[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6343496,"mediaKeyId","2252217-c0a2c297453575a0699ade4556d426a8","parentId",2252217,"title","TennCare director: managed-care model, shared-savings have funded new services including rural and behavioral health investments","audioSeconds",451,"startMs",4389000,"endMs",4840000,"viewUrl","/Search/View?dp=1&key=2252217-c0a2c297453575a0699ade4556d426a8&start=4389&end=4840","thumbnailUrl","https://assets.pipeline.soar.com/2252217-c0a2c297453575a0699ade4556d426a8/thumbnail_4389000.jpg","articleUrl","/articles/6343496/Tennessee/TennCare-director-managed-care-model-shared-savings-have-funded-new-services-including-rural-and-behavioral-health-investments","mediaUrl","https://secure.pipeline.soar.com/6343496-9e6bb99fa2bcc8eb8b035ca84dd2a71b/orig.mp4?Expires=1774629600&Signature=Im5PostZoDiBDiSvMOOSRRc4NLzrJ3Uez3iuGaB3KzH2JsT3ErrPIcX~C~3ythuQSrmvIt9-~GnyPDalgWC91V25MQ0WSntCAevK3OwYG4ehTxqwaXWo0td4J~wJGGp8dC7f5iQQ65lXXlXpiTOdKyls5DXEKamWhDw2-66l2eD0U0kermPXeSHuN8dT7ST7IvjldR~M3w1rkz21mBdE8gceUl9FAHtzeS~TIOxBdJwUFELQKzydx3tDSRaNafWEUagjGplC4CslvVu-0rre6BNP0MVeAjDgOLVW4-5yD6pD~ywYwt4AX~~J8spMrUh59s-43JGJMF7lhBv3sbh4Hw__&Key-Pair-Id=KUT5TJCACFTXG","author","Tennessee House of Representatives","date","2025-02-04T00:00:00Z","article","TennCare Director Steven Smith told the House Health Committee on Feb. 1, 2025, that TennCare covers approximately 1.4 million Tennesseans, accounts for an $18 billion-plus budget and has used a managed-care model and a shared-savings waiver (TennCare 3) to finance new services and provider investments.

“TennCare is more successful today than at any point in our 30 year history,” Smith said, describing a multi-year shift from an “unpredictable and unsustainable” financing model to one that captures and reinvests federal shared savings. Smith said the TennCare 3 waiver produced more than $900 million in shared savings in its first three years and that the program has reinvested those funds in initiatives including adult dental coverage, elimination of waiting lists for some home- and community-based services, rural health investments and behavioral-health funding.

Under TennCare’s current structure, Smith said the program covers about 20% of the state’s population and pays for roughly half of births in the state. He described managed care as the primary financing model and said the program receives about 65% of its funding from the federal government.

Smith outlined several specific investments made with shared-savings funds. Year 1 investments expanded a “Strong Families” initiative that served additional children, pregnant women and parents; the state added an adult dental benefit covering roughly 600,000 adults, according to Smith’s presentation. Year 2 targeted rural health and behavioral health, including the Healthcare Resiliency Program administered by the Department of Health; year 3 shared savings included a $100 million allocation to the HEAL program for hurricane relief in affected communities.

On reserves and contingency funding, Smith said TennCare’s reserve (the so-called 10K reserve) totaled about $1.5 billion as of last year but that roughly $500 million of that had been set aside for pandemic-related costs and shared-savings commitments. He said unobligated reserves were about $300 million and that the historical average reserve has been approximately 4% of the program budget (he estimated that 4% would equal roughly $720 million for comparison).

Committee members asked about behavioral-health access, maternal health and workforce shortages. Representative Mackenzie asked whether TennCare’s investments are increasing access to behavioral-health services; Smith said the program has made record behavioral-health investments over four years, including a $100 million behavioral-health investment spread over five years and negotiated rate increases through managed care. Victor Wu, TennCare’s chief medical officer, described efforts to identify behavioral-health needs earlier, strengthen screening in pediatric and primary-care settings and partner with children’s hospitals and OB providers for postpartum care.

On maternal health, Representative Hammer asked about strategies beyond extending postpartum coverage to 12 months. Wu said early engagement in the first trimester, remote patient monitoring, telehealth and partnerships with providers are among the tools TennCare is pursuing, while acknowledging workforce and provider-workflow barriers to rapid uptake of new technologies.

Smith said preparation for the TennCare 3 waiver’s expiration in 2031 would begin years ahead of time and that federal negotiations typically start about two years before a waiver term ends. He also described the program’s recent consumer-satisfaction results (a University of Tennessee survey reporting a 96% satisfaction rate), improvements on national quality metrics and ongoing efforts to align cost management and quality improvement.

