Wisconsin Primary Care Programs: Why Are Shortage Designations Important?

A number of federal and state benefits, P-01692, are linked with Health Professional Shortage Area designations (HPSAs) and/or Medically Underserved Area/Population designations (MUA/Ps). These benefits are designed to encourage health professionals to work in rural and inner-city shortage areas and increase access to primary care, dental care and mental health services.

Provider Payment Incentives Linked with HPSAs or Governor's Designation for RHCs

  • Medicare HPSA bonus: 10% bonus payment for covered physician or psychiatrist services in geographic HPSAs (primary care and mental health HPSAs respectively)
  • Medicare HPSA surgical incentive payment: 10% bonus payment for general surgeons for major surgical procedures performed in geographic primary care HPSAs.
  • Wisconsin Medicaid HPSA bonus: 20% reimbursement bonus for covered services by primary care physicians, advanced practice nurses and physician assistants located in a HPSA or serving recipients living in a HPSA (includes a 50% bonus for certain Obstetric services).
  • Rural Health Clinic Certification: Certified RHCs are eligible for Medicare and Medicaid cost-based reimbursement for outpatient services in rural HPSAs or rural MUAs or Governor Designated Shortage Areas for RHCs.

Provider Recruitment Resources Linked with HPSAs or MUA/Ps

Federal Community Health Center Funding Linked with MUA/Ps

  • Non-profit community organizations located in MUA/Ps are eligible to apply for federal grants under the Community Health Centers Program (community health center, migrant health center, health care for the homeless, public housing health center).
  • Federally funded community health centers are then eligible for cost-based reimbursement from Medicare and Medicaid as federally qualified health centers (FQHCs).

Health Professions Training Resources Linked with HPSAs and MUA/Ps

Health professions academic training programs who apply for many of the education and training grants from the federal Bureau of Health Workforce are given a funding preference if they can demonstrate that they recruit students from and if their graduates serve populations in designated HPSAs and MUA/Ps.

Glossary

 
Last revised January 12, 2023