Hospitals not yet seeing influx of former TennCare patients
“It’s probably just too early in the ballgame to tell what is going to happen,” said Dr. Clay Runnels, medical director for the emergency department at Johnson City Medical Center. “I imagine when it’s really going to hit us hard is when we start seeing people with sore throats, runny noses, fevers.”
Gov. Phil Bredesen has said he’s cutting about 190,000 adults from TennCare and reducing benefits for thousands of others because the state cannot afford the $8.7 billion program in its current form.
When he announced the cuts last winter, hospitals and advocates for TennCare enrollees predicted an influx of patients to emergency rooms, creating longer waits and straining hospital finances.
They feared former enrollees wouldn’t be able to pay for needed medical care, and their conditions would worsen as a result.
Michele Johnson, a lawyer for the Tennessee Justice Center, the main advocate for enrollees, said most of the people losing TennCare coverage already have chronic illnesses such as heart disease, diabetes, hypertension and mental illness.
They have stocked up on medications, she suggested, by cutting their pills in half and by getting samples from doctors.
“So when a person with hypertension doesn’t get their medicine, has a stroke and is paralyzed, it doesn’t happen overnight,” Johnson said.
Vanderbilt University Medical Center administrators said they had not noticed an increase in emergency room visits, but are seeing an upswing in uninsured patients.
Dr. Corey Slovis, chairman of Vanderbilt’s Department of Emergency Medicine, said his biggest concern is that former TennCare patients will delay care for medical problems that deteriorate into life-threatening crises.
“That is our true medical fear,” Slovis said. “It is very unfortunate that in 2005, in the United States and in Tennessee and in Nashville, that we have not developed a better safety net.”
Bredesen, however, said he’s doing what he can to strengthen the $104 million safety net he set up to help those being disenrolled.
On Wednesday, Bredesen announced that Centerstone, the state’s largest provider of mental health services, is providing $800,000 in free services to its patients who are severely mentally ill and transitioning from TennCare.
The day before, the governor said the state had finalized plans for a transitional assistance program for insulin-dependent TennCare patients who are losing coverage. Bredesen has also gotten local pharmacies to provide free generic drugs to people being cut.
Many doctors are continuing to treat former enrollees even if they can’t pay, said Russ Miller, senior vice president of the Tennessee Medical Association.
But he warns that generosity won’t last long because of the “strain on your ability to operate your practice.”
“That is something we are very concerned about for physicians across the state, and the farther you get from metropolitan markets, the worse and the more acute that problem is going to become,” Miller said.