Tennessee | Spring | 2009 | Health Plan Analysis

Recent moves to better control pharmaceutical expenses at the large TennCare program for Medicaid beneficiaries have resulted in compliance to preferred drugs by about 98 percent of the program's pharmacy members. At the same time, SXC Health Solutions Corp., the new pharmacy benefits manager for TennCare, may be on track to meet its supplemental rebate target. Commercial enrollment in the state was steady in 2008, but losses are sure to occur in 2009 with layoffs in state government and at manufacturing plants. Consumer-driven health plan membership grew in Tennessee in 2008, with the largest CDHP operator being BlueCross BlueShield of Tennessee. CDHP occupies about 5 percent of the commercial health market. BlueCross has begun implementing medical home pilot projects with primary-care practices near Memphis and in Cookeville. The CoverTN program has created a new program called Tennesseans Between Jobs for residents who were laid off within the past six months. Meanwhile, the state has lowered copays on smoking cessation aids and drugs in anticipation of increasing premiums for state workers, university employees and others on the state plan who are using tobacco products. In the Medicare sector, BlueCross has launched a new product that pools retirees of municipal accounts; at the same time, the carrier is working to build its Medicare PPO network in advance of new rules limiting the private fee-for-service product.

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