Unless you have lived in Idaho for the last ten years, you know that TennCare is the state’s healthcare program for 1.3 million poor, sick and disabled Tennesseans.

First conceived by Gov. McWherter in the last years of his administration, TennCare was designed to slow the cost of the federally mandated Medicaid program while providing health care to many citizens that cannot afford it. TennCare accomplished those goals.

Gov. Bredesen inherited a program from Gov. Sundquist that was poorly managed and under so many court orders that it had become a huge drain on our state’s financial resources. At the request of the governor, a consulting firm was asked to analyze TennCare and make suggestions on how to make it work better.

The McKinsey Company Report was privately funded by healthcare providers and other stakeholders within Tennessee and is available at www.tennessee.gov/governor.

The first half of the McKinsey Company Report provided a warning that the program was in deeper trouble than imagined. The second half was released this week. This 90-page document provides over twenty-five specific initiatives for reforming TennCare and saving it. In five categories, these initiatives comprise the framework for TennCare reform - everything from more effective disease management to bringing benefits more closely in line with other states.

The first half report showed that, left untouched, TennCare would use 91 percent of all new state revenues in 2008. This is unacceptable. TennCare serves a vital role and is a needed safety net for Tennessee families; however, it cannot be left unchecked. We must continually examine the amount spent and the ways money is allocated in order to preserve this program.

To repeat last year’s balanced budget success without new taxes, we must continue practicing strong fiscal management. We must reign in TennCare costs so the program can exist without drawing resources away from our top priority, education.

The 25 reform options outlined in the second part of the report fall in the following five broad categories: Coverage (adjusting the type, amount, scope and duration of benefits); Enrollment (re-examining who qualifies for the program); Care Management (better managing healthcare delivery); Pharmacy (controlling growth in pharmaceutical spending); and MCO Optimization (restructuring the system of managed-care organizations that serve as middlemen between providers and patients).

There is no quick fix for TennCare. A lot of time and cooperation will be required to put the program back on the right track. I intend to work closely with Gov. Bredesen as he develops a solution from these 25 options. On Tuesday, the governor will present his solution in a speech to a joint session of the General Assembly.

I believe the program can be fixed in such a way to cut costs and continue providing health care to those who need it.