The economic recession and the rising healthcare costs experienced
by many states in the U.S. is leading us towards the enactment of
legislation that will reform the way that healthcare is provided
and paid for within the individual states. TennCare was developed
in Tennessee as a bold healthcare reform strategy that would
simultaneously contain rapidly rising Medicaid costs while
expanding insurance for a large, uninsured Tennessee population.
The implementation of TennCare in January 1994 instituted the move
of Tennessee's Medicaid patients into managed care health plans.
This study describes the design, rationale, implementation
strategy, and issues of the reform program, as well as offering in
depth insight regarding the effects of the reform strategy on
disproportionate share hospitals, i.e. hospitals that serve a large
portion of Medicaid and uninsured patients. Data spanning ten years
of pre- and post-Tenncare were analyzed to determine the effects of
TennCare on the hospitals. Dr. Ogbonna provides a template for
dealing with policy, managerial, and administrative issues of
rising healthcare costs in Tennessee and the nation in general.
General
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