SlideShare a Scribd company logo
www.publicpartnerships.com

case study:

Financial Administration and Support Brokerage
Services within Managed Care in Tennessee

THE RESULT
PCG Public Partnerships, LLC (PPL) worked side-by-side with TennCare,
structuring the participant direction program for a year prior to go-live
and helping TennCare with participant direction policies, procedures,
rules, and regulations. Among other tasks, PPL
•	 Developed data transfers between PPL, the three MCOs, TennCare,
and the EVV system;

THE CLIENT
Tennessee Department of Finance and Administration,
Bureau of TennCare (TennCare)

•	 Subcontracted with three supports brokerage agencies to provide
statewide services;
•	 Launched PPL services regionally, following the roll-out of the
CHOICES program;

THE PROJECT

•	 Enforced state and federal program requirements;

Provision of financial administration and supports brokerage
services for consumer direction in the TennCare CHOICES
Long-Term Care Program.

•	 Configured PPL information technology platforms to fit the state’s
unique program requirements;
•	 Developed materials and processes to support program participants;
•	 Customized reports to the state’s program requirements; and
•	 Instituted monthly meetings with the state to improve program
efficiency.

THE OPPORTUNITY
In 2008, the state of Tennessee passed the Long-Term Care Community
Choices Act (CHOICES), fundamentally restructuring the long-term care
system in Tennessee. Among other things, CHOICES integrated nursing
facility and home and community-based care into a managed care delivery
system. It also provided participant direction as an option to those who
were eligible for home and community-based care.
Unlike traditional participant direction programs, TennCare structured
this program within managed care. Medicaid recipients would select
a managed care organization and, should participant direction be
appropriate, the managed care organization (MCO) and financial
administrator would work together to authorize the individual for services.
TennCare also determined that it wanted consumer directed workers to
utilize a telephonic timesheet system (EVV) rather than standard physical
or electronic timesheets. Finally, the program also required supports
brokerage services.

THE RESULT
•	 Since April 2010, over 1,000 individuals have been referred for
participant direction and about 360 are actively receiving services.
•	 On average, another 28 individuals per month start receiving services.
•	 On average, PPL customer service staff members field 1,300 calls per
month.
•	 Vital employment of over 300 FTEs providing consumer-directed
services.
•	 PPL won a re-bid for the contract.

The expectation was that the CHOICES program would be popular
because until the CHOICES program, Tennessee offered few home and
community-based options for long-term care recipients. Consumer
direction numbers could not be predicted but were expected to grow
significantly over time.

PCG Public Partnerships, LLC | 148 State Street, Tenth Floor, Boston, Massachusetts 02109 | tel: (855) 243-8775 fax: (617) 717-0085
Copyright Public Consulting Group, Inc.

More Related Content

What's hot

Public Health - Lloyd Michener
Public Health - Lloyd MichenerPublic Health - Lloyd Michener
Public Health - Lloyd Michener
American Academy of Family Physicians
 
Hsj awards dragons den
Hsj awards dragons denHsj awards dragons den
Hsj awards dragons den
NHS Improving Quality
 
FINAL Internship Abstract
FINAL Internship AbstractFINAL Internship Abstract
FINAL Internship Abstract
Ewelina Gwiszcz
 
Frontier Medicine Better Health Partnership
Frontier Medicine Better Health PartnershipFrontier Medicine Better Health Partnership
Frontier Medicine Better Health Partnership
MineralRegional
 
PCG Public Partnerships Case Study, VA DMAS Program
PCG Public Partnerships Case Study, VA DMAS ProgramPCG Public Partnerships Case Study, VA DMAS Program
PCG Public Partnerships Case Study, VA DMAS Program
Public Consulting Group
 
Public Health - Bellinda Schoof
Public Health - Bellinda SchoofPublic Health - Bellinda Schoof
Public Health - Bellinda Schoof
American Academy of Family Physicians
 
