Secret Shopper research shows bias against patients with ‘worse’ insurance

The underlying causes of health disparities are many, and sometimes healthcare providers can exacerbate disparities with how they operate.

Health equity researchers have conducted "secret shopper" studies, revealing how healthcare providers limit appointments — and even treatment recommendations — to people with certain types of insurance.

“Patients with Medicaid were significantly less likely to be offered appointments compared to those with Medicare or private insurance, and in many cases, clinics told us they weren't accepting any new Medicaid patients or that they didn't take Medicaid at all,” says Dr. Daniel Wiznia, Associate Professor of Orthopaedics & Rehabilitation at Yale and a former member of Movement Is Life’s Steering Committee.

“But when we would call back with private insurance, suddenly they have plenty of appointments available for the private insurance patients,” he says.

Wiznia and his colleagues also found that even when Medicaid patients were offered appointments, wait times were often much longer — delays which can have serious consequences. 

“So if a Medicaid patient has to wait six weeks or eight weeks for an appointment, while a private patient just waits maybe a week, that can really impact outcomes, especially for patients with chronic conditions or urgent needs,” he says.

Wiznia joined Movement Is Life’s Dr. Mary O’Connor to discuss these findings in detail. He offers advice to patients who may find themselves in a situation where they’re denied care due to their insurance status and explains how raising reimbursement rates for Medicaid could help address the problem.

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