Medically Underserved Area (MUA) and Health Professional Shortage Area (HPSA)
In some geographic areas, the need for specific providers is high enough to qualify for a federal designation such as a Medically Underserved Area (MUA) or a Health Professional Shortage Area (HPSA) for either primary care, dental or mental health services.
Vermont currently has only a few RSAs that meet the strict federal criteria to qualify for designation as a HPSA. Designations are pending for: Chelsea-Corinth RSA, Windsor RSA, Ludlow RSA, Arlington RSA and Waitsfield RSA.
Vermont’s 60+ Federally Qualified Health Center (FQHC) sites and 10 Rural Health Clinics (RHCs) have facility-based HPSA designations based on specific criteria for their defined service areas. As with geographic HPSAs, if the need score is high enough, providers in that area may qualify for additional federal resources to help recruit and retain providers and sustain the practice in that location.
Governor-Certified Rural Shortage Area (GCRSA)
Another type of shortage designation is called the Governor-Certified Rural Shortage Area (GCRSA). This designation allows primary care providers in a designated area to be certified by the Centers for Medicare and Medicaid Services (CMS) as a Rural Health Clinic (RHC). This certification allows reimbursement for Medicaid and Medicare patients at a higher rate than usual in exchange for accepting all patients regardless of insurance type and offering a sliding fee scale.
In Vermont, these criteria consider the ratio of providers to population, as well as rates of poverty and premature mortality. RSAs that currently qualify for GCRSA designations are Hardwick, Brighton, Newport and Castleton RSAs.