The Government, Undercover


A quickly-scuttled plan by the Department of Health and Human Services (HHS) to use "mystery shoppers" to test the availability of primary-care physicians (PCPs) would likely never be extended to HM—but the federal tack has certainly touched a nerve with some practitioners. (Ed note: updated June 29, 2011)

"Using surrogate patients or a sneaky way to get the data feels a bit less straightforward," says James Levy, PA-C, vice president of personnel for Traverse City-based Hospitalists of Northern Michigan. "If I were the government, I'm sure it would occur to me to do it that way. Nobody is going to be comfortable with surreptitious observations. That would seem to carry the message that the government doesn’t trust the providers it's reimbursing."

The government proposed using people pretending to be patients, both insured and uninsured, to gauge how long it takes to get PCP appointments. The action was proposed in the April 28 Federal Register. Comments were solicited, but negative feedback prompted HHS to drop the plan in a June 29 announcement.

Levy and David Friar, MD, CEO of Northern Hospitalists, say that the logistics of hospital admission make it near impossible for the government to have anybody pose as something they're not. Still, in an email, Dr. Friar adds that, aside from "philosophical indignation," he would likely not object should HHS try a similar tack with hospitalist groups.

"In essence, every patient that sees a hospitalist is a mystery patient," he writes. "We don't control who comes in, or what their diagnosis is or when they'll arrive. We have little control over any of those things. Since payors are collecting data on every aspect of hospitalists’ performance, and what they aren't, the hospitals we work for are, we have little left to hide."

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