In a web exclusive for Health Affairs, Tennessee Blue Cross Blue Shield President Vicky Gregg discusses the lessons of her non-profit's continued financial success and the meltdown of the TennCare experiment. The CEO's interview with economist James Robinson touches on two key healthcare stories: the controversy over the profitability of non-profits and the issue of Medicaid reform.
On pricing: "There was a considerable pushback to the formulary, which ultimately led to court orders that precluded any formulary from being put into place. We had use of generics, for example, up into the high 60 percent, but after the pushback, it's now dropped to approximately 40 percent, even below what we see in our commercially insured population."
On TennCare: "To get the legislation passed, the advocates promised everything to everybody, and we were rewarded as a state to provide more and more care, because the more we spent, the more federal dollars we brought in."
- see the interview from Health Affairs