RECOMMENDATIONS

  1. Clearly, all participants expressed a desire to have more information about the TennCare program.  Areas of information needed center around coverage of services, care available through specialists, and how people receive emergency services through TennCare.  The State should ensure that:
    1. MCOs become more aware of the informational needs of TennCare members, and include information on these areas in their next mailing to members.
    2. Beneficiaries have access to “800” numbers whereby questions about TennCare can be answered in a reasonable amount of time.
    3. MCOs perform sufficient outreach activities.
  2. Printed literature should be made available to fathers that explains the health care needs of children.
    1. The State should ensure that absent fathers have access to this literature as well.  This information could be mailed to them, and also posted in public places, such as county offices, public health clinics, and libraries.
    2. Radio and TV “spot” commercials can also serve as a beneficial means of conveying this information to the general public.
  3. In terms of the fatherhood initiative, and the role of the father in the health care of their children, it is clear that fathers are interested in being involved, but are limited in their involvement, often due to bad relations with the child’s mother.
    1. For fathers living apart from their children, societal barriers due to separation or divorce from the mother, and anger between the two parties often will prohibit the fathers’ involvement in their children’s day to day lives and these societal barriers cannot be remedied by State or Federal agencies.  The lack of participation in these focus groups indicates a certain level of “distrust” of fathers towards government entities.
    2. It may prove worthwhile for HCFA and States to attempt a public relations campaign targeted at this group in order to establish more of a trust relationship.
    3. Medicaid mothers want their children’s fathers to be involved in providing financial (medical) support, and in situations where fathers do provide financial help, mothers should be encouraged by their State or county caseworkers to share information with the absent fathers regarding their childrens’ health care.
  4. While TennCare is considered to be a good program, many concerns were expressed that there are not enough providers (notably pediatricians and dentists) participating in the rural communities to ensure sufficient access to care.
    1. While this report cannot make a definitive conclusion on this subject, we wish to highlight this concern, and recommend that the State agency and the HCFA TennCare review team monitor provider enrollment, particularly in rural Tennessee.
    2. Where necessary, TennCare should encourage its MCOs to expand their provider network.
  5. Another barrier identified in this study that is not easily remedied is that of provider bias towards Medicaid/TennCare members.  Prejudice in many forms is deep rooted in our society, and cannot be “fixed” with a pamphlet or poster, or an “edict” by a government agency.
    1. However, it is recommended that the State remind its providers when they enroll in an MCO of TennCare that a condition of being a provider is that all plan members are to be treated with the respect and dignity they are entitled to and deserve, and are to receive the highest possible level of care.
    2. Complaints made by beneficiaries should be investigated thoroughly, and where bias, and/or insufficient care is demonstrated, that provider should be terminated from TennCare.

Where to?

[ Title Page | Executive Summary | Overview of TennCare | Methods | Focus Group Responses | Barriers ]

[ HHS Fatherhood Initiative ]

[ ASPE Home Page | HHS Home Page ]