The Senate Finance, Ways and Means Committee has approved a resolution sponsored by Senator Mark Green, MD that encourages Governor Bill Haslam to seek an “appropriate waiver in order to implement the TennCare Opt Out program as a pilot program” based on consumer control and choice of healthcare spending within the Medicaid-eligible patient population. The bill is pending final consideration on the Senate floor on Monday.
"Healthcare innovation must include the approach that places the patient, in control of their personal healthcare choices and incentivizes them to shop and save,” said Senator Green referring to the proposed pilot program. “A patient knowing they benefit from wise wellness behaviors coupled with the selection of cost-effective care when needed will make the greatest positive impact on our healthcare system.”
The pilot program would enroll volunteer participants whose income qualifies them for temporary assistance for needy families (TANF) in the TennCare flexible savings account initiative. Enrollees would receive an electronic benefits transfer (EBT) card funded by premiums paid by TennCare to purchase primary care services and medications on an annual basis. Electronic payment is made immediately to treating physicians which reduces administrative costs and encourages provider participation. Patients in the demonstration program with funds remaining in the health savings account at the year’s end keep those dollars as a reward for their healthier choices that have maintained wellness and their effective budgeting of spending, it was stated.
“The TennCare Opt Out pilot will align the goals of patients, providers and taxpayers who know the best way to reduce the cost of something is by putting the consumer in charge,” said Senator Green, a practicing physician who serves as vice chairman of the Senate Commerce and Labor Committee.
He said in 2011 a study done on similar programs found a decrease in the consumption of healthcare by eleven percent. Should this pilot program achieve similar savings, the dollars made available would allow expanding coverage to hundreds of thousands of Tennesseans who currently are without healthcare.
If the Senate approves the bill, it then moves to the House of Representatives.