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September 9, 1998

Managed Care for Mental Health in Tennessee

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(10):884-885. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-10-jac80015

To the Editor.—Although the article on TennCare Partners by Dr Chang and colleagues1 shows the plan's many flaws, several events not mentioned by the authors add insight into the mistakes made by Tennessee. When TennCare Partners was proposed in 1995, details of the state's contracts with the behavior health organizations (BHOs) were left to the Tennessee Department of Finance and Administration. Despite protests from community mental health centers and advocates, the administration did not include risk-adjusted capitation rates to BHOs or providers. The state chose 3 coalitions of large, for-profit managed care companies to manage TennCare Partners, including Nashville-based Columbia/HCA, Greenspring, and Merit behavioral health companies.2

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