Tennessee

The State of Tennessee has launched the Tennessee Health Care Innovation Initiative, a state-wide initiative to transition its healthcare payment system to better reward patient-centered, high-quality, high-value health care outcomes for all Tennesseans. The Tennessee Health Care Innovation Initiative is led by the state Division of Healthcare Finance and Administration (the division of state government that includes TennCare) but includes a broad coalition of stakeholders with close involvement from many leading healthcare providers. The state is currently finalizing its strategy and beginning phased implementation for 2014. Tennessee is pursuing two complementary payment strategies: First, a retrospective episode-based payment strategy to reward providers for providing high-quality and efficient care for acute medical and behavioral treatments and conditions. Second, a Patient-Centered Medical Home (PCMH) strategy to reward health care providers who care for their patients on an ongoing basis, promote prevention, treat chronic conditions, and coordinate care over time.

Primary Care Innovations and PCMH Activity

Dual Eligible	2703 SPA	CPC	CPC+	PCMH QHP	PCMH Legislation	Private Payer

Multi-Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program	Outcomes
Tennessee Comprehensive Primary Care Plus	Multi-Payer	Statewide	CMS Comprehensive Primary Care Plus (CPC+)

Public Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
Changing High-risk Asthma in Memphis through Partnership (CHAMP) program - Le Bonheur Children's Hospital	Grant	Memphis and Shelby County, Tennessee	CMS Health Care Innovation Award (Round 1)
CMS State Innovation Model (SIM) Test Award - Tennessee	Grant	Statewide	CMS State Innovation Model (SIM)
MyHealth Team at Vanderbilt University	Grant	18 rural and urban counties in Tennessee and Kentucky	CMS Health Care Innovation Award (Round 1)
Project SAFEMED - University of Tennessee Health Science Center	Grant	Statewide	CMS Health Care Innovation Award (Round 1)
TennCare Managed Care Organizations	Medicaid	Statewide	Medicaid Section 1115 Waiver
Tennessee Health Homes	Medicaid	Tennessee	ACA Section 2703 Health Homes

Private Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
Aetna Whole Health - Baptist Memorial Health Care	Commercial	Mid-South
BCBS Tennessee Patient-Centered Medical Home	Commercial	Statewide
Cigna Collaborative Accountable Care Program - Cumberland Center for Healthcare Innovation	Commercial	Middle Tennessee	Cigna Collaborative Care Program
Cigna Collaborative Accountable Care Program - Health Choice	Commercial	Memphis	Cigna Collaborative Care Program
Cigna Collaborative Accountable Care Program - Jackson Clinic	Commercial	Jackson and West Tennessee	Cigna Collaborative Care Program
Cigna Collaborative Accountable Care Program - Synergy HealthCare LLC	Commercial	Nashville and Central Tennessee	Cigna Collaborative Care Program
Cigna Patient-Centered Medical Home Pilot - Holston Medical Group	Commercial	Kingsport	Cigna Collaborative Care Program
Humana medical home program - State of Franklin Healthcare	Commercial	Johnson City	Humana Medical Home Program
Humana medical home program - Summit Medical Group	Commercial	Knoxville	Humana Medical Home Program