Tennessee Medicaid (TennCare) Proves That Primary Care Transformation Drives Medicaid Profitability
TennCare has built one of the most effective Medicaid models in the U.S., centered on primary care transformation and behavioral health integration.
Programs like PCMH and Tennessee Health Link align risk, quality, and cost directly with provider performance.
Why This Works:
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Risk Managed at the PCP Level
CDPS+Rx aligns acuity with primary care delivery. -
Quality Embedded in Workflow
HEDIS and CAHPS are operationalized at the practice level. -
Behavioral Health Integration
A major cost driver addressed directly through coordinated care.
HLTHWorks POV
Provider enablement—not strategy alone—is what drives margin in Medicaid.
In Tennessee, growth is driven at the provider level—not the corporate level.
If your PCP network isn’t delivering on risk, quality, and behavioral integration, HLTHWorks can help operationalize a provider performance model that drives real financial results.
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