tests were done or vitamins were prescribed.

 

Percentage of children with 2nd birthday during the measurement year with appropriate immunizations

Numerator: Number of children in the "universe" who received all of the following: 4 DTP/DTaP, 3 IPV, 1 MMR, 3 Hib, 3 HepB, 1VZV (Varicella) and 4 Pneumoccocal conjugate, prior to or on their 2nd birthday whose second birthday occurred during the measurement year (prior to 31 December), among those children included in the denominator.

Denominator (Universe): Number of children with at least one medical encounter during the reporting period, who had their second birthday during the reporting period, who did not have a contraindication for a specific vaccine. For measurement year 2008, this includes children with a date of birth on or after January 1, 2006 and on or before December 31, 2006, who were seen for the first time in the clinic prior to their second birthday, regardless of whether or not they came to the clinic for vaccinations or well child care.

 

Percentage of women 21-64 years of age who received one or more Pap tests during the measurement year or during the two years prior to the measurement year

Numerator: Number of female patients 21-64 years of age receiving one or more Pap tests during the measurement year or during the two years prior to the measurement year (for measurement year 2008, patients born on or after January 1, 1944 and on or before December 31, 1987), among those women included in the denominator.

Denominator (Universe): Number of female patients 21-64 years of age during the measurement year (for measurement year 2008, patients born on or after January 1, 1944 and on or before December 31, 1987) who were seen for a medical encounter at least once during 2008 and were first seen by the grantee before their 65th birthday.

 

Health Outcomes / Disparities

Percentage diabetic patients whose HbA1c levels are less than or equal to 9 percent

Numerator: Number of adult patients age 18 and older with a diagnosis of Type 1 or Type 2 diabetes whose most recent hemoglobin A1c level during the measurement year is ≤ 9%, among those patients included in the denominator.

Denominator (Universe): Number of adult patients age 18 years and older as of December 31 of the measurement year (for measurement year 2008, date of birth on or before December 31, 1990) with a diagnosis of Type 1 or Type 2 diabetes, who have been seen in the clinic at least twice during the reporting year and do not meet any of the exclusion criteria.

 

Percentage of adult patients 18 years and older  with diagnosed hypertension whose most recent blood pressure was less than 140/90

Numerator: Patients 18 years and older (for measurement year 2008, date of birth on or before December 31,1990) with a diagnosis of hypertension with most recent systolic blood pressure measurement < 140 mm Hg and diastolic blood pressure < 90 mm Hg.

Denominator (Universe): All patients ≥ 18 years of age as of December 31 of the measurement year (for measurement year 2008, date of birth on or before December 31,1990) with diagnosis of hypertension and have been seen at least twice during the reporting year, and have a diagnosis of hypertension.

 

Percentage of births less than 2,500 grams to health center patients

Numerator: Women in the "Universe" whose child weighed less than 2,500 grams during the measurement year, regardless of who did the delivery.

Denominator (Universe): Total births for all women who were seen for prenatal care during the measurement year regardless of who did the delivery.

Financial Viability / Costs

Total cost per patient

Numerator: Total accrued cost before donations and after allocation of overhead.

Denominator: Total number of patients

UDS Lines: T8AL17CC/TLC for existing grantees

 

Medical cost per medical encounter

Numerator: Total accrued medical staff and medical other cost after allocation of overhead (excludes lab and x-ray cost).

Denominator: Non-nursing medical encounters (excludes nursing (RN) and psychiatrist encounters).

UDS Lines: T8AL1CC + T8AL3CC/T5L15CB - TT5L11CB for existing grantees

 

Change in net assets to expense ratio

Numerator: Ending Net Assets - Beginning Net Assets

Denominator: Total Expense
Note: Net Assets = Total Assets – Total Liabilities

 

Working capital to monthly expense ratio

Numerator: Current Assets - Current Liabilities

Denominator: Total Expense / Number of Months in Audit

 

Long term debt to equity ratio

Numerator: Long Term Liabilities

Denominator: Net Assets

 

Note

  • Health centers must also include one Behavioral Health (e.g., Mental Health or Substance Abuse) and one Oral Health performance measure of their choice in the Health Care Plan.

Requirements & Regulations Related Links
 

Authorizing Legislation (Section 330 of the Public Health Service Act)

Community Health Center Program Regulations

Migrant Health Program Regulations

Grant Award Requirements

Program Information Notices & Program Assistance Letters

Medicare Benefit Policy Manual, Chapter 13


Preventive and Primary
Health Care Guidelines
 

Clinical Information

Preventive Services

Clinical Practice

CDC Catch-up Immunization Scheduler