TennCare Payment Reform

The Tennessee Healthcare Innovation Initiative, otherwise known as TennCare payment reform, is the state’s plan to reduce the cost of healthcare and increase quality by keeping providers accountable for the care they provide.

TMA has worked since the program’s inception in 2012 to protect physicians’ interests and help members understand the complexities of new value-based reimbursement models.

TMA Resources

TMA offers medical practices a range of free resources to help them understand the Tennessee Health Care Innovation Initiative. Get assistance in the following areas:

  • Education - We can answer your questions about payment reform, covering everything from general inquiries to the fine print within specific episodes of care.
  • Strategy - We’ll work with you to predict how data collection and reporting will affect your reimbursements and identify practice modifications that can help you achieve rewards and avoid penalties. We can also help connect physicians to vendors and other third party resources to support episode-based and patient-centered integrated care.
  • Analytics - Our informatics expert will help you drill down into reports from the state’s MCOs, help manage issues related to practice data and anticipate opportunities for success as additional waves of episodes are released.
  • Advocacy - TMA will continue to seek out physicians’ questions, concerns, and recommendations on how to improve the state’s implementation of the initiative.

* This project is funded under a Grant contract with the State of Tennessee. Services are available to providers regardless of their membership in TMA.