Medically Underserved Area/Population (MUA/P) Application Process

State Primary Care Offices (PCOs) use the Shortage Designation Management System (SDMS) to submit MUA and MUP applications to us for review.  

Eligibility for MUA/P designation depends 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.

How the Index of Medical Underservice (IMU) works

The IMU scale is from zero to 100. Zero represents completely underserved. One hundred represents least underserved.  

HRSA calculates the IMU by assigning a weighted value to an area or population’s performance on four demographic and health indicators. The weighted values are then added together.

What indicators do we use?

  • 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 1,000 population ratio [28.7 points max] + Percent of Population at 100% FPL [25.1 points max] + Percent Population age 65 and over [20.2 points max] + Infant Mortality Rate [26 points max] = IMU Score Out of 100

How the application process works for exceptional Medical Underserved Populations (MUPs)

A state governor can recommend, and a PCO can then request, an exceptional MUP for a population that demonstrates need but does not meet the regular criteria for designation.  

What must the applications describe?

They should describe in detail:

  • the unusual local conditions;
  • access barriers; and
  • other demonstrated needs which led to the recommendation for exceptional designation.  

These requests must also include a written recommendation for designation from the governor or other chief executive officer of the state (or state-equivalent) and local health official, as well as any supporting data. 

Date Last Reviewed:  May 2020