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TennCare Joins the Catalyst for Payment Reform

Wednesday, December 19, 2012 | 09:29am
Health care purchasers look towards ways to improve quality and reduce costs
NASHVILLE – The Bureau of TennCare announced today its decision to join Catalyst for Payment Reform (CPR).  CPR is a national independent organization led by large purchasers of health insurance with active involvement of providers, health plans, consumers and labor groups working to improve health care quality and reduce costs by identifying and coordinating workable solutions to improve how health care is paid for in the U.S.

TennCare joins more than 20 other large purchasers of health insurance in this effort.  This includes companies such as FedEx, GE, Intel, Verizon, Xerox, 3M and Walmart as well as two other state Medicaid programs – South Carolina and Ohio. Purchasing partners interact on a regular basis with major health insurance companies such as Aetna, CIGNA, UnitedHealthcare and WellPoint to discuss progress in advancing innovations, paying for value and aligning payments with purchaser goals. 
“I fully support the decision made by the Bureau of TennCare to join CPR,” Gov. Haslam said. “Participating in this initiative demonstrates the development of a public/private partnership which has the potential to improve our state and guide the health care system in the proper direction." 
CPR provides member organizations with resources such as market assessment tools, model health plan contract language, action briefs, payment framework and opportunities to collaborative and share best practices with other CPR member organizations. The members of CPR share a common interest in designing payment methodologies that cut waste and reflect performance, create alignment between purchasers and federal organizations such as the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS), and implement price transparency and value pricing.       
“Joining CPR was a logical next step for TennCare,” said Health Care Finance and Administration Deputy Commissioner Darin Gordon.  “The goals and approaches of this group align with several current TennCare initiatives aimed at accelerating payment reform in Tennessee, with the ultimate goal of moving away from fee-for-service type payments towards models that reward providers for the efficient delivery of high quality care.”
TennCare’s commitment to CPR includes performing a self assessment of capabilities and coordination with current plans, using CPR model health plan contract language when appropriate and participating in coordinated initiatives with other purchasers. 
To learn more about the Catalyst for Payment Reform visit

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