OBJECTIVES: Provider continuity is defined as seeing the same health care provider over time. Previous studies indicated that high provider continuity improves health care outcomes and the efficiency of health care delivery.  The impact of provider continuity in sickle cell disease (SCD) care, however, is unknown. This study examined the association between provider continuity and the risk of SCD-related hospitalization and re-hospitalization within 30 days of discharge. METHODS: A retrospective cohort study was conducted using Florida Medicaid claims data from 2001-2005. Patients with claims containing SCD-related ICD-9 codes (282.41-282.42, 282.6- 282.64, 282.68-282.69) were selected. To be eligible, individuals had to be aged <65 years, continuously enrolled in Medicaid, and have made ≥2 ambulatory visits. Modified modified continuity index (MMCI) scores were calculated to quantify provider continuity.  Cox proportional hazard modeling was used to examine the relationship between MMCI and hospitalization and 30-day re-hospitalization controlling for basic demographics, prior utilization, SCD treatments and complications. RESULTS: A total of 2422 patients with mean age of 10.2 (SD=11.9) and 47.2% male were included. Average MMCI score was 0.60 (SD=0.28), 53.47% had ≥1 SCD-related hospitalization; of those, 18.8% were re-hospitalized within 30 days.  After controlling for patient-level factors, patients with higher provider continuity were less likely to be hospitalized (HR=0.53, 95% CI: 0.44-0.65), but MMCI was not significantly associated with 30-day risk of re-hospitalization (HR=0.89, 95% CI=0.55-1.43).  CONCLUSIONS: Higher provider continuity was associated with a lower risk of SCD-related hospitalization in the Florida Medicaid SCD population, but did not affect the rate of 30-day re-hospitalization.  Policies that improve and maintain continuity between SCD patients and a single provider may lead to lower hospitalization rates and possibly lower health care costs.