Health Resources and Services Administration (HRSA)

Description:

PolicyMap downloads Hospitals, Federally Qualified Health Center (FQHC), Home Health Agencies, Nursing facilities, Psychiatric & Community Mental Health Services, and other health facilities points from the HRSA Geospatial Database. These geocoded locations from the HRSA Geospatial Data Warehouse are from a “Provider of Service” extract from the Online Survey and Certification Reporting System database maintained by Centers for Medicare and Medicaid Services. They are included in the HRSA Warehouse because they are the most readily-obtainable data on various classes of health care facility such as hospitals, hospices, rural health clinics, etc.

The Nursing Facility locations provided by HRSA are those facilities participating in Medicare and Medicaid for individuals requiring nursing care and assistance with daily life activities. The Hospitals are those facilities participating in Medicare and Medicaid Services for individuals requiring temporary or long-term medical treatment. The Critical Access Hospitals are those institutions participating in Medicare and Medicaid and meeting the following requirements: being located in rural areas and being located more than 35 miles from any other Hospital or Critical Access Hospital, having no more than 25 inpatient beds and maintaining an average length of stay of 96 hours per patient for acute inpatient care, and providing 24 hour emergency care services.

“Federally Qualified Health Centers (FQHCs)” (often referred to as “Community Health Centers”) receive funding under the Health Center Cluster federal grant program to provide care for underserved populations. The types of providers eligible include Community Health Centers, Migrant Health Centers, Health Care for the Homeless Programs, Public Housing Primary Care Programs, and care providers for some tribal organizations.

On PolicyMap there is also a dataset called “Community Health Centers and Look-Alikes”, which PolicyMap downloads from the Health Resources and Services Administration (HRSA) website. This includes those receiving grants and community health centers that are eligible but not currently receiving grant funding. Although they are not receiving grants, these providers – or “look-alikes” – are eligible for some benefits including enhanced reimbursement from Medicare and Medicaid. Mapping both FQHCs and “look-alikes” might provide a fuller picture of the health-care safety net in a community.

PolicyMap joins individual health center performance data to the Community Health Centers and Look-Alikes point dataset. HRSA tracks this performance data via the Uniform Data System (UDS), which is a reporting requirement for grantees of the following HRSA primary care programs, as defined in the Public Health Service Act: Community Health Center, Migrant Health Center, Health Care for the Homeless, Public Housing Primary Care. Because the UDS data is self-reported, some performance data did not match up with the Community Health Centers and Look-Alikes dataset, resulting in a 95.8% match. For information about health center performance data, see: https://bphc.hrsa.gov/datareporting/index.html.

Medically Underserved Areas (MUAs) are census tracts designated by the Health Resources and Services Administration as having too few primary care providers, high infant mortality, high poverty, and/or high elderly population. See: http://muafind.hrsa.gov/. Medically Underserved Populations (MUP) are areas where a specific population group is underserved, including groups with economic, cultural, or linguistic barriers to primary medical care. If a population group does not meet the criteria for an MUP, but exceptional conditions exist which are a barrier to health services, they can be designated with a recommendation from the state’s Governor.

Due to what HRSA terms a “source data error”, some areas have multiple designations. In these instances, if any designation is MUA, MUA is shown on the map. If MUP and Governor are designated for a single area, MUP is shown. If multiple IMU scores are provided, the lowest score is shown on the map. Although MUA and MUP data is shown on PolicyMap at the tract level, it is provided by HRSA at the tract, county, and minor civil division (MCD). County and MCD level data is shown at the tract level. In cases where a tract was only partially covered by an applicable MCD, it was labeled as not being an MUA or MUP.

The data layers on PolicyMap related to health care professions, health facilities, and hospital utilization are all from HRSA’s Area Health Resource File (AHRF). This data is compiled by HRSA from multiple original data sources, which means that different indicators are available for different years. PolicyMap calculated all the rates in this dataset using the Census’s population estimates for the appropriate year. For more information about the AHRF, see: https://data.hrsa.gov/data/about.

Health Professional Shortage Areas (HPSAs) are defined by the Health Resources and Services Administration (HRSA) as areas that need more health providers in primary care, dental health, or mental health. All HPSAs are defined on the basis of three basic criteria: the ratio of population to health providers, percent of population below the federal poverty level, and travel time to the nearest source of care outside the HPSA area. Dental HPSAs also consider an area’s water flouridation status. Mental HPSAs also consider substance and alcohol abuse prevalence, and percentage of the population over the age of 65 or under the age of 18. Primary Care HPSAs also consider infant mortality rate and low birth weight rate. HPSAs may be designated as “geographic”, “population”, or “point” shortage areas. A geographic HPSA is an area where all residents may experience a shortage of providers. A population HPSA is an area where a specific group of people may experience a shortage of providers. A point HPSA is a specific facility, clinic, or health center that may experience a shortage of providers. PolicyMap excludes point HPSAs as they may not be reflective of the larger population or geographic area. If a census tract is designated as a HPSA more than once, the status and scores for the most recently updated HPSA are shown. HRSA updates HPSA status frequently, so there may be a lag between the data shown on PolicyMap and the latest designation from HRSA. Go to https://data.hrsa.gov/tools/shortage-area to check whether a site of interest lies within a HPSA.

Maternity Care Health Professional Target Areas (MCTAs) are areas within an existing Primary Care Health Professional Shortage Areas (HPSA) that are experiencing a shortage of maternity health care professionals. Maternity Care Target Areas can receive a score between 0-25. What goes into the MCTA score: Population-to-Full-Time-Equivalent Maternity Care Health Professional Ratio [5 points max], Percentage of Population With Income at or Below 200 Percent of the Federal Poverty Level (FPL) [5 points max], Travel Distance/Time to Nearest Source of Accessible Care Outside of the MCTA [5 points max], Fertility Rate [2 points max], Social Vulnerability [2 points max], Maternal Health Indicators, Pre-Pregnancy Obesity [1 point max], Pre-Pregnancy Diabetes [1 point max], Pre-Pregnancy Hypertension [1 point max], Cigarette Smoking [1 point max], Prenatal Care Initiation in the 1st Trimester [1 point max], Behavioral Health Factor [1 point max]