Health Landscape
Health Landscape Health Landscape
MeTA priorities and milestones in Zambia
MeTA priorities and milestones in ZambiaMeTA priorities and milestones in Zambia
MeTA priorities and milestones in Zambia
MeTApresents
 
Health Centre Advisory Committee: Pilot Capacity Strengthening Project
Health Centre Advisory Committee: Pilot Capacity Strengthening ProjectHealth Centre Advisory Committee: Pilot Capacity Strengthening Project
Health Centre Advisory Committee: Pilot Capacity Strengthening Project
Rebekah McKay-Smith
 
Telehealth - Latoya Thomas
Telehealth - Latoya ThomasTelehealth - Latoya Thomas
Telehealth - Latoya Thomas
American Academy of Family Physicians
 
Medicaid Managed Care - Beth Kohler
Medicaid Managed Care - Beth KohlerMedicaid Managed Care - Beth Kohler
Medicaid Managed Care - Beth Kohler
American Academy of Family Physicians
 
Welcome dec 2014 fl summit setrc
Welcome dec 2014 fl summit setrcWelcome dec 2014 fl summit setrc
Welcome dec 2014 fl summit setrc
Samantha Haas
 
Dec 2014 fl summit setrc
Dec 2014 fl summit setrc Dec 2014 fl summit setrc
Dec 2014 fl summit setrc
Samantha Haas
 
Leveraging Social Health Insurance
Leveraging Social Health InsuranceLeveraging Social Health Insurance
Leveraging Social Health Insurance
Leizel Rombaua MD MPH PHD
 
Government Affairs Update - Bob Hall
Government Affairs Update - Bob HallGovernment Affairs Update - Bob Hall
Government Affairs Update - Bob Hall
American Academy of Family Physicians
 
Vaccines - Miller
Vaccines - MillerVaccines - Miller
Overview of CNCS Priorities and Performance Measures
Overview of CNCS Priorities and Performance MeasuresOverview of CNCS Priorities and Performance Measures
Overview of CNCS Priorities and Performance Measures
serviceresources
 
Medicaid Managed Care - Jeff Smith
Medicaid Managed Care - Jeff SmithMedicaid Managed Care - Jeff Smith
Medicaid Managed Care - Jeff Smith
American Academy of Family Physicians
 
James Andati Best Practices Presentation
James Andati Best Practices PresentationJames Andati Best Practices Presentation
James Andati Best Practices Presentation
James Andati
 
Jamerson.aafp slc 2013
Jamerson.aafp slc 2013Jamerson.aafp slc 2013
Jamerson.aafp slc 2013
MGreenhalgh4
 

What's hot (20)

Public Health - Lloyd Michener
Public Health - Lloyd MichenerPublic Health - Lloyd Michener
Public Health - Lloyd Michener
 
Hsj awards dragons den
Hsj awards dragons denHsj awards dragons den
Hsj awards dragons den
 
FINAL Internship Abstract
FINAL Internship AbstractFINAL Internship Abstract
FINAL Internship Abstract
 
Frontier Medicine Better Health Partnership
Frontier Medicine Better Health PartnershipFrontier Medicine Better Health Partnership
Frontier Medicine Better Health Partnership
 
PCG Public Partnerships Case Study, VA DMAS Program
PCG Public Partnerships Case Study, VA DMAS ProgramPCG Public Partnerships Case Study, VA DMAS Program
PCG Public Partnerships Case Study, VA DMAS Program
 
Public Health - Bellinda Schoof
Public Health - Bellinda SchoofPublic Health - Bellinda Schoof
Public Health - Bellinda Schoof
 
Health Landscape
Health Landscape Health Landscape
Health Landscape
 
MeTA priorities and milestones in Zambia
MeTA priorities and milestones in ZambiaMeTA priorities and milestones in Zambia
MeTA priorities and milestones in Zambia
 
