Reasons for the HHS Doc Spy Program

by Tevi Troy

Anyone wondering why HHS might engage in a spy operation to determine if doctors are denying appointments to Medicare and Medicaid recipients should read this fascinating article in the Summer National Affairs by Avik Roy called “Saving Medicare from Itself.” Roy includes a table showing physicians who accept no new patients, by form of insurance. According to the chart, doctors are less likely to take new Medicare patients than privately insured patients, and even less likely to take new Medicaid patients than Medicare ones. He also shows that things are likely to get worse for Medicare patients, as “thanks to last year’s health-care law, Medicare payment rates are set to fall below those of Medicaid in the latter part of this decade, according to Medicare’s chief actuary, Richard Foster.”

For this reason, as well as a host of others, HHS is right to be worried about doctor acceptance of Medicare patients. As I noted yesterday, though, a spy program is not the answer. We need significant reforms to Medicare in order to ensure that seniors can get the medical care they need. As Roy argues regarding Medicare, “Unless the program is reformed to rely less on such price controls, Medicare patients will find it increasingly difficult to get care.”

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