Medically Underserved Area (MUA)

Key facts

Designated by

HRSA Bureau of Health Workforce

Scoring tool

Index of Medical Underservice (IMU), scored 0 to 100

Qualifying score

IMU of 62.0 or less

Main program link

Eligibility for the Health Center Program under Section 330

What is a Medically Underserved Area?

A Medically Underserved Area is a federal designation for a place whose residents have too few primary care services. The Health Resources and Services Administration (HRSA) makes the designation after scoring the proposed area with the Index of Medical Underservice (IMU).

An MUA can be a whole county, a group of contiguous counties, a group of urban census tracts, or a group of county or civil divisions. The designation covers everyone living in that area.

How the Index of Medical Underservice is calculated

The IMU converts four measures into weighted values and adds them together. Lower scores mean greater underservice, and an area qualifies at 62.0 or less.

• Ratio of primary care physicians per 1,000 population.
• Infant mortality rate.
• Percentage of the population with incomes below the federal poverty level.
• Percentage of the population aged 65 or older.

MUA vs HPSA

A Health Professional Shortage Area (HPSA) measures a shortage of providers in one discipline (primary care, dental or mental health) and carries a score used to prioritize clinician placements. An MUA measures broader underservice in primary care using health status and demographic factors, not provider counts alone. An area can be one without the other.

The two designations also feed different programs. MUAs and Medically Underserved Populations (MUPs) are central to Health Center Program eligibility, while HPSAs drive National Health Service Corps placements and the Medicare HPSA bonus. MUA designations have not received the regular data refreshes that HPSAs get, so some have been in place for decades.

Why MUAs matter

Organizations applying to become federally funded health centers or look-alikes must serve an MUA or MUP, so MUA maps predict where new Federally Qualified Health Centers (FQHCs) can open. MUAs also count as qualifying locations for Conrad 30 physicians. Payer network teams and site selection analysts use MUA boundaries alongside HPSAs to identify communities where adding a clinic or provider has the most effect on access.