What Are Health Professional Shortage Areas And How Are Physician Assistants Helping?

Across the U.S., there are approximately 6,700 Health Professional Shortage Areas (HPSAs), according to the Health Resources & Services Administration (HRSA). A HPSA designation indicates that a specific geographic area or population is suffering from a health care provider shortage. Shortages can impact both urban or rural areas and even facility-level populations.

Generally, in order to receive an HPSA designation, there must be fewer than 1 physician per 3,500 people. Currently, over 79 million Americans live in HPSAs. As part of the designation process, shortage areas are segmented into types and categories.

Physician with Stethoscope

HPSA Types

HPSAs are spread across three general types:

    • Primary health care – Denotes a shortage of physicians in a service area. Physician shortages are calculated from family physicians, pediatrics, ob/gyn, and general internal medicine practices only.
    • Mental health care – Denotes a shortage of mental health professionals and psychiatrists in a service area. Mental health care shortages are calculated from ratios of population to mental health providers.
    • Dental health care – Denotes a shortage of dentists in a service area. A dental shortage is calculated from general dentists only.

HPSA Categories

In addition to types, HPSAs are further divided into three categories:

    • Geographic area – Designation based on a shortage of healthcare providers within a geographically defined population. Typically, though not always, based on county-wide areas.
    • Population groups – Designation denoting a shortage of providers for specific population groups such as low income, migrant farmworkers, and other potentially at-risk groups.
    • Facilities – These designations are reserved for the following facilities: correctional facilities, community health centers, rural health clinics, and other Federally Qualified Health Centers.

The various types and categories mean that HPSAs can vary from densely populated urban areas suffering from a shortage of physicians, to sparsely populated rural counties suffering from a lack of mental health providers. Fortunately, programs and incentives have been set in place at both federal and state levels to help combat these shortages.

The benefits of working in an HPSA

In order to help alleviate the health professional shortages, there are a number of programs that offer financial incentives for practicing or providing health care in HPSAs. One such program is the National Health Service Corps (NHSC) loan repayment program. Through this program, healthcare professionals who provide 2 years of full-time service in designated HPSAs are eligible for up to $50,000 in loan repayments.

In addition to the NHSC program, there are often state-level loan repayment programs available to health providers. Furthermore, there are even some programs which provide additional signing bonuses to providers who decide to practice in shortage areas.

Altogether, these incentive programs are a major help in attracting health professionals, such as physician assistants, to HPSAs. According to a 2017 National Commission of Certified Physician Assistants (NCCPA) report, 55% of PAs who accepted jobs in shortage areas say they did so because of loan forgiveness programs.

How Physician Assistants Can Help Shortages

Despite current incentives to help attract healthcare professionals to HPSAs, the Health Resources & Services Administration (HRSA) predicts there will be a shortage of up to 20,400 primary care physicians by 2020. The two largest factors for this growing shortage are population aging and expansion of medical benefit coverage. The HRSA believes physician assistants will play a critical role in alleviating this shortage.

With their shorter training times, the supply of PAs is outpacing the supply of physicians. PAs are becoming increasingly important in addressing the nation’s health provider shortage. The HRSA notes that if the supply of nurse practitioners and PAs continues to grow and can be successfully integrated, the shortage of 20,400 physicians in 2020 could be reduced to only 6,400.

Physician assistants can take a pivotal role in the forefront of addressing the country’s healthcare shortage. If you’d like to play an active role in the health of your community or hundreds of communities across the U.S., a career as a PA could be for you. Learn more about becoming a PA and the flexibility of online PA programs to get started.


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