TennCare Brass Says There’s Life After the Blues

Tennessee officials are negotiating with three health plans, hoping some or all will pick up where Blue Cross Blue Shield of Tennessee left off. BCBS made good on its threat to leave TennCare in the absence of fundamental changes in the managed Medicaid program.

Blue Cross Blue Shield will exit TennCare in June. It covers 645,000 TennCare recipients — about half of those enrolled in the program — and the other eight TennCare HMOs aren’t interested in picking up the Blues’ enrollees. Like Blue Cross Blue Shield, most, if not all, TennCare HMOs are having trouble breaking even. The Blues had asked the state to absorb financial losses and to place limits on the program’s pharmacy benefit.

State officials now are willing to give the three HMOs they are courting some perks that neither the Blues nor the other eight health plans get — limited insurance risk and information technology improvements, to name a couple.