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Identifying Health Professional Shortage and Medically Underserved Areas

The Health Resources and Services Administration's negotiated rulemaking committee to reconsider health professional shortage area (HPSA) and medically underserved area (MUA) reconvened in Washington DC this week. Roughly 60 hours of committee work has now been completed, and many, many hours ahead before we submit our first report to the Secretary of HHS in March 2011. To date the committee has tentatively agreed that there should be HPSAs, MUA/MUPs designations going forward. (The proposed 2008 HHS rule would have combined these into one single designation.) However, beyond that tentative decision point, all options are still on the table for consideration. The focus of this week’s discussion is on determining a structure for assessing need and demand, as well as developing a framework for addressing sub-population methods. My assessment of this process, is that January will be a key month for determining the ultimate success or failure of this group’s ability to develop a path forward. At that time, we will tackle the issues of health status/outcomes analysis and options, reach agreement on a need/demand model, begin discussion on subpopulations, and take our first look at rational service areas. Simply stated, this will be the meeting where many of the tough issues will be addressed. We will also then have a better idea of the ability of our committee to reach consensus on some very difficult issues. For members of the public who wish to be heard on this topic, the committee is accepting public comment into the process. All comments can be submitted to: NPatterson@HRSA.gov. What are the rural health concerns as this process moves forward? A quick look at our 2008 comments to the proposed rule provides a great overview of the rural concerns: NRHA 2008 HPSA/MUA(P) Comments

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