Majority of Power Poll says 'no thanks’ to voucher expansion plan but think state lawmakers will forge ahead
Survey respondents don't favor a union at the VW plant and don't think UAW's unionization efforts will succeed
A majority of Power Poll respondents don’t support a proposed expansion of a school voucher program in Tennessee. However, a substantial majority of respondents — nearly three-fourths — think state lawmakers will proceed anyway.
That’s the bottom line from the December Chattanooga Power Poll.
In late November, Republican Gov. Bill Lee announced his plan to take a small pilot voucher program, one limited to Hamilton, Davidson and Shelby counties this year, and extend it to 20,000 students next year and statewide after that. The vouchers are valued at about $7,000 and are given to parents to spend on approved private schools. There would be income criteria applied to half of the 20,000 next year, but all students would be eligible the following year.
Quality means more than paying the bills
BlueCross works to improve care across the state
By Dr. Angeline Brunetto
Vice President, Chief Medical Officer
BlueCross BlueShield of Tennessee
When I was a practicing emergency medicine physician, I thought I could change the world one person at a time. And I did so for more than 20 years. In my days in the ER, I thought of health insurers as just the ones who paid the bills. I was wrong.
By joining the BlueCross Medicare team, I’ve been part of a movement where we affect change not just for individuals or communities, but the entire state.
The Provider/Insurer Relationship Focused on Clinical Quality
The role of the insurer has changed in recent years. It is definitely not just the “payer of bills” generated by providers. While we always advocate for affordability, the provider/insurer relationship has evolved into more of a partnership with quality care at its center.
Quality care starts with preventive care. I support the care coordination efforts for our Medicare Advantage members, but members with other types of BlueCross coverage have access to this type of support, as well. That means we engage with all our members using a variety of touchpoints — calls, texts, emails, in-person visits — and encouraging them to see their doctors more often and spend more time with them going over recommended screenings, their medications, or whatever concerns they may have.
As insurers, one of our roles is helping make sure the care our members receive meets high standards and follows evidence-based best practices. We define quality not just from the benefits we offer but the resulting outcomes. We have regular meetings with physician practices to understand their pain points and ensure the best possible outcomes for those we serve.
We’re also now focused on social factors that impact the health and wellbeing of a patient.
A story that stuck with me involved a Medicare Advantage member who uses an automated blood pressure cuff. To help support our provider networks, we’d formed an internal team to stay connected with such members. One of our case managers called this member to check in and learned they were homeless and living in their car. In working to close one gap in care, our team identified a crucial need and was able to connect the member with the right resources.
This story illustrates our concierge approach and how we’ve helped take some of the procedural burden off physicians. We ask them about their needs and their barriers to administering effective treatment. We’ve developed case management teams, clinical teams and population health teams that work with providers and hospitals on everything from discharge coordination to office documentation and paperwork.
Through our health navigator program, we reach out directly to patients upon discharge and ask them a series of questions — do you understand why you were in the hospital, do you understand your next steps, can you afford the medications, etc. — and offer ourselves as a resource if they struggle to answer any of these. Insurers and providers alike don’t want these patients to end up right back in the hospital.
BlueCross Medicare Advantage Plan Awarded 4.5 Star Quality Rating
Every year, Medicare evaluates plans based on a 5-star rating system. Because of our personal approach, the Centers for Medicare & Medicaid Services (CMS) awarded our Medicare Advantage plan a 4.5 Star quality rating, which means members received timely preventive screenings and health care and overall are extremely satisfied with our plans.
Looking ahead to 2024, we plan to bring members into this process more directly by creating workgroups to hear how we can more effectively support them on their health journey. We recognize that while our CMS rating is a testament to the quality of service we deliver, there are many situations that our members and their families experience where we can learn and better support them. We want to identify and resolve those pain points before they happen for anyone else.
Affecting change on a statewide level is meaningful. But the heart of that change lies with the people we serve. For the more than 3 million Tennesseans in a BlueCross plan and for the communities in which we live, we’re looking at every opportunity to reduce red tape and improve the quality of care they receive.
About 2,400 students are participating in the pilot program this year.
The governor has said the program will be funded through the state’s general fund, not monies allocated to K-12 education. He has not offered specific cost estimates or other details, such as accountability measures for private schools approved to participate.
Power Poll members balked at the voucher expansion: When asked, “Do you support this [voucher expansion] plan?,” 57% said “no” while 43% said “yes.”
The next question, though, reflected the Power Poll membership’s grasp of the political reality in Tennessee. A significant 73% of survey respondents said they think the Tennessee General Assembly, in firm control of the GOP, will approve Lee’s proposal; 27% said lawmakers would not.
But, but, but … General Assembly approval may not be a slam dunk. Recall that in 2019, Lee’s voucher plan barely squeaked by.
Reaction to the proposal has been swift and loud. Supporters argue that parents need more choices for educating their children, and Lee campaigned on a pledge to do just that. And while the state has poured hundreds of millions of dollars more into public education, moving the needle on student achievement and readiness for post-secondary learning has been slow.
Opponents worry about the potential detrimental effect on public education funding, perceived inequities in voucher distribution, and the subsequent strain on schools they say are already underfunded.
Power Poll members clearly share some concerns as well. About two-thirds — 66% — said they think “expanding a voucher program statewide will harm public schools.”
Steve Errico, co-owner of RiverWorks Marketing Group, acknowledged that private school vouchers “may take funding from public schools but public schools are in desperate need of change and maybe this will help be the catalyst.”
The cliche “if you always do what you’ve always done, you’ll always get what you’ve always got” could apply to the state of education, he suggested.
“Chattanooga public schools have been the least attractive aspect of our community when I talk with people coming in from the outside. That’s part of why we have such a large and vibrant private school presence,” he wrote. "s… But like most entrenched bureaucracies, institutional orthodoxy in education prevents meaningful change.”
Legislators return to Nashville in about three weeks.
Turning to the second issue in this month’s Power Poll, survey respondents said they do not think workers at the Chattanooga Volkswagen plant should form a union: 64% said “no,” they should not while 36% said workers should form a union.
The gap between those who said “not” and those who said “yes’ narrowed — a lot — in a question about whether the UAW would be successful. Respondents said no, but it was tighter: 56% said “no” when asked if the unionization effort would be successful while 44% said “yes.”
The head of the UAW, which is trying to organize a union there, was in town recently to talk up the benefits. This is the third attempt the UAW has made at getting into the VW plant.
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About Power Poll: Power Poll asks questions of the most powerful, influential people in U.S. cities. It is not a scientific survey. But because the people responding to the surveys comprise the leadership structure of their cities, the results afford a fascinating glimpse into the thoughts, opinions, and beliefs of those in a position to make change. Power Poll is distinctly nonpartisan.
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