Health Starts

Health Starts is TennCare’s approach to improving the health of Tennesseans by focusing on the conditions where they live, work, and play. TennCare’s vision for Health Starts is that all TennCare members are screened for Social Determinants of Health (SDOH) with a unified screening tool and identified needs are met by community resources, resulting in the improved health of each TennCare member. Examples of SDOH include safe housing, access to nutritious foods and transportation, education, and job opportunities. TennCare has identified three interconnected workstreams to achieve this vision: Provider Partnerships, Technology Supports, and Workforce Development.

If you have any questions related to Health Starts, please email

Provider Partnerships

SDOH, or non-medical risk factors, that go unaddressed can contribute to negative health outcomes for individuals and increased health care expenditures for the State. The purpose of the Provider Partnerships is to address social needs and improve health outcomes of TennCare members through the providers they see for health care. TennCare’s Managed Care Organizations partner with health care providers across the state to screen for non-medical risk factors, refer members to appropriate community-based organizations (CBOs), and close the loop on referrals to ensure needs have been met. The partnerships established between the MCOs, providers, and CBOs expand the capabilities of different provider groups and increase the reach of CBOs within the community.

The Provider Partnerships also aim to gather data regarding best practices related to screening, referring, and closing the loop. This data will help determine a pathway to address the social needs of TennCare members through scalable and sustainable solutions.

To learn more about this effort, please read the issue brief about Tennessee Medicaid’s Health Starts Provider Partnerships.

If you're a provider, and you want to address social needs in your community, please reach out to the contact for your Managed Care Organization.

UnitedHealthcare Community Plan

April Blair
Social Drivers of Health Director

Wellpoint (formerly known as Amerigroup)

Emily Goolsby, LMSW
Health Starts Program Manager


Trish Olivier, M.Ed, M.S.
Manager, Innovative Partnerships & Strategic Improvement

Technology Supports

TennCare will implement and scale technology tools to providers and community organizations that can help support screening and referrals as well as tracking referral completion and outcome data.

Workforce Development

The Workforce Development workstream invests in the development of evidence-based models of care incorporating non-traditional providers to either directly address a member's health needs or to improve navigation through community resources and the health care system.


According to the American Public Health Association1, a community health worker (CHW) is “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.” CHWs serve as links between the community and health/social services to expand access to care and improve health outcomes. CHWs have been shown to improve health outcomes, lower healthcare costs, and reduce health disparities when integrated into communities in a coordinated, intentional model of care


TennCare is investing in CHW infrastructure through grant opportunities to increase continuity, capacity, and sustainability of the CHW workforce. The TennCare CHW Grant Opportunity was created to support the CHW infrastructure and assist CHWs in meeting CHW program standards and best practices by:

1. Supporting organizations employing CHWs to make key investments in organizational infrastructure and overhead costs

2. Providing technical assistance to organizations employing CHWs to implement evidence-based best practices and integrate evidence-based CHW models

The grantees will create CHW organizational infrastructure and utilize technical assistance to implement CHW models that strengthen the CHW workforce and improve the lives of TennCare members across the state.

TennCare CHW Infrastructure Grant Awardees (2023)

  • BCBST Sanitas
  • Darsalud (Lifedoc Health)
  • Matter Healthcare
  • Mental Health Cooperative
  • Methodist LeBonheur Healthcare
  • Regional One Health
  • Senior (IHCM) Solutions
  • Siloam Health

Detailed information about the CHW Infrastructure Grant can be found in the attachments below:


TennCare aims to establish program standards for CHW organizations that reflect evidence-based practices and align expectations between CHW organizations, TennCare, and TennCare MCOs. TennCare is partnering with Tennessee Community Health Worker Association (TNCHWA), a statewide CHW association, to develop statewide CHW program standards and a pathway to establishing an accreditation entity. Through this initiative, TennCare will invest in key statewide efforts to establish a training or certification program to train for core competencies.


1. American Public Health Association (APHA)


The State has committed to understanding the doula workforce and its role within Tennessee to support women and babies. This commitment includes implementing doula pilot projects, facilitated by the state’s Managed Care Organizations (MCO), to increase understanding around the barriers, challenges, and opportunities specific to Tennessee regarding doula services and programs for individuals covered by Medicaid.