Primary Care · 8 min read

The US Primary Care Shortage: What HRSA Data Reveals

HRSA's designation data records where federal criteria identify a primary-care provider shortage. It is a source-grounded reference, not a measure of appointments, insurance coverage, hospital access, or health outcomes.

Key Takeaway

Use this page to understand the HPSA record, then verify a local designation and available services with HRSA. A designation is not a personal care recommendation and cannot show whether a particular clinician has appointments, accepts insurance, or meets your needs.

The short answer

HRSA's March 2026 summary records 101.7 million people in designated primary medical HPSAs and estimates 17,306 additional practitioners would be needed to remove those designations. These are federal designation measures, not care-access or outcome counts. According to the HRSA Data Warehouse, the live figures below describe federal provider-supply designations, not care quality or appointment availability.

By the numbers

The scope, by the numbers

37.4%
U.S. residents in a shortage area
8,233
Active HPSA designations
25,866
Providers needed to clear them

States with the most active HPSA designations

Total active Health Professional Shortage Area designations across primary care, mental health and dental, HRSA Data Warehouse

designations
Source HRSA Data Warehouse, Health Professional Shortage Areas As of August 2026

Find primary-care shortage counties

The 150 counties with the highest primary-care HPSA scores on file. Filter by state, by minimum score, or by name, then open a county for its full designation record.

Showing 150 of 150 counties

CountyStateHPSA scoreCounty population
Madison CountyMS25109,145
Lauderdale CountyMS2572,984
St. Croix CountyVI2541,004
Bolivar CountyMS2530,985
Holmes CountyMS2517,000
Amite CountyMS2512,720
Claiborne CountyMS259,135
Mili CountyMH25Not on file
Bikar CountyMH25Not on file
Erikub CountyMH25Not on file
Arno CountyMH25Not on file
Rongrik CountyMH25Not on file
Bikini CountyMH25Not on file
Jemo CountyMH25Not on file
Ailinglaplap CountyMH25Not on file
Ujae CountyMH25Not on file
Ebon CountyMH25Not on file
Kwajalein CountyMH25Not on file
Ailuk CountyMH25Not on file
Ujelang CountyMH25Not on file
Enewetak CountyMH25Not on file
Namorik CountyMH25Not on file
Maloelap CountyMH25Not on file
Namu CountyMH25Not on file
Mejit CountyMH25Not on file
Jaluit CountyMH25Not on file
Rongelap CountyMH25Not on file
Utrik CountyMH25Not on file
Ailinginae CountyMH25Not on file
Wotho CountyMH25Not on file
Likiep CountyMH25Not on file
Wotje CountyMH25Not on file
Toke CountyMH25Not on file
Lae CountyMH25Not on file
Majuro CountyMH25Not on file
Lib CountyMH25Not on file
Jabat CountyMH25Not on file
Aur CountyMH25Not on file
Kosrae CountyFM25Not on file
Pohnpei CountyFM25Not on file
Yap CountyFM25Not on file
Wayne CountyMI241,793,561
Fulton CountyGA241,066,710
Fresno CountyCA241,008,654
DeKalb CountyGA24764,382
Jefferson CountyAL24674,721
Baltimore City CountyMD24585,708
St. Louis City CountyMO24301,578
Leon CountyFL24292,198
Muscogee CountyGA24206,922
Robeson CountyNC24116,530
Dougherty CountyGA2485,790
Glynn CountyGA2484,499
Jefferson CountyAR2467,260
Jones CountyMS2467,246
Washington CountyMS2444,922
Rio Arriba CountyNM2440,363
Itawamba CountyMS2423,863
Coahoma CountyMS2421,390
Leake CountyMS2421,275
Crisp CountyGA2420,128
Greene CountyGA2418,915
Lee CountySC2416,531
Clarke CountyMS2415,615
Early CountyGA2410,854
Johnson CountyGA249,189
Seminole CountyGA249,147
Stewart CountyGA245,314
Mora CountyNM244,189
Peleliu CountyPW24Not on file
Ngardmau CountyPW24Not on file
Angaur CountyPW24Not on file
Ngatpang CountyPW24Not on file
Ngchesar CountyPW24Not on file
Kayangel CountyPW24Not on file
Melekeok CountyPW24Not on file
Ngaraard CountyPW24Not on file
Ngarchelong CountyPW24Not on file
Airai CountyPW24Not on file
Sonsorol CountyPW24Not on file
Ngernmlengui CountyPW24Not on file
Hatoboheit CountyPW24Not on file
Ngiwal CountyPW24Not on file
Aimeliik CountyPW24Not on file
Koror CountyPW24Not on file
Not Determined CountyMH24Not on file
Cuyahoga CountyOH231,264,817
Duval CountyFL23995,567
Marion CountyIN23977,203
Guilford CountyNC23541,299
St. Clair CountyIL23257,400
Jefferson CountyTX23256,526
Hinds CountyMS23227,742
Santa Fe CountyNM23154,823
Laramie CountyWY23100,512
Mercer CountyWV2359,664
Scott CountyMO2338,059
Floyd CountyKY2335,942
Marshall CountyMS2333,752
Leflore CountyMS2328,339
Emanuel CountyGA2322,768
Hertford CountyNC2321,552
Lincoln CountyWV2320,463
McDowell CountyWV2319,111
Tallahatchie CountyMS2312,715
Wilcox CountyAL2310,600
Tunica CountyMS239,782
Webster CountyWV238,378
Vieques CountyPR238,249
Jefferson CountyMS237,260
Lake CountyTN237,005
Quitman CountyMS236,176
Jim Hogg CountyTX234,838
Maricao CountyPR234,755
Tensas CountyLA234,147
Sioux CountyND233,898
Chuuk CountyFM23Not on file
Harris CountyTX224,731,145
Clark CountyNV222,265,461
Broward CountyFL221,944,375
Mecklenburg CountyNC221,115,482
Prince George's CountyMD22967,201
Erie CountyNY22954,236
Shelby CountyTN22929,744
Macomb CountyMI22881,217
El Paso CountyTX22865,657
Hamilton CountyOH22830,639
Jefferson CountyKY22782,969
Jackson CountyMO22717,204
District of Columbia CountyDC22689,545
Bernalillo CountyNM22676,444
Lucas CountyOH22431,279
Orleans CountyLA22383,997
Fayette CountyKY22322,570
Lubbock CountyTX22310,639
Winnebago CountyIL22285,350
Caddo CountyLA22237,848
Lake CountyOH22232,603
Tuscaloosa CountyAL22227,036
Champaign CountyIL22205,865
Sangamon CountyIL22196,343
Wyandotte CountyKS22169,245
Bibb CountyGA22157,346
Rankin CountyMS22157,031
Guam CountyGU22153,836
Macon CountyIL22103,998
Daviess CountyKY22103,312
Orangeburg CountySC2284,223
Cape Girardeau CountyMO2281,710
Forrest CountyMS2278,158

