A Health Podyssey

Jane Zhu Gets Spooky About Phantom Providers


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Finding access to mental health services can be challenging in the United States.


The explosion of the demand for services, the inadequate workforce to provide them, and payment levels and methods that don't always support the care people need all contribute to these challenges.


There are also longstanding concerns around access to all types of care for people enrolled in Medicaid, primarily due to low payment rates for services.


If you put those together, it's not surprising that access to mental health services for people on Medicaid poses particular challenges. And since Medicaid is the largest payer for mental health services and treatment in the United States, these are challenges that need to be addressed.


Jane Zhu from Oregon Health and Science University joins A Health Podyssey to discuss access to mental health services for Medicaid enrollees.


Zhu and colleagues published a paper in the July 2022 issue of Health Affairs assessing the prevalence of what they call "phantom providers" in Oregon Medicaid managed care networks


These are providers who are listed in network directories but not providing many services to Medicaid patients. They found that a large share of mental health providers listed in these network directories saw four or fewer Medicaid patients in 2018. The shares were largest for specialists and people authorized to prescribe medication.

Order the July 2022 issue of Health Affairs for research on type 2 diabetes and more.

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A Health PodysseyBy Health Affairs

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