TY - JOUR
T1 - Impact of tennCare reform on care of patients with rheumatic diseases
AU - Braverman, Aliza
AU - Tang, Baowei
AU - Cross, Jessica
AU - Raza, Syed Hasan
AU - Nesheiwat, Joseph P.
AU - Carbone, Laura D.
PY - 2008/5
Y1 - 2008/5
N2 - Background: As a consequence of costcutting changes, termed "TennCare reform," to Tennessee's state-funded health care plan, a number of beneficiaries have either had their benefits substantially reduced or have been disenrolled entirely. The purpose of this study was to determine the impact of these reforms on the health of patients with chronic rheumatic diseases. Methods: We determined differences with adherence to scheduled appointments in an urban academic rheumatology clinic in the 3 months before and in the 3 months after TennCare reform. A telephone survey was conducted to determine plans for future rheumatic care among those patients scheduled to be seen in this clinic in the 3 months after TennCare reform. Results: Overall, 402 of the 601 patients scheduled for a rheumatology clinic appointment before TennCare reform (67%) adhered to their scheduled rheumatology appointment, compared with 362 of 595 patients (61%) scheduled for an appointment after TennCare reform, a difference that was statistically significant (P = 0.034). After TennCare reform, patients who did not adhere with clinic follow-up were more likely to have been disenrolled from TennCare (P < 0.001). By telephone survey, among those who were disenrolled from TennCare, almost half indicated that they did not know where they were going to receive future rheumatic disease care. Among those who retained TennCare, less than half indicated that they could afford to purchase all of their medications. Conclusions: TennCare reform has significantly limited care for patients with rheumatic diseases. The long-term consequences of this merit future study.
AB - Background: As a consequence of costcutting changes, termed "TennCare reform," to Tennessee's state-funded health care plan, a number of beneficiaries have either had their benefits substantially reduced or have been disenrolled entirely. The purpose of this study was to determine the impact of these reforms on the health of patients with chronic rheumatic diseases. Methods: We determined differences with adherence to scheduled appointments in an urban academic rheumatology clinic in the 3 months before and in the 3 months after TennCare reform. A telephone survey was conducted to determine plans for future rheumatic care among those patients scheduled to be seen in this clinic in the 3 months after TennCare reform. Results: Overall, 402 of the 601 patients scheduled for a rheumatology clinic appointment before TennCare reform (67%) adhered to their scheduled rheumatology appointment, compared with 362 of 595 patients (61%) scheduled for an appointment after TennCare reform, a difference that was statistically significant (P = 0.034). After TennCare reform, patients who did not adhere with clinic follow-up were more likely to have been disenrolled from TennCare (P < 0.001). By telephone survey, among those who were disenrolled from TennCare, almost half indicated that they did not know where they were going to receive future rheumatic disease care. Among those who retained TennCare, less than half indicated that they could afford to purchase all of their medications. Conclusions: TennCare reform has significantly limited care for patients with rheumatic diseases. The long-term consequences of this merit future study.
KW - Rheumatic diseases
KW - TennCare Reform
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U2 - 10.1097/MAJ.0b013e31815ac511
DO - 10.1097/MAJ.0b013e31815ac511
M3 - Article
C2 - 18480652
AN - SCOPUS:45549095690
SN - 0002-9629
VL - 335
SP - 363
EP - 367
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 5
ER -