Source: HRSA Data Warehouse designation records, the same extract behind every county page here (download it). A HPSA score is HRSA's designation severity on a 0–25 scale for primary-care care; a higher score means HRSA scored the area as a greater shortage. It does not tell you whether a specific provider has an opening, accepts your insurance, or offers the service you need. Confirm care options with an official directory and the provider.

The Scope of the Shortage

HRSA maintains a current registry of Health Professional Shortage Areas. Its quarterly summary for March 31, 2026 lists 8,789 primary medical HPSA designations, covering 101,733,016 people, and estimates 17,306 additional practitioners would be needed to remove those designations.

Those figures describe HRSA designation records and the agency's provider-need estimate. They do not establish how quickly a person can get an appointment, whether a clinician accepts a plan, travel time, hospital capacity, or a community's health outcomes. For a current local record, use HRSA's HPSA Find alongside the local service directories below.

Where the recorded clinician gap is largest

This view summarizes the states with the largest HRSA clinician-needed estimates in the current snapshot. It helps frame the full table below, but it is not a vacancy count or a measure of appointment access.

States with the largest recorded primary-care clinician gap

Sum of HRSA's clinicians-needed estimates for active primary-care HPSA records that report an estimate

clinicians needed
Source HRSA Data Warehouse, Health Professional Shortage Areas As of 2026-08-15

Compare primary-care shortage records by state

The interactive table uses this portal's 2026-08-15 HRSA data snapshot. It groups active primary-care HPSA records with a recorded clinicians-needed estimate by state and de-duplicates a designation ID within its state. This keeps the count and the estimate on the same population without treating the result as a vacancy count, a wait-time measure, or evidence that an individual can or cannot obtain care. Filter or sort below; state names open the profile.

