Inaccurate Provider Lists a Major Barrier to Care

A recent study in California, published in the journal Health Affairs, closely echoes a study that Consumer Health First published last year, in which secret shoppers were deployed to examine access to primary care providers using insurance provider network directories.

In the California study, “secret shoppers” posing as patients were able to schedule an appointment with a primary care physician less than 30% of the time out of the 743 providers contacted.

Our results were similar, and for the same reason. Our report found that of 1,493 OBGYN providers listed in MD, only 22.5% were able to provide a well woman exam within four weeks. 

The answer in both cases lies mainly in the inaccuracy of the data that is in the online directory consumers use. As the California study reports, this results in consumers having “access to health insurance is not necessarily synonymous with access to health care services.”

In Maryland, Consumer Health First worked during the most recent General Assembly to get legislation passed to address this issue. That legislation has resulted in the creation of a Task Force at the Maryland Insurance Administration to put regulations regarding Network Adequacy into effect.