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Health Care Shortage

Unmet Need Designation

Each year the Oregon Office of Rural Health, using multiple criteria, assesses the unmet health care needs for rural Oregon communities. The formula and its results are below.




HPSA and MUA Designations

Below is a list of documents that describe Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA) designations:

The NEW Health Professional Shortage Area (HPSA) Fact Sheet (March 2010) is now available in downloadable format from the Centers for Medicare & Medicaid Services’ Medicare Learning Network on the CMS website. This fact sheet provides general requirements and an overview of the Health Professional Shortage Area (HPSA) payment system.

For more information about HPSA and MUA designations go to the Health Services and Resources Administration's Bureau of Health Professions website.

For specific Medicare regulations governing the Rural Health Clinic program see the National Association of Rural Health Clinic's Interpretive Guidelines - RURAL HEALTH CLINICS, or visit our Rural Health Clinics page.

If you have questions about HPSA and MUA designated places in Oregon, please contact:

Oregon Health Policy and Research

Oregon Governor’s Health Care Shortage Area Designation

Governor Ted Kulongoski announced that the U.S. Department of Health and Human Services (HHS) has approved his request for an Oregon-specific definition of health care shortages that will strengthen access to health care for residents in remote areas of Oregon.

“I am working to expand access to health care for all Oregonians, including rural communities struggling to meet the needs of residents,” the Governor said. “With approval of this request, more rural Oregonians will have access to quality care.”

The Governor submitted a proposal in June to HHS that outlined specific certification criteria for designation of an “Oregon Governor’s Health Care Shortage Area.” The new designation expands eligibility for Rural Health Clinic certification in rural areas such as Lakeview and Enterprise. Certified Rural Health Clinics receive cost-based reimbursement for care provided to Medicaid and Medicare patients, who are disproportionately represented in rural communities.

“This new designation will help strengthen the health care infrastructure in rural and frontier counties,” said Scott Ekblad, director of the Oregon Office of Rural Health. “Economically fragile clinics will now be able to qualify for federal assistance that makes caring for their Medicare and Medicaid patients affordable.”

With the 10th largest land mass in the country, Oregon’s geography creates challenges in access to health care for many rural Oregonians, including time-consuming, long-distance travel to receive care. A 2005 Office of Rural Health report, “Oregon Federally Certified Rural Health Clinics,” identified areas of the state where no federal shortage area designations previously existed, but where health clinics are economically fragile. A closer look at those economically fragile health clinics revealed that they are primarily located in Oregon’s remote counties that did not qualify for existing federal shortage designations.

The new state-based certification process will allow the state to identify areas where health care systems are fragile but do not meet the current federal designation criteria. Under the new state criteria, 10 counties in Oregon that qualify as “frontier” counties—Baker, Wallowa, Grant, Wheeler, Sherman, Gilliam, Morrow, Harney, Malheur and Lake—will automatically qualify for the shortage designation. The average population in Oregon’s frontier counties is 2.1 persons per square mile. Out of the ten counties in Oregon that qualify as frontier, seven have populations with fewer than three persons per square mile; five have populations fewer than two persons per square mile, and three have fewer than one person per square mile. Oregon frontier counties have 2.6 percent of the population in the state and only 1.3 percent of physicians.

The proposal submitted to Health and Human Services was a collaborative effort of the Governor’s Office, the Oregon Department of Human Services, and the Oregon Office of Rural Health at Oregon Health and Science University.

Text above is reprinted from The Oregonian.

This is the original designation document.