About HRSA & HPSA Designations
The Health Resources and Services Administration (HRSA) is an agency within the U.S. Department of Health and Human Services that works to improve access to health care for people who are uninsured, isolated, or medically vulnerable.
What Is HRSA?
HRSA is the primary federal agency for improving access to health care services for people who are geographically isolated, economically or medically vulnerable. Through its programs and grants, HRSA supports a network of community health centers, rural health clinics, and other safety-net providers.
One of HRSA's key functions is identifying and designating areas of the country that face shortages of health professionals. These designations help direct federal resources, workforce recruitment incentives, and Medicare bonus payments to the communities that need them most.
What Is a Health Professional Shortage Area?
A Health Professional Shortage Area (HPSA) is a designated geographic area, population group, or facility that has a shortage of health professionals. HPSAs are designated across three disciplines:
Primary Care
Shortage of primary care physicians (family medicine, internal medicine, pediatrics, OB/GYN, general practice).
Mental Health
Shortage of mental health professionals (psychiatrists, psychologists, clinical social workers, psychiatric NPs).
Dental Health
Shortage of dental professionals (dentists, dental hygienists) providing general dental care.
Three Types of HPSA Designations
Geographic HPSA
A defined geographic area (such as a county or group of census tracts) where the ratio of providers to population falls below the threshold. Anyone residing in the area is considered to be in a shortage area.
Population HPSA
A specific population group within an area that faces barriers to accessing care, such as low-income populations, migrant farmworkers, or homeless populations, even if the overall area has sufficient providers.
Facility HPSA
Specific facilities such as federally qualified health centers (FQHCs), rural health clinics, correctional facilities, or Indian Health Service facilities that serve underserved populations.
How Designations Are Determined
HRSA uses a data-driven scoring system to evaluate whether an area qualifies for HPSA designation. Key factors include:
Provider-to-Population Ratio
The number of full-time-equivalent primary care providers per population. A ratio above 3,500:1 is the primary threshold for geographic designation.
Poverty Rate
The percentage of the population living at or below the federal poverty level, indicating economic barriers to care.
Travel Time to Nearest Source of Care
The travel time or distance to the nearest source of care outside the designated area, capturing geographic isolation.
Infant Mortality Rate
Used as a health outcome indicator for the severity of the primary care shortage in the area.
Elderly Population Percentage
The proportion of the population aged 65 and older, who typically require more primary care services.
The Impact of HPSA Designation
HPSA designations unlock critical resources for underserved communities, including the 10% Medicare bonus, National Health Service Corps placements, loan repayment programs for providers, and priority for federal grants.
Check Your Area