Health Centre Advisory Committee: Pilot Capacity Strengthening Project
Health Centre Advisory Committee: Pilot Capacity Strengthening ProjectHealth Centre Advisory Committee: Pilot Capacity Strengthening Project
Health Centre Advisory Committee: Pilot Capacity Strengthening Project
 
Telehealth - Latoya Thomas
Telehealth - Latoya ThomasTelehealth - Latoya Thomas
Telehealth - Latoya Thomas
 
Medicaid Managed Care - Beth Kohler
Medicaid Managed Care - Beth KohlerMedicaid Managed Care - Beth Kohler
Medicaid Managed Care - Beth Kohler
 
Welcome dec 2014 fl summit setrc
Welcome dec 2014 fl summit setrcWelcome dec 2014 fl summit setrc
Welcome dec 2014 fl summit setrc
 
Dec 2014 fl summit setrc
Dec 2014 fl summit setrc Dec 2014 fl summit setrc
Dec 2014 fl summit setrc
 
Leveraging Social Health Insurance
Leveraging Social Health InsuranceLeveraging Social Health Insurance
Leveraging Social Health Insurance
 
Government Affairs Update - Bob Hall
Government Affairs Update - Bob HallGovernment Affairs Update - Bob Hall
Government Affairs Update - Bob Hall
 
Vaccines - Miller
Vaccines - MillerVaccines - Miller
Vaccines - Miller
 
Overview of CNCS Priorities and Performance Measures
Overview of CNCS Priorities and Performance MeasuresOverview of CNCS Priorities and Performance Measures
Overview of CNCS Priorities and Performance Measures
 
Medicaid Managed Care - Jeff Smith
Medicaid Managed Care - Jeff SmithMedicaid Managed Care - Jeff Smith
Medicaid Managed Care - Jeff Smith
 
James Andati Best Practices Presentation
James Andati Best Practices PresentationJames Andati Best Practices Presentation
James Andati Best Practices Presentation
 
Jamerson.aafp slc 2013
Jamerson.aafp slc 2013Jamerson.aafp slc 2013
Jamerson.aafp slc 2013
 

Viewers also liked

Referral screening, intake form
Referral screening, intake formReferral screening, intake form
Referral screening, intake form
fullcirclePLLC
 
Log net install update autocad
Log net install update autocadLog net install update autocad
Log net install update autocad
Diego Santos Seabra
 
Let it be song
Let it be songLet it be song
Let it be song
chushog
 
Unisa odl conference wessels and binza september 2012
Unisa odl conference wessels and binza september 2012Unisa odl conference wessels and binza september 2012
Unisa odl conference wessels and binza september 2012
RochelleWessels
 
Metadata Administration – A Case Study
Metadata Administration – A Case StudyMetadata Administration – A Case Study
Metadata Administration – A Case Study
afriedgan
 
Galicia se rinde a la comida basura - La Voz de Galicia
Galicia se rinde a la comida basura - La Voz de GaliciaGalicia se rinde a la comida basura - La Voz de Galicia
Galicia se rinde a la comida basura - La Voz de Galicia
EAE Business School
 
Pisada zapatillas
Pisada zapatillasPisada zapatillas
Pisada zapatillas
yogui1970
 
учителя математики
учителя математикиучителя математики
учителя математики
maltzewa
 
I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...
I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...
I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...
filolacabrera
 
Cover Letter
Cover LetterCover Letter
Cover Letter
Imran Raja
 
Catalogo mimate (1)
Catalogo mimate (1)Catalogo mimate (1)
Catalogo mimate (1)
Ana Rocío Rodríguez
 
Speaking
SpeakingSpeaking
Speaking
alsalcunsoed
 
Mi recetario
Mi recetarioMi recetario
Mi recetario
Olgaa29
 
Narayaneeyam telugu transliteration 023
Narayaneeyam telugu transliteration 023Narayaneeyam telugu transliteration 023
Narayaneeyam telugu transliteration 023
Ravi Ramakrishnan
 
Oded Korach CV 2015 eng
Oded Korach CV 2015 engOded Korach CV 2015 eng
Oded Korach CV 2015 eng
Oded Korach
 
