By Caleb Graves, TN HIMSS Advocacy Committee Chair/Director of Business Development–Staffing as a Mission

In early July, the TN HIMSS Advocacy Committee met with state officials from TennCare and the Office of eHealth to discuss ways to work together. TN HIMSS has more than  2,400 individual members and it is important for state officials to know our members stand ready to be a resource when needed. Our membership has expertise across the health care IT spectrum. Maintaining a close relationship with the state only helps achieve HIMSS’ overall mission of developing our health ecosystem by leveraging the power of information AND technology.

TN HIMSS Ambassadors D.J. King, Josh Scales, Caleb Graves, Monica Greene and Joshua Harvey meet with TennCare officials

For those new to the TN HIMSS Chapter or as a refresher, TennCare is the state of Tennessee’s Medicaid program. TennCare covers 1.4 million people or roughly 1 out of every 5 Tennesseans plus the program covers approximately 50% of births in the state and has an annual budget of $12 billion. TennCare is not a fee-for-service Medicaid model, but operates as an integrated, full-risk, managed care program.TennCare contracts with managed care organizations (MCOs) who  work directly with providers and patients. It is easy to see how and why TennCare is a critical partner in delivering health care services to our state.

During our meeting, we covered three main topics: TennCare priorities, Care Coordination Tool, and the challenges of a statewide Healthcare Information Exchange (HIE). 

First, we discussed TennCare’s four main priorities. 

1) TennCare Connect – an eligibility system for Tennesseans to sign up for TennCare or CoverKids. This top priority was launched statewide in March 2019. TennCare Connect makes it easier for Tennesseans  to apply for TennCare or CoverKids services either online or via phone.  

2) Delivery System Reform – Tennessee is s changing the way health care is paid for, moving from paying for volume to paying for value.  Tennessee is  leading by example with its approach bringing together health care providers, clinicians, major insurance companies and employers to reform the health care delivery system in the state. 

3) Opioid Epidemic – this is not a problem unique to Tennessee but a national issue from coast to coast. TennCare has long worked to confront the impacts of opioid abuse.  TennCare’s opioid strategy includes reducing the risk of TennCare members becoming newly dependent or addicted to opioids and increasing patient engagement, early detection of dependence, and evidence-based pain treatment for TennCare members chronically using opioids. 

4) Community Engagement – as mentioned previously, TennCare serves 20% of our state’s population and the Office of eHealth and TennCare are committed to staying engaged in the community to find ways to continue improving their services. 

Secondly, we discussed how TennCare and the Office of eHealth are living out the mission of HIMSS by leveraging information AND technology to provide better care through their Care Coordination Tool. This tool is an online web-based application to identify gaps of care in the Medicaid population. Patients who are part of a Patient Center Medical Home (21 in the state) or Tennessee Health Link (13 entities focused on behavioral health) are now having their care followed and tracked by providers who are looking for gaps of care. When a gap is identified, providers can be proactive and help prevent patients from going untreated for needed care. 

Lastly, we talked about the importance of interoperability and what does that mean for Tennessee. While a statewide Health Information Exchange (HIE) would be helpful the question comes down to cost and how best to keep it sustainable. Since TennCare serves the Medicaid population in the state a statewide HIE is not a top priority when the agency has realized success in developing  a platform specifically for its  focused population.  

Overall, the TN HIMSS Advocacy Committee is extremely grateful for the time and insights from TennCare and the Office of eHealth. We look forward to continuing working together and helping one another achieve our goals and objectives. For more information about TennCare please visit their website at

If you have enjoyed this blog post and are interested in Advocacy efforts with TN HIMSS please feel free to reach out to me at