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Who we are

You are at the heart of all that we do

We want you to get the care you deserve. Our mission is our passion: to improve the lives of our members. No matter what you have going on in your life, we’re here for you every step of the way.

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We connect you to what matters most.

We do more than get you the care you need. We go the extra mile. And because we’re based in Tennessee, we can point you to local, community resources to meet your needs. From foods banks, to job fairs, to help with housing and clothes, and more. Wherever you are, we’re here with one-on-one help.

One-on-One Help
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If you have questions about the quality of your health care, we can help.

We make sure the care you receive is safe, effective and on time. All to give you the peace of mind that comes with being healthier. We also look for ways to improve what we do. That’s why we have one of the highest-rated plans in the state.

Here's some helpful information for you
Where can I get more information about my health?

To improve our quality of care, we’ve made health information easier for you to find. Just visit the Your Health page. Or take a look at these health topics.

You can learn more about:
  • ADHD
  • Depression
  • Antibiotics
  • Diabetes
  • Asthma
  • Heart Disease
  • COPD
  • Quitting Smoking

What does this mean for me as a member?

  • We are committed to quality.
  • We provide high-quality care and services.
  • We measure the care you receive.
  • We find out how you feel about your care.
  • We meet guidelines for protecting and improving your health.

How do we measure quality?

The tools we use to measure quality are developed by organizations such as National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality. Many other health plans also use these tools. These organizations share our scores with the public. So you can compare how different health plans improve their members’ health.

What does quality mean to us as your plan?

Quality is more than a rating to us. It’s also about how we’re helping you improve your health.

We look for answers to questions like:

  • Are you getting checkups and screenings you need?
  • Do you take the medicines that are prescribed?
  • If you’re pregnant, do you get prenatal care?
  • If you have a health condition – like heart disease or diabetes – do you get the extra help you need to stay on top of it?
  • Do you feel you have a good choice of doctors?
  • How easy is it for you to get care?

To get these answers, we collect information from sources like claims and chart reviews. We also ask you and your doctors questions to find out how we can better meet your needs.

Each year, our Quality Improvement Program reviews our findings to make sure:

  • You get high-quality care and services
  • You get the right care
  • It’s easy for you to get care

But there’s more we want to do – especially with preventing health problems or helping you live well even if you have a health condition.

If caught early, many health problems can be treated before they affect your long-term health. Screenings and tests help make this possible. That’s why we remind you of checkups and screenings by phone, mail, text and email. It’s also why we host health fairs, screenings and events throughout the state.

What are our quality goals and objectives?

  • Be the best TennCare Managed Care Organization
  • Maintain high credentials by NCQA
  • Achieve a 4-Star rating across all regions in Tennessee
  • Provide great member and doctor satisfaction
  • Provide effective health care cost and use
  • Improve health care delivery and coordination
  • Improve the health of our members

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