Persistent Primary Care Health Professional Shortage Areas (HPSAs) and Health Care Access in Rural America

Congress passed the Health Professions Educational Assistance Act of 1976 to address the crisis in primary care supply in rural and inner-city locations of the United States. This legislation created primary care Health Professional Service Areas (HPSAs), which help states and communities increase their primary care supply through eligibility for loan repayment, technical assistance, increased reimbursement through Medicare, Federally Qualified Health Center (FQHC), and Rural Health Clinic designation. This study examines the degree to which persistence of primary care HPSA designation in rural counties is associated with lower population socioeconomic status and deficiencies in access to health care services.