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March Issue of The American Journal of Managed Care® Focuses on Medicaid Access, Fragmentation Issues


The issues that plague the rest of the US healthcare system—such as care access and care fragmentation—are also present in Medicaid, according to a series of articles examining various outcomes in multiple states’ Medicaid programs in the current issue of The American Journal of Managed Care®.

(CRANBURY, N.J.) The March issue of The American Journal of Managed Care® (AJMC®) focuses on the impact of Medicaid across the country, including challenges with access to specialists, the association of fragmented care with later emergency department visits, difficulties in having a usual source of care in an urban area with many providers, and more.

Writing in an editorial board letter, health economist Austin Frakt, PhD, noted the immense popularity of Medicaid among Americans, even if that popularity hasn’t translated into action by policy makers in the 14 states that so far have not expanded the safety-net program.

But Medicaid does not address the healthcare access issues associated with fragmented care, he noted, which is common in US healthcare, regardless of payer.

Examples of some of the Medicaid research in the March issue of AJMC® that highlight these challenges include:

  • Community health centers in 9 states and the District of Columbia reported challenges accessing specialty care for their patients, particularly for orthopedists, gastroenterologists, neurologists, and psychiatrists. Payment policies and network adequacy rules may need to be reexamined to address these challenges. The study’s authors are Justin W. Timbie, PhD; Ashley M. Kranz, PhD; Ammarah Mahmud, MPH; and Cheryl L. Damberg, PhD.

  • A study conducted in 7 New York counties found that having more fragmented care was associated with an increase in the risk of having an emergency department visit (but not of having a hospital admission). The study’s authors are Lisa M. Kern, MD, MPH; Joanna K. Seirup, MPH; Mangala Rajan, MBA; Rachel Jawahar, PhD, MPH; and Susan S. Stuard, MBA.

  • In Philadelphia, one-third of new Medicaid enrollees lacked a usual source of primary care and an even greater number lacked a source of dental care. The study’s authors are Krisda H. Chaiyachati, MD, MPH, MSHP; Jeffrey K. Hom, MD, MSHP; Charlene Wong, MD, MSHP; Kamyar Nasseh, PhD; Xinwei Chen, MS; Ashley Beggin, BS; Elisa Zygmunt, MSW; Marko Vujicic, PhD; and David Grande, MD, MPA.

For the full issue, click here.

About The American Journal of Managed Care®

The American Journal of Managed Care® (AJMC®) is a peer-reviewed, Medline-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. AJMC.com is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC® family include The American Journal of Accountable Care® and two evidence-based series, Evidence-Based Oncology and Evidence-Based Diabetes Management. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC® publications, please contact Gil Hernandez at 609-716-7777, ext. 139.

AJMC® Media Contacts

Alexandra Ventura, 609-716-7777, ext. 121


John Patricolo, 609-325-4630, ext. 133


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