'Mystery shopper' program canceled

The HHS has dropped its plans for a “mystery shopper” survey in which two calls would be made to 4,185 primary-care physicians by persons pretending to be someone who has private insurance and another by a person saying they are enrolled in a public insurance plan.

"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," said a statement released by the HHS. "Instead, we will pursue other initiatives that build on our efforts to increase access to healthcare providers nationwide."

An initial 60-day comment period had recently concluded, and the project was said to be in the hands of the Office of Management and Budget, which would undertake its own 30-day comment period on the study.

As first reported in Modern Physician, information on the project was posted in the April 28 edition of the Federal Register, but politicians began criticizing the planned survey after an article on the proposed study was published weeks later in the New York Times.

In a statement, Rep. Tom Price, a Republican physician who represents Georgia's 6th district, cited the survey as an example of how “Big Brother is destroying healthcare in America.”

“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,” said Price in the statement. “Rather than conduct covert polling of doctor's offices, the administration ought to spend its time trying to figure out how to work with physicians and other healthcare providers to bring down the cost of care and not toss millions of Americans onto another government program that will be unaffordable, unsustainable and unable to deliver on the promises made.”

Sen. Mark Kirk, (R-Ill.) issued a letter that he requested his colleagues sign "in response to a New York Times article. "

Kirk's letter requested information on the cost of the survey and the “proposed clandestine method of collecting information.”

Among Kirk's 12 questions was one asking, “If your researchers report bad information or use this survey for extortion, bribery or other bad acts, how will they be disciplined?”

Kirk also asked, “Since there are a number of surveys answering this question already, what does this addition of taxpayer spending add?”

Though he didn't cite it by name, a recent New England Journal of Medicine report included results of a survey using the secret shopper methodology to call medical specialists in Cook County, Ill. In the study, two-thirds of the callers who identified themselves as the parent of a publicly insured child were unable to get an appointment with a specialist. Of those who were able to get an appointment, the wait time was 22 days longer than for those who identified themselves as the parent of a privately insured child, according to the study, which was funded by the state of Illinois.

The design of the HHS survey included calling 465 physician offices in Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas and West Virginia.

In an e-mail to Modern Physician, Dr. Patricia Lindholm, president of the Minnesota Medical Association, said the shortage of primary-care physicians is “an ongoing problem that is likely to get worse” and that constant threats to cut Medicare were affecting patient access. She added that about 25% of respondents to a 2010 MMA survey said they were placing new or additional limits on accepting Medicare patients because of the unpredictability of payments.

“As for the proposed study, the MMA is not sure if it will be helpful, but physicians in Minnesota don't have anything to hide,” Lindholm's e-mail stated. “Doctors answer these sorts of questions all the time. “

She added, however, that the situation may be different for physicians in other states.

“Minnesota differs from other states because it has a law that requires doctors to see Medicaid patients if they also want to treat public employees, such as teachers and state workers,” Lindholm said. “So we would expect Medicaid enrollees would have more access to care here than in other states.”