published Monday, September 26th, 2011

TennCare official Scott Pierce leaving to head BlueCross BlueShield plan

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NASHVILLE -- TennCare's No. 2 man is headed to the private sector, where he will head the TennCare arm of Chattanooga-based BlueCross BlueShield of Tennessee.

Assistant TennCare Commissioner Scott Pierce's last day in state government is Friday. Pierce is also chief financial officer for the program, which serves low-income pregnant women, children and some disabled and elderly Tennesseans.

On Oct. 3, Pierce will become president and CEO of BlueCross's Volunteer State Health Plan, which runs the BlueCare and TennCare Select lines of coverage, BlueCross spokeswoman Mary Danielson said.

"Scott's hiring is nothing more than a sign of the respect and admiration we have developed for his talents and intellect," Danielson said in an email Friday. "We look forward to bringing him on board and applying his skills to bear on serving our members and the state."

Darin Gordon, deputy state finance commissioner and TennCare Bureau director, said Pierce told him Aug. 19 he was moving to BlueCross. The nonprofit insurer provides coverage to some 450,000 of TennCare's 1.2 million enrollees.

He said Pierce immediately recused himself from all matters regarding BlueCross and other managed care organizations, "basically removing himself from any intersection with the business lines that related to TennCare."

Those functions were taken over by assistant Chief Financial Officer Casey Dungan.

Gordon said 59 percent of the $8.9 billion TennCare program involves managed care. Pierce moved his focus to elements in the remaining 41 percent, he said.

Those functions include pharmacy, long-term care, intellectually disabled children, children under custody of the Department of Children's Services and wrangling with federal budget caps.

The news of the move initially raised eyebrows. State Rep. Joanne Favors, D-Chattanooga, a registered nurse and former health care administrator, said it would have been a conflict if Pierce had kept control over MCO contractual issues and reimbursements.

But "if he's not directly overseeing the MCOs, I don't think it could be a conflict," she said.

Favors said the health care industry, particularly insurers, frequently seeks to hire experienced government officials. Pierce currently is paid $150,000 a year, according to a database of state employees.

"First, the salary [in the private sector] is so much better, and secondly, so many of the programs tested as government programs, if the public accepts them, then they are implemented in private industry," Favors said.

Tennessee Common Cause Chairman Dick Williams said the "revolving door" between government and the private sector is nothing new.

"I don't know if there's anything terribly wrong with that," Williams said. "I think the public deserves to know that and sort of see if there's anything funny or anything done previously to help BlueCross."

After listening to a description of the steps Gordon and Pierce took, Williams said, "It sounds like they handled it appropriately."

An effort to reach Pierce through a TennCare spokeswoman was unsuccessful.

TennCare, created in 1994 through a federal waiver, was plagued for years by high turnover in its management ranks. But the agency's top management has been relatively stable for about nine years, Gordon said. Pierce has been chief financial officer for five years.

Senate Speaker pro tem Bo Watson, R-Hixson, said Pierce has been "really good at what he did. He knows the numbers. He knows how the system operates."

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about Andy Sher...

Andy Sher is a Nashville-based staff writer covering Tennessee state government and politics for the Times Free Press. A Washington correspondent from 1999-2005 for the Times Free Press, Andy previously headed up state Capitol coverage for The Chattanooga Times, worked as a state Capitol reporter for The Nashville Banner and was a contributor to The Tennessee Journal, among other publications. Andy worked for 17 years at The Chattanooga Times covering police, health care, county government, ...

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Instead of being "PAID" by BlueCross he's gonna get Paid by BlueCross. "Revolving Door" What a great phrase. Meanwhile BCBST continues to lay off employees and keep its over abundance of administrative staff. Corporate Top Heaviness!

September 26, 2011 at 10:27 a.m.
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