The document discusses potential changes to the designations of underserved medical areas in Virginia. It provides background on the current Medical Underservice Area (MUA) and Health Professional Shortage Area (HPSA) designations, which are based on population ratios and weighted criteria. Previous attempts to consolidate the systems kept over 96% of existing designations. A committee is working to include non-physician practitioners in the ratios. Virginia is working to update all designations before new regulations take effect to minimize potential losses.