Tenn. Resolution to Create Alternative Medicaid Pilot Program Heads to Senate

Feb 9, 2016

Credit TennCare, via Facebook

A Tennessee resolution to test an alternative Medicaid program is heading to the senate floor. Senate Joint Resolution 88 passed out of the Senate Finance, Ways, and Means Committee today.

Republican Senator Mark Green proposed the resolution, which would create a pilot program called TennCare Opt Out.

“We basically take the patient, give them a certain amount of money. Tell them that this is their money and they use it on their healthcare needs however they need it,” Green said. “It’s not the total amount of money that we typically spend on a patient in TennCare, but it’s a subtracted amount. And then at the end of the year whatever they haven’t spent, they get that cash back as an earned income credit. So now they’re motivated to save, they’re motivated to take care of their health so they get more money back at the end of the year, and they’re saving the state of Tennessee money.”

Green says the opt out program would not increase out of pocket costs for those who choose to participate. If patients spend over what they are given, Green says they would enter into a catastrophic insurance plan set up with the remainder of the money TennCare regularly provides.

Green says there is support for the resolution in the legislature and beyond. He claims the legislature did not vote for Governor Bill Haslam’s Insure Tennessee plan to expand Medicaid because it would have created more debt, though Haslam said Insure Tennessee would not have added any cost to the state budget. Green says if the TennCare Opt Out pilot works and the program is fully implemented, savings could be used to expand the state’s Medicaid program at no extra cost.

Under the pilot program, Green says doctors are paid immediately rather than having to file a claim and wait several months for payment.

“So there’s an incentive on the doctor to take these patients, which will cause competition and lower price. You’ve got the patients who are wanting to save money and not spend money now because they get money back at the end of the year. This is free market. This will drive costs down, save money, and hopefully take care of more people,” Green said.

“Now there are certainly some patients who are very sick who are on TennCare who will not be able to go into this plan,” Green said. “But those patients who have normal health and don’t have chronic illnesses, they can go into this plan, create savings and we can cover more people.”

If the resolution passes through the senate and the house, Green says the pilot program could begin in July 2017.