Tennessee Agreement

The Tennessee Agreement: What You Need to Know

The Tennessee Agreement, also known as the Tennessee Plan, is a settlement agreement that was reached between the state of Tennessee and the federal government in 2014. The agreement was designed to help the state transition from a fee-for-service Medicaid program to a managed care program. This change was necessary due to rising costs and a lack of sustainability in the previous system.

Here are some key things you need to know about the Tennessee Agreement:

1. What is Medicaid?

Medicaid is a federal and state-funded program that provides health insurance to low-income individuals and families. In Tennessee, Medicaid is known as TennCare.

2. What is managed care?

Managed care is a system where healthcare providers are paid a fixed amount per patient, regardless of the services provided. This is in contrast to a fee-for-service system, where providers are paid for each service they provide.

3. Why did Tennessee need to transition to managed care?

The fee-for-service system in Tennessee was becoming unsustainable due to rising healthcare costs. The state needed to find a way to control costs while still providing quality healthcare to its citizens.

4. What was the Tennessee Agreement?

The Tennessee Agreement was a settlement between the state and federal government that allowed Tennessee to transition to a managed care system for Medicaid. The agreement was a waiver of certain federal Medicaid requirements that allowed the state to design its own managed care program.

5. What are the benefits of managed care?

Managed care can help control healthcare costs by incentivizing providers to provide preventative care and reduce unnecessary services. It also allows for better coordination of care between providers, which can improve patient outcomes.

6. What are the potential drawbacks of managed care?

Some critics of managed care argue that it incentivizes providers to deny necessary care in order to save costs. There is also concern that patients may not have as much choice when it comes to healthcare providers.

7. How has the Tennessee Agreement impacted healthcare in the state?

Since the implementation of the Tennessee Agreement, there have been both positive and negative outcomes. The state has been able to control costs and provide better coordinated care, but some patients have reported challenges in accessing care and receiving necessary treatments.

8. What is the future of the Tennessee Agreement?

The Tennessee Agreement is set to expire in 2021, and the state is currently in negotiations with the federal government to renew the waiver. It remains to be seen how the managed care system will continue to evolve in Tennessee.

In conclusion, the Tennessee Agreement was a significant development in the state`s healthcare system. While managed care has its benefits and drawbacks, it has allowed Tennessee to better control costs and provide quality care to its citizens. As negotiations for the renewal of the waiver continue, it will be important to continue monitoring the impact of managed care on patients and providers in the state.