A secret shopper study from Ohio State University, published in JAMA Health Forum, found that fewer than one in four calls to mental health providers listed in commercial insurance directories ended with an appointment. The researchers placed more than 5,800 calls to psychiatrists and psychologists in five states, using the directories of the largest commercial carriers.
The main problem was "ghost networks" — providers listed as in-network but unreachable or unavailable. About 60% of calls went unanswered. Among calls that were answered or outright disconnected, over half had directory inaccuracies, including wrong contact information, specialty errors, and disconnected numbers. Another one in five evaluable calls hit capacity limits, such as providers not accepting new patients.
The study suggests that existing state and federal laws, including the No Surprises Act, have not translated into more accessible mental healthcare. The authors argue these laws focus on the wrong metrics and overlook other barriers. The article also notes that psychologists often work alone in small offices without staff to handle calls, and that a recent HHS OIG report found 28% of behavioral health clinicians in Medicaid directories were unreachable. CMS has proposed a rule to clean up Medicare Advantage directories and create a centralized provider directory.