Understanding HPSAs and MUAs

Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs) are designations based upon Federal standards. By existing in one of these designated areas, clinics are qualified to receive advantages. If your clinic is located in a rural setting in particular, it is paramount that you understand HPSA and MUA designations.

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Health Professional Shortage Areas (HPSAs)
Medically Underserved Areas (MUAs)


HPSAs are designations that indicate health care provider shortages in primary care, dental health, or mental health. These shortages may be geographic-based (a shortage of providers for the entire population within a defined geographic area), population-based (a shortage of providers for a specific population group within a defined geographic area – e.g., low income, migrant farmworkers, etc.), or facility-based (correctional facilities, state mental hospitals, Auto-HPSA facilities – see below, and other facilities serving a geographic or population with a shortage of providers). The Health Resources and Services Administration (HRSA) and State Primary Care Offices (PCOs) work together using public, private, and state-provided data to determine when such a shortage qualifies for designation as a HPSA.

Automatic Facility HPSAs (Auto-HPSAs) are facilities that are automatically designated as a HPSA by statute or through regulation without having to apply for a designation. These include Health Center Program grantees and Look-Alikes (community-based health care providers that meet the requirements of the Health Center Program but do not receive funding). A facility with an Auto-HPSA may also have separate geographic and/or population HPSAs.

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MUAs and MUPs, like HPSAs, are federally designated. The MUA is a designation for a geographic area while the MUP is for a specific population within a geographic area, such as the medically indigent or migrant and seasonal farmworkers. The geographic area may be a whole county, a group of neighboring counties, a group of urban census tracts, or a group of county or civil divisions. MUPs are specific sub-groups of people living in a defined geographic area with a shortage of primary care health services. These groups may face economic, cultural, or linguistic barriers to health care.

MUA/P designations are based on the Index of Medical Underservice (IMU). IMU is calculated based on the population to provider ratio, the percent of the population below the federal poverty level, the percent of the population over age 65, and the infant mortality rate.

For more information on MUAs and MUPs, please visit the HRSA Shortage Designation: MUAs & MUPs and MUA Find webpages.