Researchers uncover troubling misinformation in directories

A new study has found substantial inaccuracies in physician directories for Medicare Advantage (MA) patients seeking dermatologic services.

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According to a study led by Jack Resneck Jr., M.D., professor of clinical dermatology at the University of California, San Francisco, MA directories often severely overestimate the number of in-network dermatologists-and that’s just one of several problems the researchers uncovered.

The researchers arrived at their conclusions by having scripted phone calls placed to every dermatologist listed in directories for the largest MA plans in 12 U.S. metropolitan areas. The caller would ask for an appointment for his fictitious father suffering from severe itching, asked whether the dermatologist accepted the relevant plan, and finally asked for the next available appointment date.

Following are some of the study’s findings:

• Of the 4,754 total physician listings, 45.5 percent were duplicates in the same plan director

• Among the remaining unique listings, less than half-48.9 percent-of physicians were reachable, accepted the listed plan and offered an appointment for the fictitious patient

• Many of the dermatologists listed had incorrect contact information, were deceased, retired or had moved, or were not accepting new patients

• Average wait time for an appointment for the fictitious patients was about 46 days

• Accuracy of network directories and appointment wait times varied substantially by health plan and metropolitan area. For one plan, the caller was unable to make an appointment with any listed dermatologist

The authors write that inaccurate directories of doctors covered by an insurance plan may lead to people having minimal options and to the federal government approving plans that don’t meet provider-availability standards.

“These inaccuracies occurred in areas with long appointment wait times and where plans are terminating selected physician contracts,” the study concludes. “This suggests a lack of capacity that would be exacerbated by further network narrowing. Accurate physician directories are essential for proper oversight of network adequacy, and for patients who rely on these listings to evaluate health-plan options during open enrollment.”

Resneck JS, Quiggle A, Liu M, Brewster DW. The Accuracy of Dermatology Network Physician Directories Posted by Medicare Advantage Health Plans in an Era of Narrow Networks.JAMA Dermatol. 2014: doi:10.1001/jamadermatol.2014.3902