TennCare Awards Contracts to Managed Care Organizations

Friday, December 27, 2013 | 02:19 pm
Nashville, Tenn. – The Bureau of TennCare awarded managed care contracts to AmeriGroup, BlueCare Tennessee and UnitedHealthcare.  The apparent winners of the three-year contracts with possible one-year extensions were announced on December 16, 2013.  Following a 10-day inspection period the contracts were officially awarded and signed on December 27, 2013, beginning a one-year transition period.  
 
“We are pleased to continue our relationship with these organizations,” said Health Care Finance and Administration Deputy Commissioner Darin Gordon.  “All three managed care organizations (MCOs) have proven their ability to efficiently administer our integrated benefit package of physical, behavioral and long term care services and have shown each is willing to take additional steps to further improve quality and better align incentives for members and providers.”
 
Each MCO will accept full financial risk to participate in the TennCare program and will be paid set monthly capitated payments to manage and deliver care to members.  Additional requirements of these new contracts are each MCO must have the network capacity to operate statewide.  Previously, the Bureau of TennCare awarded regional contracts by selecting two companies to operate in each of the three grand regions – West, Middle and East.  The new contracts will take effect January 1, 2015 with full statewide implementation completed by the end of the calendar year 2015.
“TennCare is currently working with the health plans to ensure the transition will go as smoothly as possible for our members,” Gordon said. “Continuity of care is the utmost concern as we plan for implementation in 2015.” 
 
AmeriGroup currently serves approximately 2.8 million members in 12 states and is dedicated to offering real solutions that improve health care access and quality for members, while proactively working to reduce the overall cost of care to taxpayers.  BlueCare Tennessee and BlueCare are independent licensees of the BlueCross BlueShield Association. The Chattanooga-based company focuses on managing care and providing quality health care products, services and information for government programs.  UnitedHealthcare is an operating division of UnitedHealth Group, the largest single health carrier in the United States delivering innovative products and services to approximately 70 million Americans.  
 
TennCare is the state’s Medicaid program that provides health care for 1.2 million Tennesseans.