The committee did not take formal votes on TennCare items during the session; Smith said the TennCare budget and waiver investments will be part of upcoming budget hearings.","mediaType","Video","parentTitle","House Health Committee- February 4, 2025- House Hearing Room 1","oneSentenceSummary","TennCare Director Steven Smith told the House Health Committee that managed care and the TennCare 3 shared-savings waiver have improved program stability, produced nearly $900 million in shared savings in the waiver’s first three years and funded targeted investments such as a diaper pilot, adult dental coverage and rural health grants.","taxTitle","Health, House of Representatives, Committees, Legislative, Tennessee","taxId",35345,"location","Tennessee","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6343499,"Tennessee Department of Health outlines services, staffing and rural partnerships to House Health Committee",1966,1914000,3880000,"/Search/View?dp=1&key=2252217-c0a2c297453575a0699ade4556d426a8&start=1914&end=3880","https://assets.pipeline.soar.com/2252217-c0a2c297453575a0699ade4556d426a8/thumbnail_1914000.jpg","/articles/6343499/Tennessee/Tennessee-Department-of-Health-outlines-services-staffing-and-rural-partnerships-to-House-Health-Committee","https://secure.pipeline.soar.com/6343499-ccee25d9ca3b6c0279734ed022b7e291/orig.mp4?Expires=1774629600&Signature=e9PvoUxv4Eb4QuCbs9mzpr74-ePfAmx9MBvnEfjcsQ029xJUHOxRRsqizGN8EOk0y2tY~YlraRS5XXONs63tU2yS4Vo1j2n-yDP1r77GzP0DDzMmqaHgoBe95aiBrTctIcdLMBjGsOgnNk6UJhpo~NcFsaknHb4T~Hr3KYHBEbIjRAS5YNCoO~uapKEwFGeix~5ps3-2NgGTbEEP31k8uzT4S6yuF-DuM7wSSmrmopPE2tv1mI5VK4Ly3abad778UsRfE4qn1pmKhSKV02CsDOL6kql06OnyX-NXXHHKlgM082efbRP46MOycVX~iIYIbItVdkM4r6ppXhGCo1UjEw__&Key-Pair-Id=KUT5TJCACFTXG","Tennessee Department of Health Commissioner Ralph Alvarado told the House Health Committee on Feb. 1, 2025, that the department employs roughly 2,900 people and manages a budget of about $1.5 billion while operating primary-care clinics, dental sites and local public-health programs across all 95 counties.

Alvarado said the department’s mission is “to protect, promote, and improve the health and the well-being of all people in Tennessee” and emphasized partnerships with metro health departments and other state agencies to reach rural and underserved communities. “The department is 1 of the largest, government, struct or departments in state government and touches almost everybody in the the state,” he said.

The presentation to the House Health Committee was an overview of department programs and services and came during an informational, meet-and-greet committee session. Committee members and department leaders discussed staffing, vaccination trends, maternal and population health initiatives and coordination with metro health departments.

Among program details provided to the committee: the department operates 56 clinic locations and 16 federally qualified health centers; about 870,000 visits are made each year to local health departments; the department runs 57 primary-care clinics that see roughly 560,000 visits annually and 33 dental clinics (about 20,000 visits last year), with 12 additional dental clinic sites ready to open as dentists are hired. Commissioner Alvarado said the department’s total staff is “about over 2,900 positions,” of which “about 2,700 of those are full time” and “214 are part time.” He gave the department’s approximate budget as “a little bit over $1,500,000,000.”

Speakers framed several priorities: infectious-disease control (including syphilis and sexually transmitted infections), environmental health and restaurant inspections, opioid-overdose prevention and a public-health laboratory expansion. Dr. Tim Jones, the department’s chief medical officer, said the department receives roughly 250,000 individual communicable-disease reports annually and that about 75,000 of those are sexually transmitted infections; he noted efforts to expand testing in pregnant women to prevent congenital syphilis. He also described the department’s lab capacity and a new laboratory facility scheduled to open in about 18 months.

Deputy Commissioner J.W. Randolph described locally led County Health Councils that conduct county health assessments and community health improvement plans; he said such local planning was a top recommendation of the state’s rural health task force. Randolph also outlined the Healthcare Resiliency Program and said prior COVID-relief investments supported more than $240 million for 90-plus rural projects; he noted a new state-funded round backed by $50 million in TennCare shared-savings dollars and that the application window had recently closed.

Department officials highlighted maternal and infant initiatives—programs such as WIC, Count the Kicks, evidence-based home visiting (Healthy Families America, Nurse-Family Partnership, Parents as Teachers), safe-sleep distribution and perinatal quality efforts carried out in partnership with hospitals. A population-health speaker described programs to identify and address social drivers of health, walkability planning, safety-net clinics supported by the department and a youth tobacco-prevention effort called TN Strong (Tennessee Stop Tobacco and Revolutionize Our New Generation).

Committee members asked about recent declines in vaccination coverage, the potential return of vaccine-preventable diseases and strategies for improving county-level health rankings. Commissioner Alvarado said Tennessee has moved from a top-10 state for pediatric vaccination to a bottom-10 standing on some metrics and cited a need for engagement and public discussion. He also recommended focus areas—tobacco and cancer screening—to move state health rankings.

Alvarado and staff invited the committee to schedule a longer budget discussion; the department noted it will return later in the year for budget hearings and to provide more detailed proposals. The department also described workforce and recruitment efforts, including public-awareness campaigns and internship expansions to address high vacancy rates in dental and clinical positions.

The committee did not take formal action on any bills or motions during this informational presentation.","Commissioner Ralph Alvarado told the House Health Committee that the Department of Health employs about 2,900 people, operates primary-care clinics and dental sites, and is using shared investments and local partnerships to address low state health rankings.","actionData","errors"]

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TennCare director: managed-care model, shared-savings have funded new services including rural and behavioral health investments

Tennessee Department of Health outlines services, staffing and rural partnerships to House Health Committee