Researchers pose as heroin users to find treatment gaps

Mar 2012
57,898
39,450
New Hampshire
#1
Posing as heroin users seeking help, researchers contacted hundreds of treatment clinics in U.S. states with the highest overdose death rates. The “secret shoppers” were denied appointments much of the time, especially if they said they were insured through Medicaid.

The study revealed other roadblocks: high fees and a government website riddled with wrong phone numbers. Finding a doctor can be tough for anyone. But for those fighting addiction, motivation can be fleeting.

Families know the problems well, said Jessica Hulsey Nickel, founder of the advocacy group Addiction Policy Forum. She called the Medicaid disparity “very concerning.” Nearly 4 in 10 nonelderly adults with opioid addiction are covered by Medicaid, the federal and state insurance program for low-income patients. “I found it surprising how many calls I had to make before being offered an appointment,” said graduate student Tamara Beetham who encountered both compassion and scolding from clinic staff. “Whether you have cash in your pocket can determine whether you have access to life-saving treatment.”

Nurse practitioners and physician assistants did better than doctors in the study, accepting new patients with Medicaid 70% of the time, compared with 40% of doctors with similar patient loads. When appointments were available, the wait was less than two weeks. That suggests doctors have room in their schedules, but are shunning Medicaid because it pays less than other insurance.

Researchers pose as heroin users to find treatment gaps
 
Likes: Akosikojak

HCProf

Council Hall
Sep 2014
28,797
18,237
USA
#2
Posing as heroin users seeking help, researchers contacted hundreds of treatment clinics in U.S. states with the highest overdose death rates. The “secret shoppers” were denied appointments much of the time, especially if they said they were insured through Medicaid.

The study revealed other roadblocks: high fees and a government website riddled with wrong phone numbers. Finding a doctor can be tough for anyone. But for those fighting addiction, motivation can be fleeting.

Families know the problems well, said Jessica Hulsey Nickel, founder of the advocacy group Addiction Policy Forum. She called the Medicaid disparity “very concerning.” Nearly 4 in 10 nonelderly adults with opioid addiction are covered by Medicaid, the federal and state insurance program for low-income patients. “I found it surprising how many calls I had to make before being offered an appointment,” said graduate student Tamara Beetham who encountered both compassion and scolding from clinic staff. “Whether you have cash in your pocket can determine whether you have access to life-saving treatment.”

Nurse practitioners and physician assistants did better than doctors in the study, accepting new patients with Medicaid 70% of the time, compared with 40% of doctors with similar patient loads. When appointments were available, the wait was less than two weeks. That suggests doctors have room in their schedules, but are shunning Medicaid because it pays less than other insurance.

Researchers pose as heroin users to find treatment gaps
When my friend was going through heroin addiction with her son....she spent 24K on a inpatient rehab facility for him. She took a second mortgage on her home...in which she ended up losing a few years after. He ended up detoxing and cleaning up in jail. He then entered into a diversion program for a couple of years and lived in a half way house for addicts. He has been clean for over 2 years now. We have a popular rehab facility that is part of our hospital. We accept Medicaid and depend on it for survival. The problem with our facility is bed availability. We have over a 3 month waiting period.

Physicians and medical practices have discriminated against Medicaid patients for decades. I fired a technician over it once. She let a patient bait her into a phone fight and I overheard her telling the patient that life is not a free ride and referred to the patient as entitled. Managed care had just launched and the Medicaid program was administered by private insurance companies and HMO's. We were training our patients to make appointments at the clinic instead of going to the ER. The ER would call with symptoms of the patient and ask for permission to treat. If it was something we could handle at the clinic, we asked that they walk across the parking lot and be seen there. Many patients did not like that idea and would fight us on it.

Today, many physicians will not accept Medicaid patients, especially specialists. The reimbursement is very low and some patients tend to be non-compliant. They feel that the patients are too much work and not a return on investment.
 
Mar 2012
57,898
39,450
New Hampshire
#3
When my friend was going through heroin addiction with her son....she spent 24K on a inpatient rehab facility for him. She took a second mortgage on her home...in which she ended up losing a few years after. He ended up detoxing and cleaning up in jail. He then entered into a diversion program for a couple of years and lived in a half way house for addicts. He has been clean for over 2 years now. We have a popular rehab facility that is part of our hospital. We accept Medicaid and depend on it for survival. The problem with our facility is bed availability. We have over a 3 month waiting period.

Physicians and medical practices have discriminated against Medicaid patients for decades. I fired a technician over it once. She let a patient bait her into a phone fight and I overheard her telling the patient that life is not a free ride and referred to the patient as entitled. Managed care had just launched and the Medicaid program was administered by private insurance companies and HMO's. We were training our patients to make appointments at the clinic instead of going to the ER. The ER would call with symptoms of the patient and ask for permission to treat. If it was something we could handle at the clinic, we asked that they walk across the parking lot and be seen there. Many patients did not like that idea and would fight us on it.

Today, many physicians will not accept Medicaid patients, especially specialists. The reimbursement is very low and some patients tend to be non-compliant. They feel that the patients are too much work and not a return on investment.
Thats very true around here where doctors can make a ton of money. Entire practices that refuse to take Medicaid. Medicaid pays so low they dont see it as worth it.
 
Likes: Akosikojak
Jun 2014
49,435
50,326
United States
#4
Today, many physicians will not accept Medicaid patients, especially specialists. The reimbursement is very low and some patients tend to be non-compliant. They feel that the patients are too much work and not a return on investment.

Sounds more like a hedge fund manager than a physician.