Physician participation and nonparticipation in Medicaid managed care: the TennCare experience.


Journal Article

BACKGROUND:TennCare is a significant state health reform effort, channeling all Medicaid recipients into managed care. We examined physician attitudes about TennCare. METHODS:In 1997, we surveyed a stratified random sample of Tennessee physicians using predominantly Likert-type scale questions. All physicians surveyed were involved in patient care and were selected from seven specialties: general practice, family practice, general internal medicine, obstetrics/gynecology, neurosurgery, general surgery, and pediatrics. We asked about participation, satisfaction, perceptions of quality, and appropriateness of care. RESULTS:Major reasons for nonparticipation included bureaucracy and low compensation. Overall, dissatisfaction with TennCare was high (72% not at all or not very satisfied), relating to reimbursement issues and constraints on obtaining services, particularly pharmaceuticals. More physicians (45.9%) thought quality had declined under TennCare than believed it improved (12.6%). CONCLUSIONS:Despite strong negative opinions about TennCare, physician participation is high (85.6%) because of a sense of professional responsibility.

Full Text

Duke Authors

Cited Authors

  • Sloan, FA; Conover, CJ; Rankin, PJ

Published Date

  • November 1999

Published In

Volume / Issue

  • 92 / 11

Start / End Page

  • 1064 - 1070

PubMed ID

  • 10586831

Pubmed Central ID

  • 10586831

Electronic International Standard Serial Number (EISSN)

  • 1541-8243

International Standard Serial Number (ISSN)

  • 0038-4348

Digital Object Identifier (DOI)

  • 10.1097/00007611-199911000-00004


  • eng