In December 2014 Tennessee was awarded a two-year, $65 million State Innovation Model (SIM) testing grant to transform the state’s health care system. The grant builds on existing patient-centered medical home (PCMH) initiatives to encourage alignment across payers. Additionally, the SIM grant is working to leverage state purchasing power through a joint effort between public programs (TennCare, CoverKids, and Benefits Administration) and a coalition of commercial insurance carriers.
One goal of the SIM project is to engage over 65% of primary care providers in a multi-payer PCMH program by 2020. Through TennCare contracts, Tennessee will require the state’s three Medicaid managed care organizations to participate in the SIM-funded statewide PCMH program.
Two key strategies of the Tennessee SIM testing grant include providing additional support for the PCMH model and the continued implementation of retrospective episodes of care.
American Academy of Pediatrics