National Technical Assistance Programs (NTAP) Cooperative Agreements - The National PCA Hub (Hub) proposes to serve as the Operational Excellence National Technical Assistance Program (NTAP) to strengthen the performance, sustainability, and resilience of existing and potential health centers nationwide. Health centers face mounting operational complexity driven by workforce shortages, financial pressures, evolving payment models, expanding service expectations, and increasing demands related to data, technology, and emergency preparedness. A coordinated, outcomes-focused national approach is essential to improve access, efficiency, and long-term stability while maintaining high-quality, patient-centered care. Aligned with Make America Healthy Again (MAHA) priorities and HRSA’s Health Center Performance Improvement Framework, this project will support health centers across all seven performance domains: Governance, Leadership, and Management; Financial Sustainability; Workforce; Access and Affordability; Quality, Patient Care, and Safety; Patient Experience; and Community Health and Health-Related Needs. Technical assistance (TA) will help health centers assess performance, close operational gaps, and implement practical strategies that move beyond compliance toward sustained operational excellence. The Hub will deliver a comprehensive portfolio of 25 national TA activities, eight Communities of Practice (CoPs), and six outcomes-focused cohorts aligned with HRSA’s Operational Excellence objectives. Services will address access optimization; chronic care and preventive service operations; workforce recruitment, retention, and governance capacity; financial and revenue management; health information technology and data modernization (including cybersecurity and artificial intelligence adoption); pharmacy optimization; capital planning and growth; service expansion; workflow optimization; emergency preparedness; and train-the-trainer capacity building for Primary Care Associations (PCAs) and Health Center Controlled Networks (HCCNs). Communities of Practice. CoPs will address priority Operational Excellence objectives, including chronic care management and preventive services, financial and resource management, healthcare transformation, health information technology and data management, workflow optimization, train-the-trainer for PCAs and HCCNs, and preparedness for emergencies and environmental hazards. Each CoP will provide structured, one-year peer learning with defined performance domains and measurable application of strategies. Outcomes-Focused Cohorts. The Hub will implement six multi-year cohorts serving health centers at or below the third quartile in operational and financial performance. Cohort areas will include: 1) staffing and utilization; 2) days cash on hand; 3) addressing overall cost per patient; and 4) net operating margin. Each cohort will include at least 40 health centers and focus on advancing performance toward the next highest quartile using UDS-aligned measures, structured planning, coaching, peer exchange, and evaluation. What the Hub Uniquely Brings. The Hub will deliver a coordinated, nationwide approach to TA supported by embedded PCA infrastructure across all states and territories. Unlike episodic TA models, it integrates standardized strategies with localized reinforcement, leveraging trusted networks, UDS-aligned data targeting, and coordinated collaboration with PCAs and HCCNs to ensure implementation fidelity and reduce duplication. This approach converts fragmented TA into coordinated action that drives measurable operational gains and sustained improvement. TA will be available to all existing and potential health centers regardless of geography, H80 status, Look-Alike designation, or NTAP membership. By aligning national strategy with regional expertise and sustained implementation support, the Hub will ensure federal TA investments produce durable improvements in access, efficiency, workforce stability, and financial sustainability nationwide.
