TennCare non-emergency ER costs rise to $87 million in FY17

JOHNSON CITY, TN (WJHL) – Despite continued efforts to change the mindset of TennCare patients, the cost of non-emergency ER visits increased yet again, according to newly released numbers by the Bureau of TennCare.

The total cost to state and federal taxpayers for TennCare non-emergent ER visits was $87,911,672 in fiscal year 2017, up more than $3 million from the previous year, according to the state.

“That’s ridiculous,” Tennessee House Health Committee Member Rep. John Holsclaw (R), TN-District 4, said. “Something’s gotta be done. For little minor things they don’t need to be going to the emergency room, because that takes care away from the people that do need it, plus the cost of it.”

State claims data show some of the 1.5 million people on TennCare, including low-income pregnant women, children, people with disabilities and the elderly, use the emergency room for non-emergencies when a primary care doctor or urgent care clinic is often better suited to provide care.

The new state numbers show not only did non-emergent ER costs increase, East Tennessee, home to the highest TennCare enrollment in the state, once again led the way for the most expensive region, costing $31,118,101 million in FY17.

TennCare’s chief medical officer previously said this is a long-term problem that’s impacting all insurers, not just TennCare. Dr. Victor Wu said the key is to convince people to get yearly health checkups and preventative care, all with a primary care doctor, so they don’t end up in the emergency room.

Health professionals say the same holds true for people who are uninsured. The Tennessee Department of Health has four area clinics that offer primary care and preventative services at a sliding fee schedule to the uninsured.

“We’re going out there with health fairs and events to try to promote our services,” Primary Care Clinical Services Regional Director Linda McClure said.

McClure said routine wellness visits with a primary care physician go a long way toward keeping people out of the ER.

“We encourage folks to consider preventing worsening disease as the far better investment,” she said. “That PCP can work with you individually to help keep you and your health at its optimum.”

Rep. Holsclaw said until there’s federal heatlh care reform, states are limited in what rules they can follow to treat Medicaid patients.

“We can’t really do any action or anything, because the feds don’t know what they’re going to do,” Rep. Holsclaw said.

TDOH primary care clinics for people without insurance:

Carter County Health Department

403 East G Street

Elizabethton, TN 37643

(423) 543-2521

Greene County Health Department

810 W Church Street

Greeneville, TN 37744

(423) 798-1749

Hawkins County Health Department/Church Hill

247 Silver Lake Road

Church Hill, TN 37642

(423) 357-5341

Washington County Health Department

219 Princeton Road

Johnson City, TN 37601

(423) 975-2200

Community agencies that historically have received state “safety net dollars” to provide primary care services to the uninsured:

Roan Mountain Medical Center (FQHC)

PO Box 250

152 Highway 143

Roan Mountain, TN 37687


Baileyton Medical Center (FQHC)

580 Van Hill Road

Greeneville, TN 37745


Hawkins Medical Center (FQHC)

PO Box 850

4966 Highway 11 W

Rogersville, TN 37857


West Main Street Medical Center (FQHC)

PO Box 609

900 West Main Street

Rogersville, TN 37857


Bulls Gap Medical Center (FQHC)

PO Box 99

260 Highway 11 E

Bulls Gap, TN 37711


Church Hill Free Medical Clinic

(A mission of “Of One Accord Ministry”)

PO Box 166

Church Hill, TN 37642


Mountain City Medical Center (FQHC)

PO Box 670

222 Oak Street

Mountain City, TN 37683


Mountain City Extended Hours Health Center

1901 S, Shady Street

Mountain City, TN 37683


Bluff City Medical Center (FQHC)

229 Highway 19 E

Bluff City, TN 37618


Kingsport Medical Center

737 Sevier Avenue

Kingsport, TN 37662


Friends In Need Health Center, Inc.

1105 West Stone Drive

Kingsport, TN 37660


Healing Hands Health Center

210 Memorial Drive

Bristol, TN 37620


Dry Creek Medical Center (FQHC)

1826 North Main Avenue

Erwin, TN 37650


Limestone Medical Center (FQHC)

PO Box 217

105 Limestone Ruritan Road

Limestone, TN 37681


ETSU Family Medicine Associates

917 West Walnut Street

Johnson City, TN 37604


ETSU Johnson City Community Health Center

2151 Century Lane

Johnson City, TN 37604


Copyright WJHL 2017. All rights reserved.

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