TennCare Episodes Providers and Other Stakeholders,
Thank you for your continued dedication to provide quality care to TennCare members during the COVID-19 pandemic. The state recognizes that COVID-19 has created an unprecedented health and economic crisis for the provider community, including financial pressures on many providers.
In order to continue to support providers during this difficult time, the three TennCare Managed Care Organizations (MCOs) will waive all episodes of care risk-sharing payments in the upcoming final reports for the 2019 performance period.What this means is that if a provider owes a final episode risk-sharing payment to an MCO based on their final 2019 episode results, then the provider will not have to make that payment. These final 2019 performance reports will be released from the MCO portals on August 20, 2020. Providers who have gain-sharing payments in their final 2019 performance report will receive those payments as planned, with no changes. Providers who have no change in payment as a result of their episodes will also not be impacted.
We are in the process of analyzing the impact of this pandemic on the 2020 episodes of care performance period. We welcome input from stakeholders regarding potential adjustments to episodes design during this uniquely difficult time.
Again, we are grateful for your continued partnership and thank you for the care you are offering to our members. You can find more information on TennCare’ response during this emergency period by visiting https://www.tn.gov/tenncare/information-statistics/tenncare-information-about-coronavirus.html.
For more information on the Episodes of Care program, please visit our website https://www.tn.gov/tenncare/health-care-innovation/episodes-of-care.html
