Since 2019, the funding model for Primary Health Care (APS) in Brazil has changed structurally. Saúde Brasil 360 replaced the old per-registered-team transfer with a performance-linked model - where a significant share of federal funds depends on the quality of the data recorded and the results achieved.
For municipal managers, understanding this logic is no longer optional. It is a condition for not losing money.
How Saúde Brasil 360 works
Federal funding for APS under Saúde Brasil 360 has three components:
1. Weighted capitation
A transfer calculated from the number of people registered with Family Health and Oral Health teams, weighted by socioeconomic and vulnerability factors of the territory. Municipalities with more vulnerable populations receive a higher per capita amount.
What affects it: the quality and ongoing updating of individual registrations in e-SUS APS. Outdated or incomplete registrations directly reduce the amount received.
2. Pay for performance
A transfer tied to meeting targets on 7 strategic health indicators, such as prenatal care coverage, childhood vaccination, follow-up of hypertensive and diabetic patients, among others. Municipalities are evaluated in semiannual cycles.
What affects it: the quality of clinical records in e-SUS APS. If the care happens but is not recorded correctly, it does not count toward the calculation - it is money left on the table.
3. Incentive for strategic actions
An additional transfer for municipalities that meet specific requirements for implementing the Ministry of Health's priority programs.
Ordinance 3,493/2024: the updated targets
Ordinance GM/MS No. 3,493/2024 updated the Saúde Brasil 360 indicator targets and established new rules for calculating the maximum funding ceiling. Together with Technical Note 12/2025, it defines the criteria that apply to evaluation cycles from 2026 onward.
Municipalities that do not reach the minimum targets receive only the basic fraction of the performance component - and may lose up to 40% of that component's potential value.
The most common mistakes that cost municipalities money
In practice, loss of federal funding rarely happens because of a lack of care. It happens because of recording failures.
Care not recorded in e-SUS: professionals who see patients but do not record them in the system. The care exists, but as far as the Ministry of Health is concerned, it does not.
Records with low completeness: forms filled out incompletely, missing the fields required to calculate the indicators.
Outdated registrations: users who moved, died or switched to another team and still appear in the registry as active - inflating denominators and distorting rates.
Late or erroneous submissions: data sent after the deadline or with technical inconsistencies can be invalidated in the SISAB (Health Information System for Primary Care) consolidation process.
How a data-driven management system changes this picture
The logic is simple: you cannot improve what you do not measure. And you cannot fix what you find out about too late.
An efficient management system for Saúde Brasil 360 needs to do three things:
1. Monitor indicators in real time
Know, today, what the prenatal care coverage of Team 3 at the Central UBS (basic health unit) is - not find out in the Ministry's semiannual report. DHF's management dashboard shows Saúde Brasil 360 indicators updated in real time, with alerts when a team falls below target.
2. Identify recording gaps
Compare the number of visits performed with the number of records in e-SUS. If there is a discrepancy, there are unrecorded visits - which means lost funding. The DHF platform identifies these gaps automatically and lets the manager prompt the teams to fix them.
3. Reduce no-shows on priority indicators
Some indicators - such as prenatal visits and chronic disease follow-up - depend on the patient showing up. An automatic reminder system, such as the one offered by Celina via WhatsApp, directly reduces no-shows on these critical visits, improving the indicators that determine federal funding.
How much your municipality may be losing
To illustrate the financial impact, consider a municipality of 20,000 inhabitants with 3 Family Health teams. The pay-for-performance component of Saúde Brasil 360 can amount to between R$ 80,000 and R$ 200,000 per semiannual cycle, depending on size and score.
A municipality that reaches 60% of the targets receives 60% of that amount. A municipality that reaches 90% receives 90%. The difference can reach R$ 80,000 per semester - funds that could pay for equipment, medicines or new hires.
The role of active management
Maximizing Saúde Brasil 360 funding takes more than good systems. It takes an active management stance: constant monitoring of indicators, regular feedback to teams and quick action when an indicator starts to drop.
The DHF platform provides an automatic daily summary of output by team precisely so that managers have this view without having to generate reports manually.
If you are a health manager and want to know how your department is positioned on the Saúde Brasil 360 indicators, get in touch with our team. We do a free preliminary analysis.
