July 12, 2005

Stating the Obvious

The Tennessean echoes my thoughts today: Sundquist wrong person to lead Medicaid panel

Turning to a former governor who has firsthand experience wrestling with Medicaid makes perfect sense.

But while Sundquist's experience with Medicaid was firsthand, it was not successful. TennCare, which is Tennessee's Medicaid program, had nine directors during the Sundquist years. The computer system was always inadequate. Some of the managed care organizations within TennCare were under-funded and unprepared. Some had to be taken over by the state. All the MCOs were inadequately monitored. The Sundquist administration developed a verification process that a federal judge said violated federal law. And it removed the incentive for the MCOs to actually manage patient care when it decided that the state, not the MCOs, would bear the financial risk. That decision transformed TennCare from a managed care system to an administrative one, losing the cost-saving potential.

UPDATE: Matt White says Sundquist isn't to blame for all of TennCare's problems. Matt's co-blogger, "the pinch hitter," blames Sundquist's predecessor, Gov. Ned McWherter, the creator of TennCare. They both make a good case.