There is no more important, or more complex, issue facing our country and our state today than healthcare.
While Tennessee is doing a better job than the rest of the country in controlling costs of Medicaid growth, the costs are still taking a larger and larger percentage of our budget each year.
For the last several months, I’ve been working on a plan to change the way healthcare coverage looks in Tennessee.
In the past several years, Tennessee has shown the nation how to produce true reform in education, based on students’ results and educational outcome. We’re beginning to do the same thing with reforming government service—again by measuring outcome and results rather than only years of service as a state employee.
I believe that we have a once-in-a-lifetime opportunity to do the same thing in healthcare: To have a healthcare system that is based on outcomes and a healthcare system based on a healthier Tennessee, which is essential for our future.
That’s why I’ve been working on a plan to leverage the federal dollars available to states through the Affordable Care Act without expanding our TennCare rolls. I’d like to put in place a program to buy private health insurance for Tennesseans who have no other way to get it by using the federal money. I fundamentally believe that people having healthcare coverage is better for our citizens and state than people not having coverage.
The plan I propose would include co-pays for those who can afford to pay something. We are also working with providers to lower the cost of care and to move from a model of paying for every service regardless of the result to a payment method that is based on outcomes and quality of care. Our hospitals and medical providers have put a lot of sincere effort into working with us toward payment reform, and I am grateful for their commitment to date.
To succeed, we also need cooperation from the U.S. Department of Health and Human Services, but unfortunately, we haven’t received assurances from Washington at this point.
The whole reason to accept these federal dollars would be to leverage them to shape and impact healthcare coverage in Tennessee. All we’re asking from Washington is to allow us to use the funds to provide coverage in the same way many other Tennesseans will access coverage whether or not we expand. It’s a reasonable ‘ask.’
Our plan can save Tennessee money, and if it does, it will also save the federal government at least three dollars for every one dollar we save and in some cases even more.
I believe that Tennessee can be a model for what true healthcare reform looks like—to cover more Tennesseans and to take significant steps to save Tennessee and the United States from the unsustainable path we are on now.
It’s my hope that we can provide quality healthcare for more Tennesseans while transforming the relationship among healthcare users, providers and payers. If Tennessee can do that, we all win.