TennCare patients may lose 24-hour home care

By BRAD SCHRADE • Tennessean Staff Writer • August 18, 2008 The problem for the state is that the most vulnerable patients are also the most expensive, and are getting costlier by the year. And there is only so much money to go around in the $7-billion-a-year state Medicaid program that serves 1.2 million recipients. Gov. Phil Bredesen and his administration say the home nursing aide program is both unsustainable and more generous than any other medical benefit offered by the state. The program had 10,800 people who received some private-duty nursing or home health services in the 2007 fiscal year, costing $243 million, according to the latest figures available from the TennCare Bureau. But within that group, about 1,000 patients receive high-cost services, such as 24-hour nursing or aide care at their homes. The annual cost for 24-hour care is about $300,000 a person, or about five times the cost to live in a nursing home. The cost for a handful of patients totals $1 million annually if all their medical costs are included. The state and their for-profit managed care companies began the transition to nursing home care in April, and have mailed out letters to several hundred patients receiving the in-home benefit. In late July, the federal government approved the changes, which will begin taking effect in early September.