Gettysburg, Pa. (July 21, 2019) – OPEN MINDS has released an updated suite of Medicaid market intelligence resources on the state of Maryland. The resources include an analysis of the Tennessee’ s Medicaid system, Medicaid managed care vendor contracts, and additional state-specific information.
The Tennessee’s Medicaid managed care program called TennCare II—typically referred to as TennCare—is authorized through a 1115 demonstration waiver. The state contracts with three health plans that deliver physical health and behavioral health benefits and long-term services and supports (LTSS) for most populations, including families and children, dual eligibles, and aged and disabled adults.
The state’s three statewide health plans provide coverage on a full-risk capitated basis for most of the Medicaid population. Enrollees may select a health plan or may be assigned to one. Contracts for the three health plans are available for download. Medicaid services, including LTSS, are provided to enrollees using two different delivery vehicles:
- Health plans:
- TennCare Select:
- Provides services to special populations through a partially at-risk prepaid inpatient health plan (PIHP) that receives an administrative fee from the state
Note: Plans receive value-based reimbursements of up to 1.5% bonus payments applied to member months from the preceding calendar year for each of the six HEDIS measures on which they show significant improvement.
The Tennessee Medicaid Managed Care Contracts are available now for all Elite OPEN MINDS Circle members. Individual contracts may be purchased in the OPEN MINDS shop for $1,500 each.
Additionally, the OPEN MINDS team has four in-depth profiles of the Tennessee state health system:
- Tennessee Health Care System Landscape: An OPEN MINDS State Profile, which provides information on each state’s largest health plans, Medicaid expansion policy, health insurance marketplace plans, demographics, population health insurance coverage by payer, and more.
- Tennessee Medicaid System: An OPEN MINDS State Profile, which provides a detailed exploration of each state’s Medicaid financing system, including a review of the managed care financing systems, largest health plans by enrollment, key players in the state Medicaid department, and plans for future system changes and contract reprocurements.
- Tennessee Behavioral Health System State Profile Report, which provides a comprehensive listing of behavioral health benefits in the state, care coordination programs related to behavioral health, and behavioral health subcontractors for health plans.
- Tennessee Medicaid/Medicare Dual Eligible System: An OPEN MINDS State Profile, which provides an overview of each state’s dual eligible financing system, as well as the largest Medicare health plans serving dual eligibles and details on new initiatives involving the dual eligible population.
The Tennessee suite of state profiles is now available now for the Elite OPEN MINDS Circle members. In addition, the OPEN MINDS team has a wealth of additional Tennessee-specific resources. A monthly OPEN MINDS market intelligence update is available to all health and human services executives. To sign up, OPEN MINDS Circle members should set their email preferences under the My Account Settings.
All of these resources, and more, are available as part of an OPEN MINDS Circle Elite membership. Membership includes unlimited organizational access to all OPEN MINDS content and databases, plus executive education events, and other exclusive Elite member benefits. Learn more about becoming an Elite OPEN MINDS Circle member online at www.openminds.com/elite.
For additional questions and inquiries, please contact Sarah C. Threnhauser, Executive Vice President, OPEN MINDS at 717-334-1329 or firstname.lastname@example.org.
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OPEN MINDS is an award-winning information source, executive education provider, and business solutions firm specializing in the domains of health and human services serving consumers with chronic conditions and complex support needs. For thirty years, we’ve been pioneers for change – helping organizations implement the transformational business practices they need to succeed in an evolving market with new reimbursement, competition, policies, and regulations.
OPEN MINDS is powered by a national team of experienced executives and subject matter experts with specific expertise and experience in nine key market areas – mental health, addictions, chronic conditions, autism and intellectual/developmental disabilities, long-term care, children’s services, social services, juvenile justice, and corrections health care. Our mission is to improve the quality of care for consumers with complex support needs by improving the effectiveness of those serving them – provider organizations, payer and insurance organizations, government agencies, pharmaceutical organizations, and technology firms. Learn more at www.openminds.com.