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HHS Calls Off 'Mystery Shopper' Program to Investigate Doctors HHS Calls Off 'Mystery Shopper' Program to Investigate Doctors

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HEALTH CARE

HHS Calls Off 'Mystery Shopper' Program to Investigate Doctors

The Department of Health and Human Services is scrapping a plan to use “mystery shoppers” to investigate whether primary care physicians are filtering patients depending on the type of insurance they have.

Following criticism from physicians, medical associations, and members of Congress, the agency announced on Tuesday that it would not move forward with the mystery shopper plan, instead focusing on improving access to primary care through training and encouraging physicians to practice in underserved areas.

 

“After reviewing feedback received during the public comment period, we have determined that now is not the time to move forward with this research project,” an HHS spokesperson said in a statement. “Instead, we will pursue other initiatives that build on our efforts to increase access to health care providers nationwide.”

The Obama administration originally proposed hiring secret shoppers to call more than 4,000 primary care physicians in nine states and pose as prospective new patients. The purpose of the program would be to determine the doctors' willingness to accept new patients with public health insurance.

Evidence suggests that at least some doctors are turning away Medicaid patients. An April survey by the American College of Emergency Physicians found that 97 percent of emergency room doctors reported treating Medicaid patients who could not find a primary care physician to accept their insurance. A study in the June issue of the New England Journal of Medicine found children on Medicaid’s Chip Health Insurance Program in Illinois were turned away from doctor’s offices 65.6 percent of the time, compared with only 10 percent of the time if they were insured with Blue Cross and Blue Shield.

 

The problem Medicaid patients have in getting doctors to care for them could only get worse with the expansion of the Medicaid program under the 2010 health care law.

A New York Times report about the mystery shopper plan annoyed some over the weekend.

“Doctors should be able to spend their time focusing on providing the highest level of quality care to their patients, not wondering when Uncle Sam might be calling to spy on them,” Rep. Tom Price, R-Ga, who is an orthopedic surgeon, said in a statement. “This type of outrageous action sows yet another level of distrust between government and the people it serves, and it does nothing to address the underlying issue of access to care.”

This article appears in the June 29, 2011 edition of National Journal Daily PM Update.

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