TennCare Comments on Healthy Adult Opportunity Guidance

Thursday, January 30, 2020 | 01:02pm

Nashville – The Centers for Medicare and Medicaid Services (CMS) released today new guidance, the Healthy Adult Opportunity initiative, which includes provisions that will support states seeking greater flexibility to improve the health of Medicaid populations. Below is a statement from TennCare in response to the new guidance.

“We are encouraged by the guidance released today from CMS. While this guidance does not address Tennessee’s block grant proposal directly, or require any change in our approach, it is very encouraging that it reflects several of the key innovative principles we identified in our waiver request months ago. We are excited about CMS’s recognition that the misaligned incentives of Medicaid financing do not necessarily drive quality, value, or fiscal sustainability. Specifically, it is encouraging that CMS recognizes that states should have the opportunity to earn shared savings through quality-based performance that can then be reinvested in their Medicaid programs and the health (not just health care) of their Medicaid members. We are also pleased that CMS recognizes the need for state flexibility regarding prescription drug benefits. We look forward to future discussions with CMS on Tennessee’s innovative modified block grant proposal to ensure our Medicaid program remains a national leader in quality, efficiency and innovation.”

Tennessee submitted a modified block grant proposal to CMS on November 20, 2019 being the first state in the nation to propose this type of innovative, alternative financing arrangement to the federal Centers for Medicare and Medicaid Services. You can find Amendment 42 as submitted to CMS at http://tn.gov/content/dam/tn/tenncare/documents2/Amendment42FinalVersion.pdf.

About TennCare

TennCare is the state of Tennessee’s Medicaid program which provides health insurance to approximately 1.4 million low-income Tennesseans including pregnant women, children, caretaker relatives of dependent children and older adults, and adults with disabilities. With a satisfaction rating above 90 percent since 2009, TennCare provides health insurance, including long-term services and supports, through the use of managed care.