Tennessee
TennCare CHOICES
TennCare is Tennessee's statewide, mandatory Medicaid managed care system. It has operated since 1994 as an 1115 Waiver program. In 2010, long-term services and supports were added to the mix of managed care services under the name TennCare CHOICES, which serves adults with physical disabilities and seniors needing LTSS. People receiving services related to intellectual and developmental disabilities are currently excluded from CHOICES, but a companion managed LTSS program, Employment and Community First (ECF) CHOICES, has been developed for this population.
Capitation rate categories for TennCare CHOICES depend on level of care need (nursing home level, regardless of whether the person resides in a nursing home or in the community, versus non-nursing home level), Medicare coverage status (dual versus non-dual), and region of the state.
More information
Program documents
Contract with managed care organizations:
TennCare 1115 Waiver Extension Request:
CMS Approval and Special Terms & Conditions:
Level-of-care determination instrument (PAE):
Quality Assessment Strategy:
Capitation rate information and annual Actuarial Review of the TennCare Program
TennCare Annual Reports and Enrollment Data