Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas/Populations (MUA/P) Scoring Criteria

This webpage provided information that describes the scoring criteria for shortage designations.

Final

Issued by: Health Resources and Services Administration (HRSA)

Issue Date: August 01, 2019

Shortage Designation Scoring Criteria

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Announcement

Shortage Designation Modernization Project
We modernized the shortage designation process with automated procedures and standardized data sets.

A Health Professional Shortage Area (HPSA) is a geographic area, population, or facility with a shortage of primary care, dental, or mental health providers and services.

The Health Resources and Services Administration (HRSA) and State Primary Care Offices (PCOs) work together using public, private, and state-provided data to determine when such a shortage qualifies for designation as a HPSA.

What are the Scoring Criteria?

Health Professional Shortage Area (HPSA) & Automatic HPSA

We calculate HPSA scores based on discipline-specific methodology.

Three scoring criteria are common across all HPSA disciplines:

Population to provider ratio
Percentage of the population below 100% of the Federal Poverty Level (FPL)
Travel time to the nearest source of care (NSC) outside the HPSA designation

Review the HPSA scoring methodology, differentiated by discipline:

Primary Care HPSA Scoring

Primary Care HPSAs can receive a score between 0-25.

This is broad overview of the four components we use in Primary Care HPSA scoring:

Population-to-Provider Ratio [10 points max] + Percent of Population below 100% FPL [5 points max] + Infant Health Index (Based on IMR or LBW Rate) [5 points max] + Travel Time to NSC [5 points max] = HPSA Score Out of 25

The Infant Health Index evaluates both Infant Mortality Rate (IMR) and the rate of low birth weight (LBW). It awards points based on whichever of these indicators provide the higher score.

Dental Health HPSA Scoring

Dental Health HPSAs can receive a score between 0-26.

This is a broad overview of the four components used in Dental HPSA scoring:

Population-to-Provider Ratio [10 points max] + Percent of Population below 100% FPL [10 points max] + Water Fluoridation Status [1 point max] + Travel Time to NSC = HPSA Score Out of 26

Mental Health Scoring

Mental health HPSA can receive a score between 0-25.

This is a broad overview of the seven components used in Mental Health HPSA scoring:

Population-to-Provider Ratio [7 points max] + Percent of Population below 100% FPL [5 points max] + Elderly Ratio [3 points max] + Youth Ratio [3 points max] + Alcohol Abuse Prevalence [1 point max] + Substance Abuse Prevalence [1 point max] + Travel Time to NSC [5 points max] = HPSA Score Out of 25

Medically Underserved Area and Medically Underserved Population (MUA/P)

MUA/P score is dependent on the Index of Medical Underservice (IMU) calculated for the area or population proposed for designation.

Under the established criteria, an area or population with an IMU of 62.0 or below qualifies for designation as an MUA/P.

MUA/P Indicators

Provider per 1,000 population ratio
% Population at 100% of the Federal Poverty Level (FPL)
% Population age 65 and over
Infant Mortality Rate

Provider per 1,00 population ration + percent of population at 100% FPL + Percent Population age 65 and over + infant mortality rate = IMU score out of 100

* HRSA must approve the state-developed criteria for Exceptional MUPs and Governors Designated Secretary Certified Shortage Areas for Rural Health Clinics.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.