BACKGROUND: TennCare, beginning in January 1994, channeled all Medicaid-eligible patients into managed care while expanding Medicaid coverage to large numbers of previously uninsured patients. We assessed the impact of TennCare on (1) coronary revascularization of patients who had had an acute myocardial infarction (AMI), (2) the likelihood of the patient having a usual provider of care after discharge from the hospital, and (3) health and functional status 1 to 3 years after the index AMI.