TennCare Completes Statewide Medical and Behavioral Health Integration

Wednesday, September 23, 2009 | 08:03 am

NASHVILLE — The Bureau of TennCare announced today that BlueCross BlueShield of Tennessee (BCBST) will take over behavioral health care for enrollees receiving services through TennCare Select. This transition to using a single managed care entity to provide all of the care an enrollee needs, including physical and behavioral health coverage, marks TennCare’s completion of the shift to a fully-integrated service delivery model.

 “We’re pleased to take this next step in further strengthening the TennCare program as we continue to improve the quality of care our members receive,” said Darin Gordon, TennCare Director. “By integrating behavioral health and physical health coverage, we are better able to coordinate care for all enrollees and provide services that meet the needs of the whole person.”

 The Bureau began integrating behavioral and medical health care delivery for Middle Tennessee members in 2007 with the implementation of two new managed care organizations (MCOs). TennCare continued the process with the execution of new MCO contracts in West Tennessee in November 2008 and East Tennessee this January. The transferring of behavioral health services to BCBST for TennCare Select members completes the Bureau’s phased implementation of a fully-integrated service delivery system that works with health care providers, including doctors and hospitals, to ensure TennCare members receive all of the services they need.

 “The incidence of mental illness and substance abuse among Tennesseans is one in four persons,” said Virginia Trotter Betts, Commissioner of the Tennessee Department of Mental Health and Developmental Disabilities. “Therefore, having coverage that aligns the delivery of physical and behavioral services is likely to yield improved health outcomes among our TennCare enrollees.” 

 TennCare previously delivered behavioral health services separately from medical services through behavioral health organizations (BHOs), which had the potential to result in a sometimes fragmented system for coordinating enrollees’ health care. Premier Behavioral Systems of Tennessee, LLC, served as the BHO for TennCare Select members through a shared-risk contract that ended September 1, 2009.

 TennCare Select, which is operated by BlueCross BlueShield of Tennessee, serves approximately 71,733 TennCare enrollees statewide including foster children, children receiving SSI benefits and nursing facility or ICF-MR residents under age 21. It also serves as the state’s back-up MCO should there be capacity problems with any of the other MCOs and maintains a statewide provider network.