A stunning new report claims that 50 percent of the doctors who are listed as being under contract with Medicaid to treat patients are not available for appointments,
according to The New York Times.
They are either not accepting new Medicaid patients or no longer lived at their last known addresses, according to the report from the inspector general of the Department of Health and Human Services.
"Half of providers could not offer appointments to enrollees," the investigators, led by the inspector general Daniel Levinson said in the report, which was due to be released on Tuesday.
The investigators called participating doctors’ offices and found that they were often unavailable or unable to make appointments. More than one-third of providers could not be found at the location listed by a Medicaid plan, the newspaper said.
"In these cases, callers were sometimes told that the practice had never heard of the provider, or that the provider had practiced at the location in the past but had retired or left the practice," Levinson told the Times. "Some providers had left months or even years before the time of the call."
Although 8 percent of participating doctors were at the listed locations, they claimed that they did not take part in the Medicaid health plan while another 8 percent accepted Medicaid but were not taking new patients, the Times reported.
"When providers listed as participating in a plan cannot offer appointments, it may create a significant obstacle for an enrollee seeking care," Levinson said.
"Moreover, it raises questions about the adequacy of provider networks. It suggests that the actual size of provider networks may be considerably smaller than what is presented by Medicaid managed-care plans."
The study showed that investigators contacted 1,800 doctors in 200 health plans under contract with Medicaid in 32 states to treat patients. When doctors did make appointments, the median wait time was two weeks.
"Over a quarter of providers had wait times of more than one month, and 10 percent had wait times longer than two months," the report said, adding that the delays could cause serious complications for patients.
"For example, a number of obstetricians had wait times of more than one month, and one had wait times of more than two months for an enrollee who was eight weeks pregnant. Such lengthy wait times could result in a pregnant enrollee receiving no prenatal care in the first trimester."
Primary care providers were less likely to take appointments than specialists, the report said. But specialists tended to have longer wait times, with a median wait time of 20 days, compared with 10 days for a primary care provider, such as family doctors and internists.
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