Risk Selection Among SSI Enrollees in TennCare

This paper examines risk selection among managed care plans for Supplemental Security Income (SSI) beneficiaries in Tennessee's Medicaid managed care program, TennCare, focusing in particular on TennCare's first two years (starting January 1994 and ending January 1996). Analysis starts with a review of the TennCare program, especially the characteristics of the participating managed care plans that may have affected the choices of blind and disabled SSI beneficiaries and the nature of the payment system. Then the authors summarize processes that Tennessee used to enroll beneficiaries in managed care plans and the overall distribution of SSI beneficiaries among the plans. Next, data available for analyzing risk selection and the study's analytic approach is described. Finally, risk selection evidence is reviewed, and the paper concludes with a review of the lessons the Tennessee's experience provides for future payment and policies. [40 PDF pages]