California Office of Statewide Health Planning & Development

Primary Care Health Professional Shortage Area

Health Professional Shortage Areas (HPSAs) are based on the evaluation of criteria established through federal regulation to identify geographic areas or population groups with a shortage of Primary Care providers.

Definition of Primary Care Health Professional Shortage Area (PCHPSA)

The federal PCHPSA designation (formerly Health Manpower Shortage Areas) identifies areas as having a shortage of health care providers on the basis of availability of primary care physicians.

Criteria: To qualify for designation as a PCHPSA, an area must be:

1. A rational service area: California recognizes Medical Service Study Areas as rational service areas;
2. Population to primary care physician ratio: 3,500:1 or 3,000:1 plus population features demonstrating "unusually high need;" and
3. A lack of access to health care in surrounding areas because of excessive distance, overutilization, or access barriers.

Benefits of designation as a PCHPSA include:

• Education loan repayment and personnel placement through the National Health Service Corps (NHSC);
• Improved Medicare reimbursement. Physicians in geographic PCHPSAs are automatically eligible for a 10% increase in Medicare reimbursement;
• Eligibility for Rural Health Clinic Certification (a prospective payment method designed to enhance access to primary health care in rural underserved areas);
• Eligibility for the NHSC/State Loan Repayment Program;
• Enhanced federal grant eligibility; and
• Funding preference for primary care physician, physician assistant, nurse practitioner, and nurse midwife programs that provide substantial training experience in HPSAs.