Episodes of Care
TennCare’s Episodes of Care program aims to transform the way specialty and acute healthcare services are delivered by incentivizing high-quality, cost-effective care, promoting evidence-based clinical pathways, encouraging care coordination, and reducing ineffective or inappropriate treatments.
Episodes of Care involve acute or specialized patient interactions over a specific time period. The program assigns a single principal accountable provider (or “quarterback”) who has the most impact on the overall cost and quality of a patient’s treatment within an episode. The episode can include services from multiple providers, but the episode is designed to only include spend relevant to the episode.
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News and Announcements
- Success in Delivery System Transformation
- Sign up for the Episodes of Care Newsletter
- TennCare's Episodes of Care Is Waiving 2021 Risk-Sharing Payments and Reinstating Risk-Sharing for 2022
- TennCare's Episodes of Care Is Introducing New Cost Exclusions for the Perinatal Episode (Maternity Quality Payment Incentives)
- TennCare's Episodes of Care is Waiving Risk-Sharing Payments for 2022 Respiratory Infection Episode
- Memo 2024 Episodes of Care Changes
Episode Spotlight: Otitis Media
The Otitis Media episode is one of the most frequently triggered episodes in the Episodes of Care program. To learn more about this episode and which interventions impact performance, please explore the links below.