U.S. Government sends mystery shoppers to investigate doctor’s care decisions

Health Insurance Industry NewsThe Federal government has announced its intention to try to use mystery shoppers to discover whether or not the type of insurance a person has is leading general practitioners – primary care physicians – to accept or reject the individual as a new patient.

The government has acknowledged that there is currently a sizeable problem with the ability to obtain an appointment with primary care physicians, as approximately 60 million Americans are without the ability to receive this service.

Department of Health and Human Services spokesperson, Christian Stenrud, said that “understanding access to primary care is a priority of the administration.” Among the largest barriers in this is the lack of primary care physicians in adequate numbers.

These doctors are vital to the ability of the Department to meet their goal of making certain that every American is able to receive healthcare that is of a high-quality and affordable.

The mystery shopper program will involve phoning 4,185 different primary care physician offices within nine different states. The calls will be made by Office of the Assistant Secretary for Planning and Evaluation staff members.

Each of the doctor’s offices will receive two different calls. The calls will involve the staff member pretending to be a potential new patient. In the first contact, the caller will claim to have private insurance. In the second contact, the caller will pretend to have public insurance. The callers will either express that they wish to have a routine examination, or they will indicate that they have an urgent medical need.

After the first wave of calling is complete, the physicians will receive a third call that will simply ask whether or not the office is accepting new patients and about the length of time it takes to obtain an appointment.

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