Physicians' experiences with Medicaid managed care: the Tennessee American College of physicians survey on TennCare
Bailey, J.E.; Bush, A.J.; Bertram, P.D.; Somes, G.W.
Tennessee Medicine Journal of the Tennessee Medical Association 91(8): 313-316
1998
ISSN/ISBN: 1088-6222 PMID: 9697403 Document Number: 489097
Despite widespread introduction of Medicaid managed care (MMC), physicians have not been surveyed regarding its impact on patient care. This study documented physician experiences with MMC in Tennessee, where a statewide experimental managed care program (TennCare) delivers services through 12 capitated managed care organizations (MCOs). Practicing Tennessee American College of Physician (ACP) members (n = 1,181) were questioned regarding recent experience with the TennCare program, assessment of the program, and suggestions for improvement. The results, derived from 306 physician respondents (response rate 26%), were as expected, based on findings of a prior administrative focus group and independent surveys. Physicians' experiences were similar regardless of practice type. Most physicians rated the TennCare program as either fair (43%) or poor (42%) overall. The majority cited administrative complexity as a major problem that frequently adversely affected patient care. Physician experience suggests that administrative procedures and medication formularies should be streamlined and standardized to improve patient care.