UT Study: Satisfaction with TennCare Remains High; Number of Uninsured Children Declines

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KNOXVILLE — In the past year, the number of uninsured children in Tennessee has declined, while the number of uninsured adults has increased. Also, TennCare — the state’s medical assistance program for low-income adults and uninsured children — continues to get high marks from those who receive its benefits.

Those findings are included in “The Impact of TennCare: A Survey of Recipients 2009″ recently released by the Center for Business and Economic Research (CBER) at the University of Tennessee, Knoxville. The study was done by Bill Fox, CBER director and economics professor, and Christopher Carty, research associate.

TennCare is a Medicaid waiver, or “demonstration” program, meaning that the state has been allowed by the Centers for Medicare and Medicaid Services (CMS) to waive certain Medicaid regulations in order to demonstrate the effectiveness of a managed care approach for delivering health care services to those eligible for Medicaid benefits. With an annual budget of $7 billion, TennCare provides health coverage for 1.2 million low-income children, pregnant women and disabled Tennesseans.

According to CBER’s report, there are an estimated 616,967 uninsured Tennesseans, which represents about 10 percent of the state’s population. Although the number of uninsured is somewhat higher now than a year ago, the difference is not statistically significant. However, the percentage of uninsured children (3.7 percent) is down more than 1 percent from last year (4.9 percent), and the percentage of uninsured adults (11.9 percent) is higher than last year (10.6 percent).

“The substantial decrease in the number of uninsured children can be partially attributed to the CoverKids program and an increase in the number of children covered by TennCare as a result of declining economic conditions,” the report notes.

The report also looks at why people don’t have insurance. In 2009, as in past years, “can’t afford it” remains the primary reason.

“While financial pressures continue to limit people from obtaining coverage, 3 percent indicate that they just did not get around to securing it, and 5 percent indicate that a major reason is that they do not need insurance,” the report notes.

As for the quality of medical care they receive, “both Tennesseans in general and Medicaid/TennCare recipients are reporting quality ratings that are at their highest since TennCare’s inception in 1994.”

The study also looks at where Medicaid/TennCare recipients initially seek medical care — the doctor’s office or the hospital emergency room. Since 1994, there has been a general decline in the percentage of Medicaid/TennCare recipients who seek initial health care at hospital emergency rooms.

However, TennCare recipients continue to see doctors more regularly than other people. Eighty-seven percent of TennCare heads of household see a physician at least every few months, as do 69 percent of TennCare children. By comparison, 63 percent of all other heads of household and 61 percent of all children see doctors that frequently.

“More frequent usage of physicians may indicate increased preventative medical care through annual visits but may also reflect that the population of TennCare adults is one that has greater need for medical services,” the report says.

In summary, the report notes that “TennCare recipients’ experience with medical care remains positive, with the gap between their experiences and those of all Tennesseans narrowing somewhat compared to 2008. TennCare continues to receive positive feedback from its recipients, indicating the program is providing health care in a satisfactory manner and up to the expectations of those it serves.”

The state Department of Finance and Administration contracted with CBER to conduct the survey. This survey is a regular follow-up to previous surveys conducted since 1993, the last year of Medicaid before TennCare was adopted.

The survey interviewed 5,000 heads of household by telephone between April and June 2009. To review the entire survey, visit http://cber.bus.utk.edu/.

C O N T A C T :

Amy Blakely (865-974-5034, amy.blakely@tennessee.edu)

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