Pre-Impact Test of Low-Income MUP and Pop-HPSA Assessment of Population-Specific Scoring of Barriers and ATP

2 Methods % Non-White – using the % non-white amongst the poor as a proxy (ACS) % Hispanic – using the % Hispanic amongst the poor as a proxy (ACS) % Uninsured – Using ACS ratio of uninsurance for those <200% FPL to uninsurance for those <400% FPL within each state ATP scored at 100 (all Low Income are Low Income) P2P, Health Status, and other Barriers remain at the overall community level Scales and thresholds remain unchanged

3 Influence of Barriers and ATP MUP: Barriers and ATP weight = 60 of 100 points –Designation threshold = 54.3 Pop-HPSA: ATP = 50 of 100 points in mid range –Designation threshold = maximum of 80 with most of the range below that (down to 0)

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5 Results on Low Income MUP Pre-Index

6 Results on HPSA-MidRange Pre-Index

7 Low Income pre-Scoring Results MUP: 93% of Universal RSAs designated before any adjustment for low- income health status or access –90% of total pop, 94% of low income pop nationally –Likely that most or all remaining would qualify once P2P and other factors were determined for the low income pop –15% of areas designated will designate on demographics only, regardless of P2P/Health Status factors –87% of areas not qualifying as an MUA would qualify via this MUP method Pop HPSA: 69% of areas in mid range designate (vs 28% without change) –Areas in/out due to high/low P2P alone are unchanged due to no P2P update –Many more areas will fall into mid- or P2P-Only designation range once low income P2P is assessed

8 Considerations Scales still fit the range of values Different factors/variables would get ‘full scoring’ for different populations –Dropping factors/variables would leave a ‘gap’ in the scoring – would need to reweight remaining factors Reweighting could reduce impact but not eliminate underlying scoring issues Adjusting threshold would lead to a different threshold value for every population group –No data to make threshold assessment Current methods score ‘risk’ at the community level only for MUP, and not for Pop.HPSA