Unite and Protect – Our Profession, Our Patients

Happy New Year – January Newsletter

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January 4, 2016 - Happy New Year from the Tennessee Health Care Innovation Initiative!

In this newsletter:
TennCare Wave 2 episodes of care performance period
Wave 2 contract amendments
Wave 2 episodes of care thresholds
Primary Care Transformation updates

TennCare Wave 2 episodes of care performance period

The first performance period for Wave 2 episodes, including COPD, colonoscopy, cholecystectomy, PCI acute and non-acute, began on January 1, 2016. This performance period will last 12 months. Throughout the performance period, providers will continue to receive quarterly reports.

Wave 2 episode contract amendments

TennCare managed care organizations sent Wave 2 episode contract amendments to providers. If you have questions or if you are a provider who thinks you should have received a contract amendment—such as a gastroenterologist or cardiologist who has TennCare patients—then you can call the TennCare MCO episode contact lines:
Amerigroup: 615-232-2160
BlueCare: 800-924-7141
UnitedHealthcare: 615-372-3509

Wave 2 episodes of care thresholds

Cost and quality thresholds for Wave 2 episodes of care (COPD, colonoscopy, cholecystectomy, PCI acute and non-acute) are available on our website. Our website will host all cost and quality threshold information here.

Primary Care Transformation

The TennCare Patient Centered Medical Homes program will launch with an initial 20-30 primary care practices on July 1, 2016. Health Homes for TennCare members with high behavioral health needs is scheduled to launch statewide on October 1, 2016. Look for a call for applications for both these programs from this email newsletter in the coming months.

Please note: A call for nominations will be sent soon for Wave 5 Episodes of Care Technical Advisory Group (TAG) members.