CHATTANOOGA, Tenn. — A new issue brief by the BlueCross BlueShield of Tennessee Health Institute finds that Tennessee has one of the highest rates of preventable hospitalizations in the country.

With effective primary care, people with conditions ranging from asthma to congestive heart failure can be treated successfully outside of hospitals, though it is not happening often enough in Tennessee, according to the brief.

The Institute examined data on people covered by Medicare that showed 89 out of every 1,000 hospital admissions in Tennessee are considered preventable. Only Kentucky, Louisiana, Mississippi, Oklahoma and West Virginia had higher rates. And, the problem in Tennessee is greater in rural areas than in metropolitan areas.

“Not only are too many people being hospitalized needlessly, but these hospitalizations come at a high cost to the Medicare program,” said Dr. Steven Coulter, president of the Health Institute. “The average cost of each preventable hospitalization is nearly $12,000.”

The data covered people discharged from hospitals for the following conditions, all of which rarely require being admitted to a hospital:



Bacterial pneumonia


Chronic obstructive pulmonary disease

Congestive heart failure






Kidney/urinary tract infections

Overall in Tennessee nearly 9 percent of hospitalizations are preventable, but in the state’s six metropolitan areas the rate is 7 percent, slightly better than the national average.

The brief’s analysis found good news in Chattanooga, which has a preventable hospitalization rate of 5.7 percent, which is 20 percent lower than other hospital service areas in the state, indicating primary care physicians there are doing a good job. Compared to the state median, this creates more than $17 million in federal government savings.

The results of the brief measure the effectiveness of primary care in Tennessee in regard to preventable hospitalization and finds it most effective in metropolitan areas and significantly less so in rural areas. For more details, view the brief at

“The results of our analysis indicate the most primary care capacity and greatest access to care is in the metropolitan areas of the state,” Coulter said. “It may also show a greater adherence to quality standards in those same areas.”

The Institute is a division of BlueCross BlueShield of Tennessee, created to provide decision makers with a fact-based, intellectual framework for public discussions on health care policy matters.

About BlueCross

BlueCross BlueShield of Tennessee's mission is to provide its customers and communities with peace of mind through affordable solutions for health and healing, life and living. Founded in 1945, the Chattanooga-based company is focused on reinventing the health plan for its 3 million members in Tennessee and across the country. Through its integrated health management approach, BlueCross provides patient-centric products and services that drive health improvement and positively impact health care quality and value. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company's website at