The study, “The Effect of Medicaid Reimbursement for Psychiatrists on the Health Care Burden of Serious Mental Illness,” published in the June 2026 issue of The American Journal of Managed Care® (AJMC®), analyzed Medicaid claims from over 44 million patients and found that adults with serious mental illness in states with higher psychiatrist reimbursement rates had 24% lower overall health care costs and 19% lower psychiatric-specific costs annually, along with reduced emergency department (ED) and inpatient utilization. SavingAdvice uses these findings to challenge the long-held assumption that higher provider payments always translate into higher spending, framing the AJMC research as evidence that better reimbursement may actually save Medicaid money by reducing expensive hospitalizations and ED visits.
The article, “Medicaid Fraud Crackdown Intensifies, But Is It Solving the Right Problem?” published on AJMC.com, the website of AJMC, examines CMS's intensifying Medicaid fraud enforcement under its CRUSH initiative while raising a critical distinction that only 4 of 21 Medicaid provisions in the federal budget reconciliation law actually target fraud. Becker's ASC Review cites the AJMC piece, using it to argue that the uncompensated care costs from administratively disenrolled but still-eligible patients don't disappear but simply shift to hospital balance sheets, making the distinction between genuine fraud enforcement and eligibility red tape a pressing financial concern for health systems and ambulatory service centers alike.
