HSD Category Reference

Recruiting tip: Target FQHCs and rural health clinics in rural counties to satisfy PCP adequacy quickly.

Recruiting tip: OB/GYN shortage counties are common in rural areas — document access exceptions proactively.

Recruiting tip: Telehealth-enabled psychiatrists can count toward standards in many states — verify current guidance.

Recruiting tip: Opioid treatment programs (OTPs) and MAT providers are highly weighted by CMS reviewers.

Recruiting tip: Interventional cardiologists and electrophysiologists count; don't limit to general cardiology.

Recruiting tip: High shortage specialty — document any access exceptions before submission.

Recruiting tip: Many ENT groups contract as groups — execute one contract to cover multiple counties.

Recruiting tip: Critical for D-SNP builds given high diabetes prevalence — prioritize early in the pipeline.

Recruiting tip: GI groups often have exclusive system relationships — identify independent GIs as backup.

Recruiting tip: Hospital-employed surgeons can count if the hospital is in-network — verify credentialing path.

Recruiting tip: Critical for D-SNP networks given HIV/AIDS prevalence — Ryan White clinics are a key source.

Recruiting tip: Dialysis centers with affiliated nephrologists satisfy standards and are mission-critical for ESRD members.

Recruiting tip: Stroke centers and neurohospitalist groups can count — verify outpatient access documentation.

Recruiting tip: Medical, surgical, and radiation oncology are tracked separately — don't conflate subspecialties.

Recruiting tip: Distinguish ophthalmologists (MD) from optometrists — CMS counts both but separately for adequacy.

Recruiting tip: Large orthopedic groups with multiple subspecialties cover the requirement across one contract.

Recruiting tip: Hospital outpatient PT departments satisfy adequacy in rural counties where independent clinics are scarce.

Recruiting tip: High shortage specialty in rural areas — file access exceptions for rural counties well in advance.

Recruiting tip: Sleep medicine and pulmonology are often bundled — verify which subspecialties satisfy standards.

Recruiting tip: Very high shortage specialty — document access exceptions for rural counties proactively.

Recruiting tip: Urologists often practice across multiple counties — one contract can cover a wide service area.

Recruiting tip: SNF adequacy is often the easiest to satisfy — most counties have at least one Medicare-certified SNF.

Recruiting tip: Ensure contracted HHAs are Medicare-certified (MA) or state-licensed (Medicaid) — certification type matters.

Recruiting tip: Teleradiology interpretations don't satisfy adequacy — members need physical access to imaging sites.