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March 6, 1996


Author Affiliations

Bureau of TennCare Nashville, Tenn

JAMA. 1996;275(9):683-684. doi:10.1001/jama.1996.03530330027017

To the Editor.  —I wish to address several statements made by Dr Mirvis and colleagues in their recent article.1 The authors state, "More than 40% of potential beneficiaries did not respond. The resulting confusion forced the state [of Tennessee] to initiate a second enrollment period in December 1993." This statement gives an incorrect picture in at least three respects.

  1. The fact that 60% of the potential beneficiaries did respond with a completed ballot selection is an unheard-of response rate for Medicaid populations. Under the Medicaid program, response rates to mail-outs were considered successful if they reached 20%.

  2. Although there was confusion, there was no second enrollment period. During 1994, the enrollment for TennCare was open all year, as originally planned.

  3. TennCare provided a 45-day allowance for individuals seeking to change managed care organizations (MCOs). This was instituted for those choosing an MCO based on the belief that their clinicians