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

J Health Econ. 2022 Jan;81:102574. doi: 10.1016/j.jhealeco.2021.102574. Epub 2021 Dec 27.


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.

Keywords: Care continuity; Chronic conditions; Disrupted care; Medicaid managed care; Patient-provider relationship.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chronic Disease
  • Delivery of Health Care
  • Humans
  • Managed Care Programs*
  • Medicaid*
  • Patient Acceptance of Health Care
  • United States