# State Primary-care clinicians needed Designations with estimate
1 Texas 1,072 261
2 New York 995 84
3 Washington 564 65
4 Illinois 532 145
5 Ohio 532 140
6 California 518 113
7 Florida 483 118
8 Missouri 482 111
9 Arizona 468 101
10 North Carolina 461 134
11 Michigan 377 90
12 Kentucky 337 120
13 Georgia 318 133
14 Tennessee 306 84
15 Oklahoma 299 80
16 Indiana 298 80
17 Maryland 294 40
18 Mississippi 288 85
19 Virginia 262 105
20 Alabama 246 69
21 New Mexico 232 33
22 Oregon 217 38
23 Minnesota 207 91
24 Arkansas 188 85
25 Louisiana 165 77
26 South Carolina 152 61
27 West Virginia 147 62
28 Puerto Rico 137 21
29 Colorado 131 67
30 Iowa 129 67
31 Nevada 124 27
32 Wisconsin 119 54
33 Kansas 118 65
34 Connecticut 103 22
35 Delaware 98 9
36 District of Columbia 95 4
37 Idaho 92 51
38 Pennsylvania 92 50
39 Utah 79 23
40 Massachusetts 67 22
41 Alaska 52 22
42 South Dakota 48 50
43 Montana 47 48
44 Hawaii 43 10
45 New Jersey 41 20
46 Nebraska 34 41
47 Federated States of Micronesia 33 4
48 Wyoming 27 24
49 Maine 25 27
50 Marshall Islands 18 1
51 North Dakota 18 28
52 American Samoa 17 1
53 Rhode Island 10 4
54 New Hampshire 9 7
55 Palau 7 1
56 Guam 5 3
57 Virgin Islands 4 3
58 Northern Mariana Islands 3 1
59 Vermont 2 4

For the accompanying ranking, interpretation, and a side-by-side state comparison, see our primary-care clinician-gap analysis by state. For a local designation, use the linked state profile or HRSA's official finder.

How to Read a Primary-Care HPSA State Table

A state table can make a designation snapshot look more precise than it is. Read each column as a federal program measure with a defined unit, then use the linked state profile and HRSA record when a local decision depends on the current status.

Designation counts are record counts

A primary-care HPSA designation can describe a geographic area, a population group, or a facility. The count in this table is a count of distinct active designation IDs in the retained HRSA file, not a count of clinics, clinicians, people, or counties with no available care.

HPSA populations can overlap

Several HPSA records can cover the same resident through different geographies, populations, or facilities. A sum of population served can therefore exceed the number of unique residents. That is why this guide does not use an HPSA population total as a direct measure of unmet need, appointment access, or the number of people who need a new clinician.

Practitioners needed is a designation estimate

The clinicians-needed column summarizes HRSA's published estimate for the primary-care designations that report one. It is useful for comparing the recorded workforce shortfall across states, but it is not a vacancy list, a forecast of hiring, or a count of every type of clinician a community can use.

The ratio is a federal threshold

For a geographic primary-care HPSA, the usual federal threshold is 3,500 residents per full-time-equivalent primary-care physician, with a 3,000-to-1 variant where high-need criteria apply. The threshold is part of HRSA's designation process; it is not a universal standard for whether a person can make an appointment or receive high-quality care.

Status changes need the official record

A later HRSA release can add, remove, or update a record, while a local service situation can change for reasons the designation file does not capture. Use the portal's paired-release comparison to see what changed in retained files, and use HPSA Find for the authoritative current designation.

State Totals Do Not Replace Local Records

A statewide total is useful for comparing the recorded scale of designation activity, but it cannot identify a person's service area, provider availability, or eligibility for a program. The same state can contain geographic, population-group, and facility designations with different boundaries and criteria.

Use the Geographic Unit That Matches the Question

Use a state comparison for a statewide workforce context, a county profile for the portal's county-level reference, and HRSA's official finder for a current designation. None of those sources alone can confirm a clinician's availability, network participation, or the care options appropriate for an individual.

