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Tennessee saves millions with episodes of care for Medicaid patients: 5 key notes

Tennessee saved millions of dollars after shifting Medicaid payments from fee-for-service to episodes of care, according to a report in the Times Free Press.

Here are five things to know:

1. The state launched the Health Care Innovation Initiative in February 2013 with the goal of employing a value-based strategy. The government saved $11.1 million during the first year.

2. TennCare and the other major insurers in Tennessee developed the episodes of care payments to reward providers for the positive patient outcomes, focusing on quality and efficiency. The episode of care gives financial rewards if patients meet quality measures and their care is cost-effective.

3. Within the first year, the Medicaid program reported 6.7 percent decreased total hip and knee replacement procedures and 3.4 percent reduction in costs associated with perinatal care before and after birth.

4. The episodes of care in total joints, perinatal care and asthma exacerbation reduced costs by $6.3 million.

5. The program added five new types of services to the episode of care:

• Chronic obstructive pulmonary disease exacerbation
• Colonoscopy
• Acute and non-acute percutaneous coronary intervention
• Cholecystectomy

The state hopes to provide 75 episodes by 2020.

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