HPSA Frequently Asked Questions

What does the acronym HPSA stand for and what does it mean?
What areas qualify for HPSA?
What are the criteria for HPSA designations?
What are HPSA designations used for?
Who can I contact in Missouri regarding HPSAs?
Is there a HPSA Designation Process?
How long does a HPSA designation last?
How do I know where HPSA Designations are in Missouri?

What health professionals are considered in Primary Care HPSA designations?
What health professionals are considered in Dental HPSA designations?
What health professionals are considered in Mental HPSA designations?
How are HPSA scores calculated?
What are Medicare HPSA Bonus Payments?

What does the acronym HPSA stand for and what does it mean?
Many Missourians live in areas, such as inner-city or rural locations, where obtaining health care is difficult because health care providers are in short supply. To identify areas facing a critical shortage of primary medical, dental, or mental health care professionals, the Department of Health and Human Services (HHS) relies on its Health Professional Shortage Area (HPSA) designation system.  Originally created in 1978 to identify areas in need of physicians and other health care providers from HHS’s National Health Service Corps (NHSC) programs, HPSA designation is now used by a variety of federal programs—including programs that provide grants for health professions. 

What areas qualify for HPSA?
Urban and rural areas can qualify for HPSA.  HPSAs are classified as geographic (a county or service area), demographic (specific population group) or institutional (federally qualified health centers or other defined facilities). 

What are the criteria for HPSA designations?
Each health professional discipline (medical, dental and mental) and each HPSA type (geographic, demographic or institutional) has its own unique eligibility criteria and specific guideline requirements. 

HRSA’s Office of Shortage Designation (OSD) develops shortage designation criteria and uses them to decide whether or not a geographic area, population group or institution is a HPSA.  These criteria are defined for shortages of primary medical care physicians, dentists, and psychiatrists.  However there are four (4) basic determinations that apply to all HPSAs.

What are HPSA designations used for?
HPSA designations are used to qualify areas, population groups, and institutions for benefits and incentives such as:

Who can I contact in Missouri regarding HPSAs?
The Missouri Primary Care Office (PCO) is the main contact for HPSA information and designation requests specific to the state of Missouri.  The PCO can be reached at 800-891-7415.

Is there a HPSA Designation Process?
Each year, the Health Resources and Services Administration, Office of Shortage Designation (OSD) sends the Missouri PCO a listing of designated HPSAs that are three (3) years or older.  These HPSAs must be updated in order to maintain their designation.  The Missouri PCO is the main contact and information source for HPSAs because they have access to the on-line application system that is used for most HPSA requests.  Therefore all requests for HPSA designations are strongly encouraged to come through the Missouri PCO.  If another individual or agency submits a HPSA request to the OSD without sharing it with the PCO, the OSD will forward the request to the PCO for their review and input. 

Once the Missouri PCO has completed the necessary data collection and analysis, if an area is determined to meet HPSA criteria, the request is submitted to the OSD.  Typically there is a 30 day comment period in which any questions, concerns, or comments can be submitted to the OSD.  Once the comment period has expired, OSD will complete evaluation of the HPSA request and determine whether the criteria for designation have been satisfied.  Every effort is made to complete action on each HPSA designation request within 90 days of the date of receipt, however; this is subject to change based upon current caseload. 

How long does a HPSA designation last?
After a service area is designated as HPSA, the designation remains for a minimum of three (3) years. 

How do I know where HPSA Designations are in Missouri?
The Health Resources and Services Administration, Office of Shortage Designation (OSD) maintains a database that is accessible through the Internet and can be used to verify the status of a HPSA designation.  Different terms are used to describe the status of HPSA designations.  Below is a brief explanation of the terms.

Designated

The area is currently designated as a HPSA.

No New Data

No new data has been submitted to continue the area’s HPSA designation.  Will move to ‘Proposed Withdrawal’ if data is not submitted within timeframe.

Proposed Withdrawal

Area is proposed for withdrawal due to lack of data and information submitted.  Will move to ‘Withdrawn’ if data and information is not submitted within timeframe.

Withdrawn

Area is not designated as HPSA. 

To view HPSA status:  http://hpsafind.hrsa.gov/HPSASearch.aspx

What health professionals are considered in Primary Care HPSA designations?
HPSA designation and criteria for Primary Medical Care refers specifically to doctors of allopathic or osteopathic medicine specializing in the fields of:

What health professionals are considered in Dental HPSA designations?
Dental HPSA designation and criteria refers specifically to Doctors of Dental Surgery (DDS) or Doctors of Dental Medicine (DMD) who practice general and/or pediatric dentistry.  Dentists who practice exclusively in any area of dental specialty are excluded from Dental HPSA criteria.  Examples of those excluded are endodontist, orthodontist, prosthodontist, periodontists, etc.

What health professionals are considered in Mental HPSA designations?
Missouri Mental HPSA designations are based solely on the definition for those doctors of allopathic or osteopathic medicine specializing in the field of psychiatry (psychiatrists).

How are HPSA scores calculated?
Some federal health care programs, such as NHSC programs, allocate their resources on the basis of HPSA scores, not just HPSA designations. Each HPSA is assigned a score on the basis of specific criteria that ranks its shortage of primary care providers, or need, relative to other HPSAs.  HPSA scores are developed to assist in determining those areas or facilities that have the greatest need for health professionals.  For example, the National Health Service Corps utilizes HPSA scores for priority assignment of clinicians. HPSA Scores range from 0 to 25 for primary care and mental health, and 0 to 26 for dental.  The higher the HPSA score is, the greater the need for health professionals.

A copy of the Federal Register Notice of the HPSA scoring criteria is available at:
http://edocket.access.gpo.gov/2003/pdf/03-13478.pdf

What are Medicare HPSA Bonus Payments?
Section 1833(m) of the Social Security Act provides bonus payments for physicians who furnish medical care services in geographic areas that are designated as Primary Care HPSA.   In addition, for claims with dates of service on or after July 1, 2004, psychiatrists furnishing services in Mental HPSAs are also eligible to receive bonus payments.

To determine if you qualify to automatically receive bonus payments, you can review the information provided at: http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/