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Disruptions to the patient-provider relationship and patient utilization and outcomes: Evidence from medicaid managed care

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  • Staiger, Becky

Abstract

The patient-provider relationship is considered a cornerstone to delivering high-value healthcare. However, in Medicaid managed care settings, disruptions to this relationship are disproportionately common. In this paper, I evaluate the impact of a primary provider’s exit from a Medicaid managed care plan on adult beneficiary healthcare utilization and outcomes. Using an event study approach, I estimate a 5% decrease in the number of beneficiaries with primary care visits in the year following the exit, with slightly larger effects in terms of percentage points for patients with chronic conditions. Additionally, I observe a nearly 50% increase in the number of beneficiaries with a chronic condition who are hospitalized following a disruption.

Suggested Citation

  • Staiger, Becky, 2022. "Disruptions to the patient-provider relationship and patient utilization and outcomes: Evidence from medicaid managed care," Journal of Health Economics, Elsevier, vol. 81(C).
    • Handle: RePEc:eee:jhecon:v:81:y:2022:i:c:s0167629621001594
    DOI: 10.1016/j.jhealeco.2021.102574
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    References listed on IDEAS

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    3. Deo Bencio, 2013. "Medicaid Analytic Extract Provider Characteristics (MAXPC) Evaluation Report, 2010," Mathematica Policy Research Reports 04ccf7ab6e4040d5a277be732, Mathematica Policy Research.
    4. Fadlon, Itzik & Van Parys, Jessica, 2020. "Primary care physician practice styles and patient care: Evidence from physician exits in Medicare," Journal of Health Economics, Elsevier, vol. 71(C).
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    Cited by:

    1. Hjalmarsson, Linn & Kaiser, Boris & Bischof, Tamara, 2023. "The impact of physician exits in primary care: A study of practice handovers," Health Policy, Elsevier, vol. 135(C).
    2. Katrin Zocher, 2024. "Exiting primary care providers," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 1033-1054, May.
    3. Monsees, Daniel & Westphal, Matthias, 2024. "Disruptions in primary care: Can resigning GPs cause persistently negative health effects?," Ruhr Economic Papers 1082, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    4. Eichmeyer, Sarah & Zhang, Jonathan, 2023. "Primary care providers’ influence on opioid use and its adverse consequences," Journal of Public Economics, Elsevier, vol. 217(C).
    5. Sabety, Adrienne, 2023. "The value of relationships in healthcare," Journal of Public Economics, Elsevier, vol. 225(C).

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    More about this item

    Keywords

    Medicaid managed care; Patient-provider relationship; Care continuity; Disrupted care; Chronic conditions;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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