HPSA vs. MUA: Two Different Measures of Underservice

What it tells you: HPSAs identify provider shortages in primary care, dental health, or mental health. MUAs and MUPs are separate HRSA designations for geographic areas or populations with a lack of access to primary care services.

What it does not tell you: Neither designation is an appointment, insurance, transportation, hospital-capacity, care-quality, or outcome measure. Do not treat either label as proof that a specific person can or cannot obtain care.

How to use it: Treat a designation as a prompt to check the underlying HRSA record and local services, not as a diagnosis or a recommendation. PlainHealthAccess summarizes the available designation data; HRSA's finder is the authoritative current lookup.

What Drives the Geographic Maldistribution

HRSA's score methodology is more specific than a simple provider count. Primary-care HPSA scoring includes provider-to-population ratio, poverty, an infant-health index, and travel time to an outside source of care. It is a federal prioritization method, not a complete explanation of why a community has a shortage.

This page summarizes the current designation snapshot used across the site. It does not claim that a shortage worsened or improved because of a particular policy, hiring cycle, or health outcome. For record-level movement between two retained HRSA exports, use the release-change report linked below.

How to See What Changed Between HRSA Releases

PlainHealthAccess retains two compatible HRSA HPSA source snapshots and compares them by stable designation ID. The release-change report shows national adds and absences, and each state profile carries a same-method change band for that state.

What the comparison reports: IDs present in the newer export but not the earlier one, IDs absent from the newer export, and counts of newly designated or no-longer-designated IDs when status fields support that read.

What it does not report: why HRSA changed a record, whether care access improved, appointment wait times, or any causal workforce story. Absent IDs are not automatically labeled "withdrawn." County-level multi-county relationship diffs stay out of scope when the earlier snapshot did not retain those links.

What This Means for You

Step 1, Check your county. Look up your county on PlainHealthAccess to see primary care, dental, and mental health HPSA status and scores.

Step 2, Understand the score's scope. Higher HPSA scores represent higher priority within HRSA's scoring method. They do not predict wait times, insurance acceptance, quality, or a person's individual ability to obtain care.

Step 3, Verify services directly. Check the official designation and contact local service directories rather than assuming that a county-level record represents every neighborhood or provider.

Step 4, Find local services. Use HRSA's Health Center Finder to locate nearby health centers and confirm their services, hours, eligibility, and appointment availability directly.

Frequently Asked Questions

How many Americans live in primary care shortage areas?

HRSA's March 31, 2026 quarterly summary lists 101,733,016 people in designated primary medical HPSAs and estimates 17,306 additional practitioners would be needed to remove those designations. These figures do not measure appointment availability or care quality.

What causes primary care shortages?

The HPSA dataset does not establish a causal explanation. HRSA's primary-care score uses provider-to-population ratio, poverty, an infant-health index, and travel time to an outside source of care.

What is the difference between an HPSA and a MUA?

HPSAs measure provider-to-population ratios, whether there are enough doctors. MUAs use a broader Index of Medical Underservice including poverty, elderly population percentage, infant mortality, and provider availability. An area can be designated as one, both, or neither depending on which criteria it meets.

How does living in a shortage area affect health outcomes?

The HPSA dataset cannot answer that question. It identifies a federal provider-shortage designation; it does not measure a person's health outcome, appointment availability, insurance acceptance, or quality of care.

Can I see whether a primary-care HPSA designation changed recently?

Yes for the published record, not for care outcomes. Open the release-change report for the national ID-level comparison, or a state profile for that state's change band. The comparison describes what moved between two retained HRSA snapshots; it does not explain why.

Sources: HRSA, Health Workforce Shortage Areas; HRSA, Scoring Shortage Designations; HRSA, March 2026 quarterly HPSA summary.

Data snapshot: 2026-08-15. HRSA's live designation data can change after this guide is published.

Every figure on PlainHealthAccess is rendered directly from HRSA source data, figures are sourced from HRSA publications and verified against primary sources. This guide analyzes primary-care HPSA designation counts by state from the live snapshot and links to the site's paired-release change report for ID-level adds and absences. It does not treat those record moves as care-outcome trends. See our editorial standards & corrections policy, the methodology behind these numbers, review the public data changelog, or report a data issue for this page.