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Highlights

To identify areas facing shortages of health care providers, the Department of Health and Human Services (HHS) relies on its health professional shortage area (HPSA) designation system. HHS designates geographic, population-group, and facility HPSAs. HHS also gives each HPSA a score to rank its need for providers relative to other HPSAs. The Health Care Safety Net Amendments of 2002 required GAO to report on the HPSA designation system. GAO reviewed (1) the number and location of HPSAs and federal programs that use HPSA designations to allocate resources or provide benefits, (2) available research on HPSA designation criteria and methodology, and (3) the impact of a 2002 provision that automatically designates federally qualified health centers and certain rural health clinics as facility HPSAs. GAO obtained and analyzed HHS's data on primary care HPSA designations as of September 2005 and January 2006 and identified reports on HPSA criteria and methodology through a literature search of peer-reviewed journals and other reports published since 1995.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should publish a list of designated HPSAs in the Federal Register or otherwise remove, through Federal Register notification, the HPSA designations for those HPSAs that no longer meet the criteria or have not provided updated data in support of their designations.
Closed - Implemented
HHS published a list of designated HPSAs in the Federal Register on November 3, 2011. An HHS official confirmed that the publication removed the HPSA designations for those HPSAs that no longer met the criteria or that had not provided updated data in support for their designations. Specifically, the official stated that all HPSAs that had a status of P (proposed withdrawal) or N (no new data submitted) from 2002 through September 1, 2011 were withdrawn effective the date of the Federal Register publication.
Department of Health and Human Services The Secretary of Health and Human Services should complete and publish HHS's proposal to revise the HPSA designation system and address the shortcomings that have been identified in the current methodology for designating HPSAs.
Closed - Implemented
HHS published its proposal to revise the HPSA designation system in the Federal Register on February 29, 2008. In response to the many comments received on the proposed rule, HHS announced in July 2008 that it would issue a revised proposal prior to issuing the final rule.

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