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Balancing Care Access and Fragmentation for Better Outcomes in Veterans With Diabetes


The authors of a study in the April 2021 issue of The American Journal of Managed Care® discuss the possible reasons behind the link between care fragmentation and hospitalizations in veterans with diabetes, as well as potential opportunities to address disjointed care in the context of the widespread telehealth uptake seen during the COVID-19 pandemic.

In recent years, Congress has taken legislative action to allow veterans to more easily access care in the community that is paid for by the Department of Veterans Affairs, or VA. While this has helped dismantle some barriers to accessing care, it has also raised concerns about care fragmentation, or the extent to which a patient’s health care is spread across multiple providers. An ample body of literature has shown worse care outcomes and higher costs in the presence of care fragmentation, which is thought to arise when the different providers and organizations do not communicate effectively with one another.

On this episode of Managed Care Cast, we’re talking with two coauthors of an Original Research article published in our April 2021 issue. The article, “Ambulatory Care Fragmentation and Hospitalization Among Veterans With Diabetes,” examines the association between the system of one’s usual care provider and their level of care fragmentation with their odds of being hospitalized.

The authors joining us today are Lisa M. Kern MD, MPH, associate professor of medicine and of population health sciences at Weill Cornell Medicine, and Drew Helmer, MD, deputy director of the Center for Innovations in Quality, Effectiveness, and Safety at Michael E. DeBakey VA Medical Center in Houston, as well as senior faculty at Baylor College of Medicine.

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