The HHS Rural Health and Primary Care Program works cooperatively with the federal Health Resources and Services Administration (HRSA), the Iowa Governor’s Office, and local communities to identify primary care provider (primary medical care, dental health care, and mental health care) shortages across the state.
Based on geographic, population and provider data analysis, primary care provider shortages can be qualified by geographic area, population group, or facility and, if qualified, are designated as one of the following: Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), and Medically Underserved Population (MUP). This allows for eligibility of state and federal recruitment and retention programs, especially in rural areas.
Additionally, county-level population to provider ratios and other data are analyzed every 4 years to assess county eligibility to qualify as a medically underserved area by the Governor. If qualified, this area is called an Iowa Governor’s Designation for Rural Health Clinics and supersedes the requirements of MUA/MUPs in the case of high need situations. This designation is utilized exclusively to satisfy a criteria to become a certified rural health clinic (RHC), which allows for enhanced Medicare and Medicaid reimbursement. Based on the results of newly analyzed data every 4 years, the following opportunities apply:
- A designation remains qualified
- A new designation is qualified, which allows for any RHC in that area to be eligible for certification
- An area no longer qualifies as a designation. In this case, any associated Rural Health Clinic certification is sustained (grandfathered) but new RHCs established in the area are not eligible for certification
Health Professional Shortage Area (HPSA) is a geographic area, population groups, or facilities designated by the Health Resources and Services Administration, as having an acute shortage of primary medical care, dental health care, and/or mental health care professionals.
Medically Underserved Area (MUA) is a geographic area designated by HRSA as having too few primary care providers, high infant mortality, high poverty or a high elderly population.
Medically Underserved Population (MUP) is a population group designated by HRSA as having too few primary care providers, high infant mortality, high poverty or a high elderly population.
The lowa Govemor's Designation for Rural Health Clinics is a medically underserved area designated by HRSA that is a criteria for Rural Health Clinic certification, which allows for enhanced Medicare and Medicaid reimbursement.
Shortage Designations for Primary Care Providers Handout
This handout provides a description of each type of designation as well as information about what programs are available to qualifying areas, populations, or facilities.
Iowa HHS Rural Health and Primary Care Program Role
The following shortage designation services are provided:
- Receives applications from local entities and works with the HRSA to approve requests for HPSAs, MUAs, and MUPs designations.
- Collects and analyzes population and provider data to facilitate the establishment or review of primary care shortage designations across Iowa.
- Coordinates with the Governor’s Office to disseminate information to federal agencies and the public regarding Governor’s shortage areas.
Shortage Designation Application and Review Process
This process applies to Health Professional Shortage Area, Medically Underserved Area, and Medically Underserved Population designations. Designation statuses are reviewed following a regular update cycle and may be updated more frequently if significant provider changes occur.
- The HHS Primary Care Office receives and reviews applications submitted by local entities year-round.
- Following review, the HHS Primary Care Office submits applications to the HRSA for consideration.
- The application is reviewed and opened for both HRSA and the HHS Primary Care Office to comment for 30 days.
- A final decision on each designation request is made within 90 days of the initial application submission date.
- The HHS Primary Care Office and interested parties are notified of the outcome within 24 hours of making the final decision. The new designation is posted to the HRSA data portal.
For more information about shortage designations, please visit the Health Resources and Services Administration Shortage Designation website.
For information about current HPSA, MUA, or MUP designations, please visit the HPSA Find website.