Tennessee Health Care Innovation Initiative Project

The State of Tennessee launched the Tennessee Health Care Innovation Initiative (THCII) to help improve the health of Tennesseans and address health care spending by changing the way health care is paid for in Tennessee. By moving toward a reimbursement model that pays providers based on quality and value rather than volume, doctors and hospitals are rewarded for delivering high quality, efficient medical care.

THCII is focused on three key areas: Episodes of Care, Tennessee Health Link and Patient-Centered Medical Homes.

Episodes of Care

Episode-based payment models focus on acute health care events, delivered by more than one provider. Providers in the best position to influence the quality and cost of care for an event are assigned as Principal Accountable Providers, who are known as Quarterbacks.

Quarterbacks whose leadership and care coordination deliver quality, cost-efficient care receive rewards beyond current reimbursement rates.

To see the details of each episode of care, please visit the State’s website.

TennCare Memo: Waiving 2019 Episodes Risk-Sharing Payments

Episodes of Care Reports

The data collected during the process is compiled in quarterly reports which allow Quarterbacks to measure their performance against cost and quality metrics. Quarterly reports are available through BlueAccess.

If you have questions, please contact your Network Manager. If you do not know who your Network Manager is, click here to locate your BlueCross contact.

Episodes of Care and Other Resources

Tennessee Health Link

People with severe and persistent mental illness often have higher rates of asthma, diabetes, high blood pressure and many other conditions. The State of Tennessee is working to better integrate care for people who suffer with physical and mental health issues. For more information, please visit the state’s Tennessee Health Link web page.

Patient-Centered Medical Homes

The Patient Centered Medical Home (PCMH) is a holistic model of care for patients directed by a primary care provider (PCP). With the goal of preventing unneeded hospital and emergency room visits, PCPs coordinate with other providers to deliver the right care, in the right place and time to their patients. To learn more, please see our

Patient Centered Medical Home Quality Thresholds