TennCare Evaluation Design

42 CFR § 431.424(e) requires that states with Section 1115 demonstration programs publish their evaluation designs on their websites. TennCare’s evaluation design was approved by CMS on March 31, 2008, but the performance measures contained within that design have been updated several times in subsequent years. A summary of TennCare’s evaluation activities—including the objectives of the evaluation design and the current performance measures attached to those objectives—is presented here at TennCare Demonstration Evaluation Design  .

Four of the objectives of the evaluation design (those concerning access, quality, satisfaction, and improvement) are addressed in TennCare’s Quality Assessment and Performance Improvement Strategy  , a document detailing the manner in which TennCare evaluates and improves the quality and accessibility of care offered to enrollees through the managed care network. In addition, a summary of progress on the objectives in the evaluation design appears each year in TennCare’s Draft Annual Report, which is filed with CMS at the end of October and is published on the TennCare website for a 30-day public comment period. Each application to extend TennCare’s Section 1115 demonstration program, furthermore, contains an Interim Evaluation Report comparing progress on the performance measures with baseline data to determine the level of success achieved on each measure.

Two additional evaluation documents completed annually are available online. One is the HEDIS/CAHPS Report, which includes extensive data on a variety of health care measures. The other is a report entitled The Impact of TennCare, which summarizes the findings of a survey conducted each year by the University of Tennessee’s Center for Business and Economic Research.