Roles and functions of educational technology in 21st century education
Roles and functions of educational technology in 21st century educationRoles and functions of educational technology in 21st century education
Roles and functions of educational technology in 21st century education
AndriaAshlyIgot
 

Viewers also liked (18)

Referral screening, intake form
Referral screening, intake formReferral screening, intake form
Referral screening, intake form
 
Doc1
Doc1Doc1
Doc1
 
Log net install update autocad
Log net install update autocadLog net install update autocad
Log net install update autocad
 
Let it be song
Let it be songLet it be song
Let it be song
 
Unisa odl conference wessels and binza september 2012
Unisa odl conference wessels and binza september 2012Unisa odl conference wessels and binza september 2012
Unisa odl conference wessels and binza september 2012
 
Metadata Administration – A Case Study
Metadata Administration – A Case StudyMetadata Administration – A Case Study
Metadata Administration – A Case Study
 
Galicia se rinde a la comida basura - La Voz de Galicia
Galicia se rinde a la comida basura - La Voz de GaliciaGalicia se rinde a la comida basura - La Voz de Galicia
Galicia se rinde a la comida basura - La Voz de Galicia
 
Pisada zapatillas
Pisada zapatillasPisada zapatillas
Pisada zapatillas
 
учителя математики
учителя математикиучителя математики
учителя математики
 
I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...
I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...
I Maratón Foto Digital IES LA CABRERA 11 de junio de 2015 - José Manuel Martí...
 
certificate
certificatecertificate
certificate
 
Cover Letter
Cover LetterCover Letter
Cover Letter
 
Catalogo mimate (1)
Catalogo mimate (1)Catalogo mimate (1)
Catalogo mimate (1)
 
Speaking
SpeakingSpeaking
Speaking
 
Mi recetario
Mi recetarioMi recetario
Mi recetario
 
Narayaneeyam telugu transliteration 023
Narayaneeyam telugu transliteration 023Narayaneeyam telugu transliteration 023
Narayaneeyam telugu transliteration 023
 
Oded Korach CV 2015 eng
Oded Korach CV 2015 engOded Korach CV 2015 eng
Oded Korach CV 2015 eng
 
Roles and functions of educational technology in 21st century education
Roles and functions of educational technology in 21st century educationRoles and functions of educational technology in 21st century education
Roles and functions of educational technology in 21st century education
 

Similar to PCG Public Partnerships Case Study, TennCare CHOICES Program

PCG Public Partnerships Case Study, TN DIDD program
PCG Public Partnerships Case Study, TN DIDD programPCG Public Partnerships Case Study, TN DIDD program
PCG Public Partnerships Case Study, TN DIDD program
Public Consulting Group
 
PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...
PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...
PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...
Public Consulting Group
 
PCG Public Partnerships Case Study, AZ DDD Program
PCG Public Partnerships Case Study, AZ DDD ProgramPCG Public Partnerships Case Study, AZ DDD Program
PCG Public Partnerships Case Study, AZ DDD Program
Public Consulting Group
 
A critical analysis of purchasing mechanism in China's Rural Health Insurance...
A critical analysis of purchasing mechanism in China's Rural Health Insurance...A critical analysis of purchasing mechanism in China's Rural Health Insurance...
A critical analysis of purchasing mechanism in China's Rural Health Insurance...
resyst
 
Poster, advancements in care coordination mn sim
Poster, advancements in care coordination mn simPoster, advancements in care coordination mn sim
Poster, advancements in care coordination mn sim
soder145
 
NYeC | PCIP Learning Series #1 - DSRIP
NYeC | PCIP Learning Series #1 - DSRIPNYeC | PCIP Learning Series #1 - DSRIP
NYeC | PCIP Learning Series #1 - DSRIP
New York eHealth Collaborative
 
