Since the early 1990’s Tennessee has made significant efforts to provide health insurance to those who need it and reduce the number of uninsured people.
- TennCare, Tennessee’s Medicaid managed care program, provides health coverage for 1.2 million low-income children, pregnant women and disabled Tennesseans on a $7 billion annual budget.
- Since 2005, changes made to the program have cut off about 225,000 adults and have left others underserved, reports the Tennessee Healthcare Campaign.
- Based on recent levels of disenrollment, the Tennessee Healthcare Campaign estimates that about a million people are now uninsured. The largest portion of uninsured adults worked more than 40 hours a week, and over half of the working uninsured work for a company with fewer than 25 employees.
Tennessee spends more money per capita on healthcare than most states, and costs keep climbing.
- Tennessee spent about $32.2 billion on health care in 2004. Tennessee’s healthcare bill keeps going up, at a 7% average annual increase between 1991 and 2004.
- Tennessee spent more on healthcare per capita in 2004 ($5,464) than the national average ($5,283).
- Between 2001 and 2005, family premiums in Tennessee increased 32.1%, while median earnings of people purchasing family coverage increased by only 6.3%.
- People who buy health insurance through their small business employer (2-50 employees) cannot be excluded due to health condition and there are some limits on the price for coverage.
- The self-employed and people who must buy individual policies have few protections: no restrictions on price and no access for pre-existing conditions. The state has a high risk pool program for people who can’t afford insurance through their employer or the individual market, but it is likely to be unaffordable for many, with a monthly premium of $649 and $1,000 annual deductible.
Tennessee, with high rates of serious illness and poor healthcare outcomes, according to standardized quality measures, faces real challenges in the future.
- A lower percentage of mothers began early prenatal care (70% in Tennessee compared to 84% nationally).
- Heart disease is a significant, ongoing problem. More people died of heart disease in Tennessee than elsewhere (259 deaths per 100,000 Tennessee residents compared to 217 nationally). Tennesseans got certain recommended heart attack treatments at a lower rate, and died at a higher rate from a heart attack in the hospital than in other states (94 deaths per 100,000 admissions compared to 82 deaths per 100,000 elsewhere).
- Tennesseans with pneumonia died in the hospital at a higher rate than in other states (75 deaths per 1,000 admissions compared to 70 deaths per 1,000 admissions elsewhere).
- Tennesseans died of cancer at a higher rate than the average in other states (208 deaths per 100,000 Tennessee residents compared to 184 nationwide).
- Diabetes patients in Tennessee are hospitalized due to their health condition at a much higher than average rate. A lower percentage of these patients receive foot exams and flu shots.
- Tennessee children, adults, and seniors with asthma are admitted to the hospital at higher rates than the national average.
- Higher percentages of nursing home residents in Tennessee are bedridden or chair bound, have urinary tract infections, and have had a catheter left in their bladder, which puts them at a high risk of infection.
- Higher percentages of home health patients improve at taking their oral medications correctly and show improved mobility than average elsewhere, but also end up back in the hospital at a higher than average rate.
Too many patients in Tennessee are injured by unsafe care.
- At least 6 out of every 100 patients in Tennessee is colonized or infected with MRSA, an antibiotic resistant superbug. Nearly 2,000 cases of ‘invasive’® MRSA (only one of many types of hospital infections) have been reported per year to the Tennessee Department of Health. In 2006, the incidence rate was 33 per 100,000 admissions, making MRSA the most common reportable communicable disease in Tennessee after chlamydia and gonorrhea. The incidence is higher among blacks than whites and is highest in west and lowest in east Tennessee. Tennessee launched initiatives to reduce MRSA.
- Although the true number of patients harmed by medical errors in each state is neither collected nor reported to the public, the Institute of Medicine estimates as many as 98,000 Americans die from these preventable mistakes each year. These errors range from doing surgery on the wrong part of the body to serious bed sores to getting the wrong dose of medication.
 http://www.statehealthfacts.org/profileind.jsp?cat=2&sub=12&rgn=44 Reflects 2004 data.
 http://www.statehealthfacts.org/profileind.jsp?cat=2&sub=23&rgn=44 Reflects 2004 data.
 http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=TN&level=3®ion=0&compGroup=N Reflects 2004 data. For example, 139 diabetes patients (with long-term complications) in Tennessee per 100,000 admissions compared to 113 nationally.
 Ibid 16. 155 children in Tennessee admitted per 100,000 compared to 132 nationally; 127 adults in Tennessee admitted per 100,000 compared to 107 nationally; 237 seniors in Tennessee compared to 203 nationally.
 Institute of Medicine, To Err is Human, Kohn, Linda, Corrigan and Donaldson, 2000, pp.26, 35.