Managed care and Medicaid reform in Tennessee: The impact of TennCare on access and health-seeking behavior

Tennessee's TennCare program, established in 1994, uses a managed care syst em to address the problem of escalating Medicaid costs while expanding cove rage to the chronically uninsured, This paper examined TennCare based an re sults of survey research commissioned by the state and conducted by the aut hors. Findings indicated that respondents formerly on Medicaid who had prev iously indicated a preference for Medicaid were now much more likely to pre fer TennCare and were now as satisfied with TennCare as they had been with Medicaid in 1993. TennCare has had some impact on health care behavior, wit h fewer recipients seeking care at a hospital and more seeking care at a do ctor's office or a clinic. At this point, Tennessee's experience with TennC are seems to be successful. Tennessee has been able to fund a fairly signif icant increase in coverage of the uninsured population while staying within the projected cost parameters of the Medicaid system.