Leveraging MLTSS to Accomplish System Objectives
Leveraging MLTSS to Accomplish System ObjectivesLeveraging MLTSS to Accomplish System Objectives
Leveraging MLTSS to Accomplish System Objectives
Aquila "Q" Jordan
 
Health information technology networks presentation
Health information technology networks presentationHealth information technology networks presentation
Health information technology networks presentation
learfield
 
Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...
Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...
Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...
soder145
 
The Next Frontier to Support Health Resource Tracking
The Next Frontier to Support Health Resource TrackingThe Next Frontier to Support Health Resource Tracking
The Next Frontier to Support Health Resource Tracking
HFG Project
 
My voice summary
My voice summaryMy voice summary
My voice summary
Adrian Hall
 
uat-012215
uat-012215uat-012215
uat-012215
Rashi Kesarwani
 
MSO Program Overview
MSO Program OverviewMSO Program Overview
MSO Program Overview
CRISP
 
Applying systems thinking: Process mapping in Bangladesh
Applying systems thinking: Process mapping in BangladeshApplying systems thinking: Process mapping in Bangladesh
Applying systems thinking: Process mapping in Bangladesh
Rebekah McKay-Smith
 
MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013
MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013
MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013
MassEHealth
 
APCRSHR10 Virtual abstract presentation of Dr Harjyot Khosa
APCRSHR10 Virtual abstract presentation of Dr Harjyot KhosaAPCRSHR10 Virtual abstract presentation of Dr Harjyot Khosa
APCRSHR10 Virtual abstract presentation of Dr Harjyot Khosa
CNS www.citizen-news.org
 
Communities for a Better Tomorrow: Working for Children Everyday in Every Way
Communities for a Better Tomorrow: Working for Children Everyday in Every WayCommunities for a Better Tomorrow: Working for Children Everyday in Every Way
Communities for a Better Tomorrow: Working for Children Everyday in Every Way
Laila Bell
 
Primary Care Spend: A Chapter Focus
Primary Care Spend: A Chapter FocusPrimary Care Spend: A Chapter Focus
Primary Care Spend: A Chapter Focus
American Academy of Family Physicians
 
PCG Public Partnerships Case Study, Ohio Department of Health (ODH)
PCG Public Partnerships Case Study, Ohio Department of Health (ODH)PCG Public Partnerships Case Study, Ohio Department of Health (ODH)
PCG Public Partnerships Case Study, Ohio Department of Health (ODH)
Public Consulting Group
 
How Decision-Support Tools Cure the Prior Authorization Time Drain
How Decision-Support Tools Cure the Prior Authorization Time DrainHow Decision-Support Tools Cure the Prior Authorization Time Drain
How Decision-Support Tools Cure the Prior Authorization Time Drain
Cognizant
 

Similar to PCG Public Partnerships Case Study, TennCare CHOICES Program (20)

PCG Public Partnerships Case Study, TN DIDD program
PCG Public Partnerships Case Study, TN DIDD programPCG Public Partnerships Case Study, TN DIDD program
PCG Public Partnerships Case Study, TN DIDD program
 
PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...
PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...
PCG Public Partnerships Case Study, New Jersey Department of Health and Senio...
 
PCG Public Partnerships Case Study, AZ DDD Program
PCG Public Partnerships Case Study, AZ DDD ProgramPCG Public Partnerships Case Study, AZ DDD Program
PCG Public Partnerships Case Study, AZ DDD Program
 
A critical analysis of purchasing mechanism in China's Rural Health Insurance...
A critical analysis of purchasing mechanism in China's Rural Health Insurance...A critical analysis of purchasing mechanism in China's Rural Health Insurance...
A critical analysis of purchasing mechanism in China's Rural Health Insurance...
 
