Children, Accountability Fall Through Tennessee Medicaid Managed Care Cracks

Analysis of implementation issues for Medicaid managed care in Tennessee (TennCare)

From 1995 to 1997, staff at the Citizen's TennCare Review Commission undertook a number of analyses to examine the effectiveness of the TennCare program, which in 1994 had replaced Tennessee's Medicaid program.

The commission is a nonprofit, non-partisan organization that provides timely, independent evaluation and analysis of the TennCare program.

Key Results

Project staff:

  • Developed and tracked critical indicators designed to assess patients' access to primary and preventive services.

  • Conducted a survey designed to assess the implementation and early performance of the Partner's Program, providing mental health services under managed care.

    The survey found that many children who had previously been eligible for state-funded mental health services no longer received them because the state tightened eligibility requirements to serve only more severely impaired children. In response to this finding, the state subsequently loosened its eligibility standards.

  • Helped the state develop a study to track cohorts of vulnerable patients under the Partner's Program.