Medicare Just Doesn't Get It

[docB]

Medicare is planning to research the primary care shortage by calling doctors to set up fake appointments and see how long it takes to get seen. Here's an article describing the program.

That doesn't bother me. The really stupid part is the script they're planning to use when they call asking for a primary care appointment:

Mystery shopper: "Hi, my name is Alexis Jackson, and I'm calling to schedule the next available appointment with Dr. Michael Krane. I am a new patient with a P.P.O. from Aetna. I just moved to the area and don't yet have a primary doctor, but I need to be seen as soon as possible." Doctor's office: "What type of problem are you experiencing?" Mystery shopper: "I've had a cough for the last two weeks, and now I'm running a fever. I've been coughing up thick greenish mucus that has some blood in it, and I'm a little short of breath."

That description is going to result in no appointment and an immediate referral to the ER. I think CMS is in for a shock about how often that happens.

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[The White Coat Investor]

That cracks me up. You're so right.

 

[WilcoWorld]

I'm OK with that script prompting a "go to the ER" response. What I'd be concerned with is an "our next available appointment is 2013" response.

...but yeah, I see your point. That sort of research isn't going to tell Medicare anything about PCP availability.

 

[deleted77919]

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[pkwraith]

It looks like HHS has decided it was a bad idea and called it off:

http://abcnews.go.com/Health/govt-decides-mystery-shopper-program-test-doctors/story?id=13951469

 

[docB]

It looks like HHS has decided it was a bad idea and called it off:

http://abcnews.go.com/Health/govt-decides-mystery-shopper-program-test-doctors/story?id=13951469

They decided it was a bad idea after they got a lot of press. I suspect they'll still do it but they'll be much more quiet about it.

 

[Daiphon]

Methinks it may have already been done... HHS is very much into the "do first, ask questions later" mentality.

Also, the data will be seriously flawed even if they use a more appropriate script; established patient visits are quickies, but new patient visits often need ~45min or more and are often limited to certain #'s per day or week.

Even if there's availability on the schedule, for say, Friday; if you're a new patient, you may not get scheduled until the next available "new patient" slot in 3 weeks.

Probably why we typically get the "I couldn't get into my PMD for a referral... I thought the ER was quicker" patients.

-t