AILSA CHANG, HOST:
To reopen businesses, states need to start testing and contact tracing on a massive scale. But only a handful of states have enough tests to do that, according to analysis conducted by NPR. Those states mostly have small populations and not a lot of experience with health crises, but they do have big ideas on how to make it work. Tennessee, for example, has decided to pay for every single test, no questions asked. Blake Farmer of member station WPLN in Nashville explains.
BLAKE FARMER, BYLINE: Testing has become so plentiful in Tennessee that people like Christine Garner are invited to just stop by the local high school and get swabbed.
CHRISTINE GARNER: I'm just, like, hypersensitive to any change in my body at all. I think a lot of people are.
FARMER: Garner helps refinance mortgages around Nashville and still interacts with customers face to face. So she wanted some assurance she wasn't a carrier, at least at this point. All she had to do was wait a few hours in her minivan. Her husband and her kids also got tested. In almost any other state, they wouldn't even qualify for a test. But almost no other state has as much testing capacity despair as Tennessee.
Dr. Lisa Piercey is the state health commissioner. She gives a lot of credit to private commercial labs.
LISA PIERCEY: We've called on almost all of them to say, hey, we need you to ramp up because you're about to get a flood of tests, and that's exactly what we've given them.
FARMER: Private labs are processing tests in lots of states. But about a month ago, Tennessee decided to guarantee payment. The state doesn't even try to bill insurance companies. It just pays the labs directly, about a hundred dollars a test. And money is a good motivator. Take Aegis Sciences, which decided to go all-in on the coronavirus market. CEO Frank Basile says he's already doubled capacity to 7,000 tests a day.
FRANK BASILE: Clearly, it's beneficial for the lab companies like us who receive the assurance of payment, and it gives us the confidence to put the effort and the capital in to make this happen.
FARMER: Those tax dollars are well-spent, says Dr. Ashish Jha of the Harvard Global Health Institute. He's been tracking testing capacity by state. Jha says Tennessee's spending could more than pay for itself since you need lots of testing to safely reopen businesses. Jha says other states should do it.
ASHISH JHA: If the state says, we'll just pay everybody a hundred bucks every time you do a test, that strikes me as very smart policy.
FARMER: The Tennessee Department of Health doesn't know exactly how much it's on the hook for yet. It's a tab that now grows by millions of dollars a week. The state's also hoping the federal government will reimburse the cost at some point. All this testing capacity is just what states need, says Dr. Kelly Moore. She's a pandemic consultant and previously worked for the Tennessee health department.
KELLY MOORE: If these highly motivated, worried well people coming out for free tests are not taking up scarce resources we need for someone else, then it's definitely not a problem to test them.
FARMER: Virtually no one is being turned away. But at some of the free mass testing events, 99% of the tests have come back negative, which sounds great. But Moore says it could prompt a state to reopen too quickly.
MOORE: We can't draw conclusions about what's going on in the whole community based on this self-selected group of people who are so motivated they come out to get tested.
FARMER: And Tennessee has started using its testing muscle in a more strategic way. Everyone who lives or works in nursing homes and prisons is getting tested this week.
For NPR News, I'm Blake Farmer in Nashville.
CHANG: And this story is part of NPR's partnership with Nashville Public Radio and Kaiser Health News. Transcript provided by NPR, Copyright NPR.