Marc Babitz, MD, a senior fellow of the Coastal Research Group, has been appointed to a 24-member federal committee that will review and update the criteria used to define health professional shortage areas (HPSAs) and medically underserved areas (MUAs).
The two types of federal designation, created respectively by the 1970 federal legislation that established the National Health Service Corps and the 1974 Health Maintenance Organization Act, are used for a variety of purposes, many of which are far afield from the purposes of either of the original acts.
There is considerable evidence that both designations were afterthoughts incorporated into these legislative acts late the process with minimal policy direction as to how they were supposed to be implemented.
Over the decades federal authorities have found ways to meet programmatic objectives even when they are implementing legislation tied to one set of designations or the other, but it is often by working around rather than being guided by the designations. They are often not a reliable guide for needs assessment studies. At their worst the designations have had perverse impacts on providing services to needful populations.
The nation has had nearly four decades experience as to their efficacy (or inefficiency) for defining geographical areas and population groups, yet this is the first attempt to deal with the issue comprehensively. The 24 person panel has a wide spectrum of representatives of providers of health services to communities of need, and of persons with experience in academic medicine, public health and health policy.
Dr Babitz has agreed to report on the progress of the committee at the 22nd National Conference on Primary Health Care Access in April 2011 in San Francisco.