TennCare enrollees are reporting record high satisfaction with the program, according to a new study by the Boyd Center for Business and Economic Research at the University of Tennessee, Knoxville, Haslam College of Business.
The Impact of TennCare: A Survey of Recipients, 2024 finds that 96% of those enrolled in the TennCare program reported being satisfied or very satisfied with the program, the highest satisfaction rate since the TennCare study began in 1993. Ninety-six percent of respondents also noted high overall satisfaction with the program for their children.
“The record high level of satisfaction with the TennCare program from our members is further evidence that TennCare is more successful today than at any point in its 30-year history,” TennCare director Stephen Smith said. “We are grateful for our many partnerships throughout the state that have led to this success and look forward to continuing our mission of improving lives through high-quality cost-effective care.”
Boyd Distinguished Professor of Health Economics Matthew Harris and Boyd Center senior research associate Emily Pratt co-authored the study, which examines the health coverage status of Tennessee residents, the use of medical facilities and satisfaction with medical services received. The study is based on a telephone and online survey of approximately 5,000 households conducted between May and July 2024.
Quality and Availability of Care
In addition to overall high satisfaction with TennCare in 2024, quality of care was ranked highly. Seventy-four percent of TennCare heads of households rated their quality of care as good or excellent, and for children specifically that number rose to 85%. Approximately 34% of TennCare households reported that they were able to see a doctor withina day of making an appointment, and 67% said they were able to see a doctor within a week.
Only 14% of TennCare users sought nonemergency health care outside their plan in 2024, up from 12% in 2023. Of that 14%, nearly two-thirds said they had sought nonemergency care only once or twice in the past year. Six percent reported that they had sought care outside the TennCare program because the service needed was unavailable, 3% said there was no TennCare provider in the area and 3% had mistakenly made an appointment with a provider who did not accept TennCare.
More TennCare households in 2024 reported receiving enrollment cards (73%), information on filing appeals (75%) and a list of rights and responsibilities (78%). These positive responses regarding TennCare materials have now returned to pre-pandemic levels.
Beginning with the 2024 study, the methodology for reporting the percentage of uninsured Tennesseans has changed. Instead of a single percentage rate, the study now calculates a probable range of percentages. According to Harris, the method used in past years — which counted only confirmed cases of uninsured individuals — can lead to undercounting.
“In previous reports, a person was only treated as uninsured if the respondent from that household stated they did not have insurance. However, there were times when those surveyed didn’t know the insurance status of others in the household or refused to answer,” he said. “Uninsured respondents were not only four times as likely to refuse or not know about the insurance status of others, but also were five times as likely to have other uninsured adults living in the household.”
The 2024 report estimates that in 2024 there were somewhere between 50,170 and 68,984 uninsured children in Tennessee, representing a range of 3.2% to 4.4% of the population under age 18 — up from 2.5% in 2023. About 8.8% to 11% of adults are estimated to not have insurance, in line with last year’s estimate of 9.1%. Combined, the number of uninsured adults and children ranges from 7.6% to 9.6% — also in line with last year’s estimate of 7.7%.
Statewide Estimates of Uninsured Populations
Figure 1. Statewide Estimate of Uninsured Populations 2024.
Affordability continues to be the most commonly cited reason for people failing to obtain health insurance in 2024, with 87% of respondents listing it as a reason for not getting coverage. Those uninsured could indicate whether they had been turned down after applying in 2024, and 29% of respondents said being turned down for insurance was a major reason for their lack of coverage.
“Our hope is that by reconciling the uninsured number with other data sources, we triangulate the results that highlight TennCare’s great work,” Harris said. “We also encourage any efforts to increase enrollment among those who may be eligible, as TennCare is an invaluable resource in improving population health and the long-run prosperity of our state.”
The Boyd Center, located within UT’s Haslam College of Business, has conducted the survey each year since 1993 under contract with the Tennessee Department of Finance and Administration.
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CONTACT:
Erin Hatfield, 865-974-6086, ehatfie1@utk.edu
