HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, June 30, 2011

Spies Like Us

Providers don't like having comparative ratings (such as HACs) published, here. Neither do they relish visits from data-rich detailers, here. And, some of them seem prone to overreacting to patients posting their opinions on web sites, here. Now, we discover, they are opposed to "secret shoppers."

Access to care isn't getting any easier, as the recent research on attempts to make appointments for Medicaid-covered children, here, made clear. So, back in April, HHS slipped a notice into the Federal Register, here, outlining a plan to "collect data from physician offices in order to accurately gauge availability of Primary Care Physicians (PCPs) accepting new patients, assess the timeliness of services from PCPs, and gain insight into the precise reasons that PCP availability is lacking." It seemed innocuous enough and was designed to probe the same private-public vector as the Illinois Medicaid audit. However, the proposal was perhaps a little too explicit in describing its preferred methodology, using "mystery shoppers." 

The HHS plan (including some of its scripted survey questions) was detailed in the New York Times earlier this week, here. It probably only took one quote from a doctor to scupper the plan, “I don’t like the idea of the government snooping… It’s a pernicious practice — Big Brother tactics, which should be opposed.”

Soon, according to Politico, here, a senator was circulating a draft letter to the Secretary and the critical headlines multiplied. By Tuesday the program was put on "indefinite hold," here, although an HHS spokesman tried hard to convince us that  “Politics did not play a role in the decision”

And to think, we were under the impression that a new world of transparency had arrived as outcomes and effectiveness research were poised to mend the healthcare system! [NPT]

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What the naysayers for the mystery shopper program fail to realize is that the government is also a customer and payor, and that this is no less a legitimate quality control exercise than it is when a department store hires a mystery shopper to check quality control. Too bad that it wasn't explained and marketed properly.

Posted by: Vickie Williams | Jun 30, 2011 10:27:49 AM

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