Poster, advancements in care coordination mn sim
Poster, advancements in care coordination mn simPoster, advancements in care coordination mn sim
Poster, advancements in care coordination mn sim
 
NYeC | PCIP Learning Series #1 - DSRIP
NYeC | PCIP Learning Series #1 - DSRIPNYeC | PCIP Learning Series #1 - DSRIP
NYeC | PCIP Learning Series #1 - DSRIP
 
Leveraging MLTSS to Accomplish System Objectives
Leveraging MLTSS to Accomplish System ObjectivesLeveraging MLTSS to Accomplish System Objectives
Leveraging MLTSS to Accomplish System Objectives
 
Health information technology networks presentation
Health information technology networks presentationHealth information technology networks presentation
Health information technology networks presentation
 
Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...
Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...
Paying for Value in Medicaid: A Synthesis of Advanced Payment Models in Four ...
 
The Next Frontier to Support Health Resource Tracking
The Next Frontier to Support Health Resource TrackingThe Next Frontier to Support Health Resource Tracking
The Next Frontier to Support Health Resource Tracking
 
My voice summary
My voice summaryMy voice summary
My voice summary
 
uat-012215
uat-012215uat-012215
uat-012215
 
MSO Program Overview
MSO Program OverviewMSO Program Overview
MSO Program Overview
 
Applying systems thinking: Process mapping in Bangladesh
Applying systems thinking: Process mapping in BangladeshApplying systems thinking: Process mapping in Bangladesh
Applying systems thinking: Process mapping in Bangladesh
 
MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013
MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013
MeHI Regional Health IT Meetings - Tewksbury, MA - Sept, 2013
 
APCRSHR10 Virtual abstract presentation of Dr Harjyot Khosa
APCRSHR10 Virtual abstract presentation of Dr Harjyot KhosaAPCRSHR10 Virtual abstract presentation of Dr Harjyot Khosa
APCRSHR10 Virtual abstract presentation of Dr Harjyot Khosa
 
Communities for a Better Tomorrow: Working for Children Everyday in Every Way
Communities for a Better Tomorrow: Working for Children Everyday in Every WayCommunities for a Better Tomorrow: Working for Children Everyday in Every Way
Communities for a Better Tomorrow: Working for Children Everyday in Every Way
 
Primary Care Spend: A Chapter Focus
Primary Care Spend: A Chapter FocusPrimary Care Spend: A Chapter Focus
Primary Care Spend: A Chapter Focus
 
PCG Public Partnerships Case Study, Ohio Department of Health (ODH)
PCG Public Partnerships Case Study, Ohio Department of Health (ODH)PCG Public Partnerships Case Study, Ohio Department of Health (ODH)
PCG Public Partnerships Case Study, Ohio Department of Health (ODH)
 
How Decision-Support Tools Cure the Prior Authorization Time Drain
How Decision-Support Tools Cure the Prior Authorization Time DrainHow Decision-Support Tools Cure the Prior Authorization Time Drain
How Decision-Support Tools Cure the Prior Authorization Time Drain
 

Recently uploaded

Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...
Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...
Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...
Suomen Pankki
 
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy Visa
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy VisaNew Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy Visa
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy Visa
Amit Kakkar
 
一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查
一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查
一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查
taqyea
 
The state of welfare Resolution Foundation Event
The state of welfare Resolution Foundation EventThe state of welfare Resolution Foundation Event
The state of welfare Resolution Foundation Event
ResolutionFoundation
 
Does teamwork really matter? Looking beyond the job posting to understand lab...
Does teamwork really matter? Looking beyond the job posting to understand lab...Does teamwork really matter? Looking beyond the job posting to understand lab...
Does teamwork really matter? Looking beyond the job posting to understand lab...
Labour Market Information Council | Conseil de l’information sur le marché du travail
 
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
5spllj1l
 
Fabular Frames and the Four Ratio Problem
Fabular Frames and the Four Ratio ProblemFabular Frames and the Four Ratio Problem
Fabular Frames and the Four Ratio Problem
Majid Iqbal
 
快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
rlo9fxi
 
falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...
falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...
falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...
Falcon Invoice Discounting
 
