A Health Professional Shortage Area (HPSA) is assigned by the federal Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) to increase the supply, capacity, and distribution of health professionals in areas that have a verifiable shortage of providers. A HPSA designation may help attract new primary care, mental health, and dental health workers and it may increase Medicare and Medicaid reimbursement to the professionals already providing care in a community. This need is evaluated based on a complex set of statistical criteria as well as both population demographics and geographic factors.
Shortage areas can fall under either the Health Professional Shortage Areas (HPSA) or Medically Underserved Areas/Populations (MUA/P) designations.
A Health Professional Shortage Area (HPSA) is designated as having a critical shortage of either primary care, dental or mental health providers. Each type of HPSA is further classified as being a specific geographic area, a specific population group, or in some cases, a specific facility. There is also an automatic designation for community health centers meeting a set of standard requirements. Once declared, a HPSA designation is valid for a period of three years.
These categories are as follows:
· Geographic Area - This designation indicates that all individuals, who are not living in a group quarter, in the area of designation, have insufficient access to primary care, mental health, or dental health services.
· Population Group - This designation indicates that a subpopulation of individuals living in the area of designation has insufficient access to primary care, mental health, or dental health services. A population group might be defined as an elevated prevalence of residents who are below 200% of federal poverty level, are on Medicaid, are migrant farm workers, or are homeless, among others.
· Facility - This designation indicates that individuals served by a specific health facility have insufficient access to primary care, mental health, or dental health professionals. The types of facilities that can be designated include federal and state correctional institutions, public and nonprofit healthcare facilities, and state and county mental hospitals.
A Medically Underserved Area/Population (MUA/P) designation identifies areas or populations with a shortage of primary care services using a different set of criteria. Medically Underserved Areas/Populations are areas or populations designated by HRSA as having: too few primary care providers, high infant mortality, high poverty and/or high elderly population. Unlike a HPSA this type of designation does not expire. An MUA/MUP may apply to whole counties, a group of counties or civil divisions, or a group of urban census tracts. The Medically Underserved Population (MUP) includes groups of persons who face documented economic, cultural or linguistic barriers to health care.