TennCare: Tennessee's answer to runaway Medicaid costs.
TennCare was implemented in Tennessee on January 1, 1994, as the state's replacement program for Medicaid. Created through a demonstration waiver under Section 1115(a) of the Social Security Act, TennCare is unlike any other state Medicaid program in the nation because it includes coverage of uninsured and uninsurable Tennesseans. By contracting with managed care organizations (MCOs) to administer the Medicaid benefit package to TennCare enrollees, the state virtually privatized the program and dramatically shifted the state's responsibility from one of total administration to an oversight function only. Amid provider lawsuits, MCO contract controversy, and general chaos surrounding the new program, the implementation of TennCare created one of the most significant health care events in the state's history. This article provides an overview of the TennCare program and its impact on enrollees, providers, and the state budget.
Baggett
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Managed Care Consulting Associates, Franklin, TN, USA.
Harkey
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JB
Alexander
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D014487:Centers for Medicare and Medicaid Services, U.S.; D003299:Cooperative Behavior; D003363:Cost Control; D004608:Eligibility Determination; D005380:Financing, Government; D008329:Managed Care Programs / Q000191:economics* / Q000592:standards; D008484:Medicaid / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D015397:Program Evaluation; D011787:Quality of Health Care; D013221:State Health Plans / Q000191:economics* / Q000592:standards / Q000639:trends; D013714:Tennessee; D014481:United States; D014600:Utilization Review