FCCS Basic Accounts Outline and Hierarchy.pptx
FCCS Basic Accounts Outline and Hierarchy.pptxFCCS Basic Accounts Outline and Hierarchy.pptx
FCCS Basic Accounts Outline and Hierarchy.pptx
nalamynandan
 
South Dakota State University degree offer diploma Transcript
South Dakota State University degree offer diploma TranscriptSouth Dakota State University degree offer diploma Transcript
South Dakota State University degree offer diploma Transcript
ynfqplhm
 
Applying the Global Internal Audit Standards_AIS.pdf
Applying the Global Internal Audit Standards_AIS.pdfApplying the Global Internal Audit Standards_AIS.pdf
Applying the Global Internal Audit Standards_AIS.pdf
alexiusbrian1
 
RMIT University degree offer diploma Transcript
RMIT University degree offer diploma TranscriptRMIT University degree offer diploma Transcript
RMIT University degree offer diploma Transcript
cahyrnui
 
Using Online job postings and survey data to understand labour market trends
Using Online job postings and survey data to understand labour market trendsUsing Online job postings and survey data to understand labour market trends
Using Online job postings and survey data to understand labour market trends
Labour Market Information Council | Conseil de l’information sur le marché du travail
 
Seeman_Fiintouch_LLP_Newsletter_Jun_2024.pdf
Seeman_Fiintouch_LLP_Newsletter_Jun_2024.pdfSeeman_Fiintouch_LLP_Newsletter_Jun_2024.pdf
Seeman_Fiintouch_LLP_Newsletter_Jun_2024.pdf
Ashis Kumar Dey
 
Who Is Abhay Bhutada, MD of Poonawalla Fincorp
Who Is Abhay Bhutada, MD of Poonawalla FincorpWho Is Abhay Bhutada, MD of Poonawalla Fincorp
Who Is Abhay Bhutada, MD of Poonawalla Fincorp
beulahfernandes8
 
Enhancing Asset Quality: Strategies for Financial Institutions
Enhancing Asset Quality: Strategies for Financial InstitutionsEnhancing Asset Quality: Strategies for Financial Institutions
Enhancing Asset Quality: Strategies for Financial Institutions
shruti1menon2
 
Upanishads summary with explanations of each upnishad
Upanishads summary with explanations of each upnishadUpanishads summary with explanations of each upnishad
Upanishads summary with explanations of each upnishad
ajaykumarxoxo04
 
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
AntoniaOwensDetwiler
 
falcon-invoice-discounting-a-strategic-approach-to-optimize-investments
falcon-invoice-discounting-a-strategic-approach-to-optimize-investmentsfalcon-invoice-discounting-a-strategic-approach-to-optimize-investments
falcon-invoice-discounting-a-strategic-approach-to-optimize-investments
Falcon Invoice Discounting
 

Recently uploaded (20)

Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...
Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...
Governor Olli Rehn: Inflation down and recovery supported by interest rate cu...
 
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy Visa
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy VisaNew Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy Visa
New Visa Rules for Tourists and Students in Thailand | Amit Kakkar Easy Visa
 
一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查
一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查
一比一原版美国新罕布什尔大学(unh)毕业证学历认证真实可查
 
The state of welfare Resolution Foundation Event
The state of welfare Resolution Foundation EventThe state of welfare Resolution Foundation Event
The state of welfare Resolution Foundation Event
 
Does teamwork really matter? Looking beyond the job posting to understand lab...
Does teamwork really matter? Looking beyond the job posting to understand lab...Does teamwork really matter? Looking beyond the job posting to understand lab...
Does teamwork really matter? Looking beyond the job posting to understand lab...
 
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
 
Fabular Frames and the Four Ratio Problem
Fabular Frames and the Four Ratio ProblemFabular Frames and the Four Ratio Problem
Fabular Frames and the Four Ratio Problem
 
快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
 
falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...
falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...
falcon-invoice-discounting-a-premier-investment-platform-for-superior-returns...
 
