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Scoring Shortage Designations

The National Health Service Corps (NHSC) statute and regulations governs our rules for designating shortage areas. We receive applications from State Primary Care Officers (PCOs) for shortage designations.

We review the applications. Once we designate an area, we calculate a score for it.

What criteria do we use for scoring?

We calculate scores using our online portal, the Shortage Designation Management System (SDMS). It contains standard national data sets.

State PCOs and facilities can provide us with supplemental data.

Health Professional Shortage Area (HPSA) and Auto-HPSAs

We calculate HPSA scores based on methodology that includes three disciplines: primary care, dental health, and mental health.

Three scoring criteria are common across all HPSA disciplines:

  • Population-to-provider ratio

  • Percent of population below 100% of the Federal Poverty Level (FPL)

  • Travel time to the nearest source of care (NSC) outside the HPSA designation area

How do we calculate scores for HPSAs?

Primary Care HPSA Scoring

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

What goes into the score?

  • Population-to-Provider Ratio [10 points max]
  • Percent of population below 100% Federal Poverty Level (FPL) [5 points max]
  • Infant Health Index (based on Infant Mortality Rate (IMR) or Low Birth Weight (LBW) Rate)* [5 points max]
  • Travel time to Nearest Source of Care (NSC) outside the HPSA designation area [5 points max]

Visual representation of the components used in primary care scoring

*The Infant Health Index evaluates both IMR and LBW rate. It awards points based on whichever has the higher score.

Dental Health HPSA Scoring

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

What goes into the score?

  • Population-to-Provider Ratio [10 points max]
  • Percent of population below 100% Federal Poverty Level (FPL) [10 points max]
  • Water fluoridation status [1 point max]
  • Travel time to Nearest Source of Care (NSC) outside the HPSA designation area [5 points max]

Visual representation of the components used in dental scoring

Mental Health HPSA Scoring

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

What goes into the score?

  • Population-to-Provider Ratio [7 points max]
  • Percent of population below 100% Federal Poverty Level (FPL) [5 points max]
  • Elderly Ratio (percent of people over age 65) [3 points max]
  • Youth Ratio (percent of people under age 18) [3 points max]
  • Alcohol Abuse Prevalence [1 point max]
  • Substance Abuse Prevalence [1 point max]
  • Travel time to Nearest Source of Care (NSC) outside the HPSA designation area [5 points max]

Visual representation of the components used in mental health scoring

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

MUA/P scores depend 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.

An area or population can receive an IMU score between 0-100. 

What goes into the score?

  • Provider per 1,000 population ratio [28.7 points max]

  • Percent of population at 100% of the Federal Poverty Level (FPL) [25.1 points max]

  • Percent of population age 65 and over [20.2 points max]

  • Infant Mortality Rate [26 points max]

Visual representation of the components used in medically underserved area and medically underserved population

Exceptional Medically Underserved Populations (MUP) and Governor-Designated Secretary Certified Areas for Rural Health Clinics

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

How to contact us

Shortage Designation Questions

Email SDB@hrsa.gov

SDMP Questions

Email SDMP@hrsa.gov

Questions about Providers in your Auto-HPSA Update Preview

Contact your State PCO

NHSC or Nurse Corps Questions

Submit a help form or call 1-800-221-9393

CMS Bonus Payment Questions

Contact your Medicare Administrative Contractor (MAC)

SDMP Webinars

Auto-HPSA Portal Training Webinars

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