Improving Access to Ophthalmic Care for Medicaid Patients in Tennessee
Abstract
Prior AAO data has determined that 93.8% of Tennesseans live as close or closer to an ophthalmologist than to their nearest Walmart. This study intends to analyze access to care for patients in Tennessee’s Medicaid program (TennCare). TennCare comprises four different health plans administered by three different Managed Care Organizations (MCOs): UnitedHealthcare Community Plan, Wellpoint (formerly Amerigroup), BlueCare, and TennCare Select, the latter two being administered by Blue Cross Blue Shield. In the vulnerable population receiving TennCare coverage, there are concerns about care across various specialties. This project aims to quantify ophthalmologist access for TennCare patients. Tennessee ophthalmology practices were sampled with an AAO-maintained practice register with additional practices searched via Google Maps. Practices were contacted by phone using a standardized script, marked as a TennCare provider if they accepted any of the four TennCare health plans, then plotted by their primary location’s county. Each Tennessean county population was plotted using 2023-estimated U.S. Census Bureau population data (range: 5,128-910,042). 47 active ophthalmology practices were identified using the AAO data with an additional 32 active practices identified via Google Maps. Of these 79 practices, 68 (86%) practices accepted at least one form of TennCare. Of Tennessee’s 95 counties, 19 were home to the primary location of at least one (range: 1-13) TennCare ophthalmology practice. While 64.75% of Tennesseans live in a county with a TennCare practice, when including contiguous counties, the proportion becomes 94.20%. Limitations to this study can be addressed in follow-up investigations, where future directions include recording numbers and subspecialty of individual ophthalmologists and documenting satellite locations. Stratifying practices by accepted health plans and comparing to health plans held by Tennesseans in unique counties could help quantify the number of per capita TennCare providers in different state regions and better determine access to care.
Start Time
16-4-2025 9:00 AM
End Time
16-4-2025 11:30 AM
Presentation Type
Poster
Presentation Category
Health
Student Type
Clinical Doctoral Student (e.g., medical student, pharmacy student)
Faculty Mentor
Brent Aebi
Faculty Department
Ophthalmology
Improving Access to Ophthalmic Care for Medicaid Patients in Tennessee
Prior AAO data has determined that 93.8% of Tennesseans live as close or closer to an ophthalmologist than to their nearest Walmart. This study intends to analyze access to care for patients in Tennessee’s Medicaid program (TennCare). TennCare comprises four different health plans administered by three different Managed Care Organizations (MCOs): UnitedHealthcare Community Plan, Wellpoint (formerly Amerigroup), BlueCare, and TennCare Select, the latter two being administered by Blue Cross Blue Shield. In the vulnerable population receiving TennCare coverage, there are concerns about care across various specialties. This project aims to quantify ophthalmologist access for TennCare patients. Tennessee ophthalmology practices were sampled with an AAO-maintained practice register with additional practices searched via Google Maps. Practices were contacted by phone using a standardized script, marked as a TennCare provider if they accepted any of the four TennCare health plans, then plotted by their primary location’s county. Each Tennessean county population was plotted using 2023-estimated U.S. Census Bureau population data (range: 5,128-910,042). 47 active ophthalmology practices were identified using the AAO data with an additional 32 active practices identified via Google Maps. Of these 79 practices, 68 (86%) practices accepted at least one form of TennCare. Of Tennessee’s 95 counties, 19 were home to the primary location of at least one (range: 1-13) TennCare ophthalmology practice. While 64.75% of Tennesseans live in a county with a TennCare practice, when including contiguous counties, the proportion becomes 94.20%. Limitations to this study can be addressed in follow-up investigations, where future directions include recording numbers and subspecialty of individual ophthalmologists and documenting satellite locations. Stratifying practices by accepted health plans and comparing to health plans held by Tennesseans in unique counties could help quantify the number of per capita TennCare providers in different state regions and better determine access to care.