Home > TennCare > Opposition > Studies

Studies

“The role of Medicaid and SCHIP as an insurance safety net ” [pdf]
Published by the Urban Institute
Study shows that, as rates of employer-sponsored insurance plans decline for children and adults, Medicaid plays an essential role in keeping children from being uninsured. Tennessee is ranked as one of the top states in terms of declining employer-sponsored insurance plans, for both children and adults.

“The impact of reducing TennCare enrollment on mortality rates” [pdf]
Published by the University of Tennessee’s Center for Health Services Research
Nationally representative data and Tennessee mortality rates are used to estimate that a reduction of 160,000 Tennesseans on TennCare will result in approximately 3,311 additional deaths over the next 15 years.  That’s an average increase of 221 deaths per year.

“Improving Long-Term Care Services in Tennessee: Meeting the Changing Needs of a Growing Population ” [pdf]
Prepared for AARP Tennessee
Roger Auerbach, former director of Oregon’s long-term care program, found in this study that most older Tennesseans and individuals with disabilities want services delivered so they can continue to live at home. Home-based care is less expensive for the state, and better for individuals and their families.

“Waiver amendment proposal fact sheet” [pdf]
Published by the Kaiser Family Foundation
Summarizes the background, key changes and eligibility rules proposed by Tennessee Section 1115 Waiver Amendment, proposed to CMS on Sept. 24, 2004.

“Economic impacts of a cut in state expenditures on TennCare: The role of the Federal Match” [pdf]
Published by the University of Tennessee’s Center for Health Services Research
TennCare is funded by a mix of state and federal funds – in 2005, the federal government paid for 64.8% of all TennCare expenditures. The federal matching formula has a substantial effect on the state’s overall economy and on job availability, particularly in the health care industry. This study finds that a $100 million reduction in state TennCare expenditures will have a total negative economic impact of $1.7 billion, with a loss of more than 16,000 jobs statewide.

“Will the New TennCare Cutbacks Help Tennessee’s Economy?” [pdf]
Published by the Center on Budget and Policy Priorities
While Gov. Bredesen’s reductions in TennCare spending would lower state budget expenditures, they would also lead to a $1.8 billion reduction in federal revenue by 2008. This reduction in economic activity will lower the revenues of hospitals, physicians, pharmacists, nursing homes and other health providers. Conservative calculations suggest that 7,000 health care jobs would be gone by 2005, and 20,000 by 2008. This dent in the health care industry would have a ripple effect in other parts of Tennessee’s economy, as former health care workers unemployed due to the TennCare cuts would spend less money.

“Coverage & Access: Medical Conditions, Resulting Financial Issues Contributed to Half of Bankruptcies in 2001, Study Says”
Published by the Kaiser Family Foundation
A study published in the journal Health Affairs finds that about half of bankruptcies filed in 2001 were because of medical bills. The number of bankruptcies filed in the U.S. has tripled between 1980 and 2001, and the number of medical-related bankruptcies has increased 23-fold during that period.

“Tennessee’s new "medically necessary" standard: Uncovering the insured?” [pdf]
Published by the Kaiser Family Foundation
Tennessee’s 2004 legislation established a definition of “medical necessity” that requires the item or service recommended by a doctor to be the “least costly” course of treatment. This study summarizes the requirements and compares them to other states, finding it to be substantially more restrictive than requirements used by other state Medicaid agencies, by Medicare, by Federal Employee Health Benefits contractors, and by private sector plans.

“Trends in Employer-Sponsored Insurance in Tennessee: A Downward Spiral?” [pdf]
Published by the University of Tennessee’s Center for Health Services Research
Employee-sponsored health insurance is the most common means of obtaining private health coverage in the U.S., but national trends show that the proportion of Americans insured by their employers is falling. This study finds that the role of employee-sponsored health insurance in Tennessee is limited and declining, especially for employees of small businesses.

“Uncompensated care in Tennessee hospitals: How much and who provides it?” [pdf]
Published by the University of Tennessee’s Center for Health Services Research
Citizens without health insurance utilize health care services, but because they don’t have insurance coverage, they receive approximately 60% of care in a form that leaves health care providers uncompensated. Much of this cost is paid by hospitals, though government grants and special programs also provide funds. This study finds that uncompensated care in Tennessee increased from $462.1 million in 1995 to $1 billion in 2003, an overall increase of 118%.

“The new TennCare waiver proposal: What is the impact on children?” [pdf]
Published by Georgetown University’s Health Policy Institute
From the study: “By restricting children’s access to health care and seeking authority to make additional changes in the future, the TennCare waiver puts the coverage and care for tens of thousands of low-income children and adults at risk.”

“The implications of a loss in public health coverage”
Published by the Kaiser Family Foundation
Medicaid and SCHIP cuts would increase emergency room visits by the uninsured, shifting the costs of health care to hospitals as uncompensated care. No more than 9% of adults currently enrolled in public health insurance programs would have access to an alternative source of insurance.

“Medicaid: An overview of spending on ‘mandatory’ vs. ‘optional’ populations and services” [pdf]
Published by the Kaiser Family Foundation
Legal distinctions between “mandatory” and “optional” services may not be useful.  While fewer than 30% of Medicaid enrollees fall into “optional” categories, spending that occurs because of states’ choices to cover “optional” services or “optional” populations makes up the majority (60.6%) of all Medicaid spending.

“Medicaid Enrollment and Spending by ‘Mandatory’ and ‘Optional’ Eligibility and Benefit Categories” [pdf]
Published by the Kaiser Family Foundation
As Medicaid spending has grown, policy-makers in Washington have sought ways to control spending growth by dividing enrollees and spending into categories. This study analyzes these categories and the actual spending that takes place.

“The TennCare Waiver and African Americans: The Truth Behind the Rhetoric” [pdf]
Published by Families USA
Two in every five African American Tennesseans are enrolled in TennCare, compared to one in every five white Tennesseans. The TennCare waiver proposal undermines progress in reducing racial and ethnic health disparities by erecting barriers to health care for African Americans in Tennessee.

“The TennCare Waiver: More (Radical) Than Meets the Eye”
Published by the National Health Law Program
From the study: “The proposed TennCare waiver released to the public on August 19 requests permission from the federal government to implement what it describes as modest ‘tailored changes’ to the current Tennessee program. However, many of the proposed changes represent significant departures from accepted norms within the medical community and from anything that has previously been approved for other states.”

“The TennCare Waiver: A Bad Deal for Seniors”
Published by Families USA
More than one out of every five Tennessee seniors is enrolled in TennCare. Most are low-income and many have serious health conditions. Despite assurances to the contrary, the TennCare waiver would have a devastating effect on all TennCare seniors’ access to affordable, quality health care.

“Proposed Cap on TennCare Spending Could Result in Major Reductions in Coverage Beyond Those Specifically Identified in the Draft Waiver” [pdf]
Published by the Center on Budget and Policy Priorities
Proposals to cap TennCare spending based on state revenue growth would result in coverage cutbacks precisely when Tennessee residents need coverage most: times of economic downturn. Despite its service appeal as a quick fix to TennCare spending pressures, a spending cap is a poor substitute for thoughtful policymaking.