June 15, 2001

Vanderbilt researcher says TennCare working for kids

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Dr. Marshall Summar and colleagues have discovered a link between the ability to generate the compound nitric oxide and development of PPHN. (photo by Dana Johnson)

Vanderbilt researcher says TennCare working for kids

A Vanderbilt pediatrician says TennCare has been good for Tennessee’s children, boosting their overall access to health care and improving their health outcomes.

Dr. William Cooper, assistant professor of Pediatrics, has been studying how public policy changes affect children and their health care needs.

“Under TennCare, there have certainly been improvements,” Cooper said. “And by studying current data with TennCare, we can continue to make improvements.”

Cooper noted that TennCare has led to improved health care access for low income families, but despite these improvements, up to 14 percent of children with chronic conditions had gaps in TennCare coverage in the 365 days following hospitalization.

“That has an adverse effect on those children,” he said. “The greatest barriers appear to be unintentional administrative barriers. We need to work on removing those barriers to further improve access.”

He said infants and children with chronic health conditions were at high risk for worsening health status if they lose health insurance coverage and access to health services and prescription drugs.

But Cooper said there was little doubt that TennCare had done much to improve the health of many children due to expanded coverage.

“TennCare has done a good job of expanding coverage for children,” he said.

Thanks to his work in researching low-income children with special needs, Cooper was recently honored by the Health Services for Children Foundation and the Academy for Health Services Research and Health Policy as the first recipient of the HSC Foundation Child Services Research Award. He is also Vanderbilt’s first faculty member to be selected as a Robert Wood Johnson Generalist Physician Faculty Scholar, which he received in 1999.

Cooper’s work has had an impact on public policy. One study described an increased rate of early infant death among the managed care organizations (MCO’s) participating in TennCare. By comparing delivery practices among MCO’s and linking death certificates to birth certificate information, Cooper found a nearly three-fold increased risk of early infant death in one MCO. That same MCO was found to have a higher proportion of extremely low birth weight infants in facilities lacking appropriate care capabilities. His findings resulted in TennCare implementing a monitoring program with feedback mechanisms to improve the delivery of prenatal services.

“Dr. Cooper’s studies assessing the impact of health policy and health policy changes on vulnerable populations of low-income children have made substantial contributions to the knowledge in the field,” said Dr. Gerald B. Hickson, professor and vice chair of Pediatrics at Vanderbilt.

Cooper graduated from Vanderbilt University School of Medicine and did his residency at Cincinnati Children’s Hospital. He returned to Vanderbilt in 1995 to begin work on a Master’s degree in Public Health. He received that degree in 1997 and has been committed to improving public policy for health care in children.

While at Children’s Hospital in Cincinnati he published research that showed babies discharged within 24 hours of birth came back to the hospital sicker. This study documented an unacceptable increase in cases of dehydration and hypernatremia in breast-fed infants whose milk supply was inadequate.

Cooper is currently researching children with asthma who lose health insurance and the adverse effects that may have on their health.

“The obvious answer would be ‘yes, it does affect their care,’” he explained. “But the research provides for quantitative data so that the public policy makers are informed.”