TennCare

TennCare is a managed care health program implemented in the state of Tennessee to replace the Medicaid program.

TennCare was proposed and implemented in 1990 by former Governor of Tennessee Ned McWherter. He demonstrated how the program could cover many of the medically-underserved uninsured and uninsurable population for about the same amount of money as was being spent to cover only the medically indigent under Medicaid.

Unfortuantely, the program has never seemed to live up to its considerable potential. Tennessee now has a higher proportion of its population on state-assisted healthcare than any other state. The cost savings largely evaporated when health-care advocates for the poor challenged many of the managed-care features and the state agreed to modifications at considerable expense. Two of the managed care organizations founded to be involved in the administation of the plan filed for bankruptcy and were liquidated, and several other of the insurance companies intially involved in it later opted to leave. The program became increasingly unpopular with doctors and hospitals as well, due to low reimbursement rates and slow payments. Providers complained that the reimbursment rates were so low as to force cost-shifting from private-pay and privately-insured patients to cover the losses on TennCare patients.

Phil Bredesen was elected Governor of Tennessee in 2002 largely on the strength of his background in managed healthcare and his promise to implement major TennCare reforms. These efforts are ongoing. Bredesen has recently indicated that if the "advocates" of health care for the poor continue to sue to prevent the enforcement of managed-care provisions that he will have no alternative but to dismantle TennCare and return to the Medicaid program.