Shortage Designation Scoring Criteria

The authorizing statute for the National Health Service Corps (NHSC) created Health Professional Shortage Areas (HPSAs) to fulfill the statutory requirement that NHSC personnel be directed to areas of greatest need. 

HPSAs are used to identify areas, populations groups, or facilities within the United States that are experiencing a shortage of health care professionals. There are three categories of HPSAs based on health discipline: primary care, dental health, and mental health.

As part of the Health Resources and Services Administration’s (HRSA) cooperative agreement with the State Primary Care Offices (PCOs), the PCOs conduct needs assessment in their states, determine what areas are eligible for designations, and submit designation applications to HRSA.  HRSA reviews the HPSA applications submitted by the State PCOs, and—if they meet the designation eligibility criteria—designates a HPSA. To further differentiate areas of greatest need, the HRSA calculates a score for each 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 area

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.

Date Last Reviewed:  May 2020


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