Tennessee Medicaid Moving To Payments For Episodes Of Care Over Three-Year Period

Over the next three years, TennCare, Tennessee’s Medicaid program is planning to implement payments for episodes of care. In May 2014, the initiative launched with the first wave of three episodes of care: acute asthma exacerbation, perinatal, and total joint replacement. In 2015, the state is implementing the second wave with the next five episodes of care: acute exacerbation of chronic obstructive pulmonary disease (COPD), screening and surveillance colonoscopy, outpatient and non-acute inpatient cholecystectomy, acute percutaneous coronary intervention (PCI) and non-acute PCI. By 2019, the state intends to have implemented episode-based reimbursement for 75 distinct episodes . . .