Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Tenncare Referral System topic
No spam. Unsubscribe anytime.
TennCare defends extension of closed‑loop referral system as lawmakers press for outcome data
Summary
TennCare told the Fiscal Review Committee it has completed more than 20,000 referrals and 60,000 assessments through its closed‑loop referral platform and asked to extend its contract cycle to align other agencies; members pressed for measurable outcome evaluations and HIPAA safeguards.
TennCare officials told the Fiscal Review Committee that the division’s closed‑loop referral platform, procured competitively for TennCare in December 2023, has logged what the agency described as "over 20,000 referrals since go live" and "over 60,000 assessments" as usage grows.
"In the first quarter of fiscal 2026 we averaged 50 referrals a day; in the second quarter that jumped to 77.6 referrals per day," TennCare chief financial officer Zane Sills said while explaining a request to exercise multiple option years and add extension years to the contract. He said the agency wants to synchronize contract cycles across sister agencies so everyone can transition to a single statewide procurement in the future.
Committee members expressed concern about procurement timing and the prospect of noncompetitive, sole‑source awards for other agencies under tight federal rural health transformation timelines. "I just wish that a program of this magnitude had been bidded out," Representative/chairman (speaker S23) said during questioning, noting the risk of fragmenting platforms across agencies. Senator Yarbrough and other members pressed TennCare for evaluation data showing whether referrals produce measurable improvements in patients' outcomes, not only counts of referrals or assessments.
TennCare acknowledged evaluation limits because the system is early in its operational life. "This kind of system is supposed to bend the cost curve over a number of years," Sills said. He and other staff said a formal evaluation is planned after additional operational experience; they also described plans to provide HIPAA and privacy controls when agencies connect to the platform. The committee approved the contract extension request after the discussion.
Next steps: TennCare said it will run a planned evaluation once more longitudinal data are available and provide members with additional information about interagency connections and privacy safeguards.
