Tennessee Episodes of Care / Patient Centered Medical Home / TN Health Link / Medication Therapy Management
State of Tennessee Episodes of Care Program Information
Episode-based payment seeks to align provider incentives with successfully achieving a patient's desired outcome during an “episode of care,” which is acute or specialist-driven health care delivered during a specified time period to treat a physical or behavioral condition. Episodes reward high-quality care, promote the use of clinical pathways and evidence-based guidelines, encourage coordination, and reduce ineffective and/or inappropriate care. Episode-based payment is applicable for most procedures, hospitalizations, acute outpatient care (e.g., broken bones), as well as some forms of treatment for chronic (e.g., cancer) and behavioral health conditions (e.g., ADHD).
For more information on individual Episodes of Care, please visit TN.gov.
- Episodes of Care website
- Patient-Centered Medical Home (PCMH) Website
- Tennessee Health Link website
- Tennessee Health Link (THL) Reconsideration Request Form
- Tennessee Patient-Centered Medical Home (PCMH) Reconsideration Request Form
- Tennessee Episodes of Care Reconsideration Request Form
- Tennessee Journey Program Reconsideration Request Form
Program Contact Information
- Email: Payment.Reform@tn.gov
Program Updates
Resources
- Journey Program - Frequently asked questions
- UnitedHealthcare 2022 Episode of Care Risk Methodology Description Wave 1
- UnitedHealthcare 2022 Episode of Care Risk Methodology Description Wave 2
- UnitedHealthcare 2023 Episode of Care Risk Methodology Description Wave 3
- UnitedHealthcare 2024 Episode of Care Risk Methodology Description Wave 4
- UnitedHealthcare 2023 Episode of Care Risk Methodology Description Wave 5
- UnitedHealthcare 2024 Episode of Care Risk Methodology Description Wave 6
- UnitedHealthcare 2024 Episode of Care Risk Methodology Description Wave 7
- UnitedHealthcare 2024 Episode of Care Risk Methodology Description Wave 8
- UnitedHealthcare 2024 Episode of Care Risk Methodology Description Wave 9
- UnitedHealthcare 2024 Episode of Care Risk Neutrality Factors