Feds mull ‘mystery shoppers’ to gauge Medicaid access to doctors

By Carrie Ghose

Columbus Business First

It can be difficult to line up that first appointment with a new family doctor, but is it harder if you’re on Medicaid, or have a host of chronic ailments?

The federal government is planning a “mystery shopper” approach to find the pinch points in availability of primary care physicians, according to a Federal Register notice.

The Department of Health and Human Services is seeking approval for a study in which researchers will call more than 4,100 doctors’ offices in nine states and seek appointments posing as patients “with a range of medical needs.” Each office will get two calls, one from someone posing as a privately insured patient, and once from a simulated patient on Medicare or Medicaid. The nine states are Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas and West Virginia.

Afterward, as a test of the method, researchers will call 465 of the practices, describe the study’s purpose and ask direct questions about availability of appointments.

The agency estimates each call will take 5 minutes, using up just under 640 hours, or 16 weeks, of staff time across the nine states.

The mystery shopping technique, a stalwart for checking customer service in the retail industry, has been used more in sting operations to find out if government regulations are being followed, such as fair housing laws.

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