FCCS Basic Accounts Outline and Hierarchy.pptx
FCCS Basic Accounts Outline and Hierarchy.pptxFCCS Basic Accounts Outline and Hierarchy.pptx
FCCS Basic Accounts Outline and Hierarchy.pptx
 
South Dakota State University degree offer diploma Transcript
South Dakota State University degree offer diploma TranscriptSouth Dakota State University degree offer diploma Transcript
South Dakota State University degree offer diploma Transcript
 
Applying the Global Internal Audit Standards_AIS.pdf
Applying the Global Internal Audit Standards_AIS.pdfApplying the Global Internal Audit Standards_AIS.pdf
Applying the Global Internal Audit Standards_AIS.pdf
 
RMIT University degree offer diploma Transcript
RMIT University degree offer diploma TranscriptRMIT University degree offer diploma Transcript
RMIT University degree offer diploma Transcript
 
Using Online job postings and survey data to understand labour market trends
Using Online job postings and survey data to understand labour market trendsUsing Online job postings and survey data to understand labour market trends
Using Online job postings and survey data to understand labour market trends
 
Seeman_Fiintouch_LLP_Newsletter_Jun_2024.pdf
Seeman_Fiintouch_LLP_Newsletter_Jun_2024.pdfSeeman_Fiintouch_LLP_Newsletter_Jun_2024.pdf
Seeman_Fiintouch_LLP_Newsletter_Jun_2024.pdf
 
Who Is Abhay Bhutada, MD of Poonawalla Fincorp
Who Is Abhay Bhutada, MD of Poonawalla FincorpWho Is Abhay Bhutada, MD of Poonawalla Fincorp
Who Is Abhay Bhutada, MD of Poonawalla Fincorp
 
Enhancing Asset Quality: Strategies for Financial Institutions
Enhancing Asset Quality: Strategies for Financial InstitutionsEnhancing Asset Quality: Strategies for Financial Institutions
Enhancing Asset Quality: Strategies for Financial Institutions
 
Upanishads summary with explanations of each upnishad
Upanishads summary with explanations of each upnishadUpanishads summary with explanations of each upnishad
Upanishads summary with explanations of each upnishad
 
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...
 
falcon-invoice-discounting-a-strategic-approach-to-optimize-investments
falcon-invoice-discounting-a-strategic-approach-to-optimize-investmentsfalcon-invoice-discounting-a-strategic-approach-to-optimize-investments
falcon-invoice-discounting-a-strategic-approach-to-optimize-investments
 

PCG Public Partnerships Case Study, TennCare CHOICES Program

  • 1. www.publicpartnerships.com case study: Financial Administration and Support Brokerage Services within Managed Care in Tennessee THE RESULT PCG Public Partnerships, LLC (PPL) worked side-by-side with TennCare, structuring the participant direction program for a year prior to go-live and helping TennCare with participant direction policies, procedures, rules, and regulations. Among other tasks, PPL • Developed data transfers between PPL, the three MCOs, TennCare, and the EVV system; THE CLIENT Tennessee Department of Finance and Administration, Bureau of TennCare (TennCare) • Subcontracted with three supports brokerage agencies to provide statewide services; • Launched PPL services regionally, following the roll-out of the CHOICES program; THE PROJECT • Enforced state and federal program requirements; Provision of financial administration and supports brokerage services for consumer direction in the TennCare CHOICES Long-Term Care Program. • Configured PPL information technology platforms to fit the state’s unique program requirements; • Developed materials and processes to support program participants; • Customized reports to the state’s program requirements; and • Instituted monthly meetings with the state to improve program efficiency. THE OPPORTUNITY In 2008, the state of Tennessee passed the Long-Term Care Community Choices Act (CHOICES), fundamentally restructuring the long-term care system in Tennessee. Among other things, CHOICES integrated nursing facility and home and community-based care into a managed care delivery system. It also provided participant direction as an option to those who were eligible for home and community-based care. Unlike traditional participant direction programs, TennCare structured this program within managed care. Medicaid recipients would select a managed care organization and, should participant direction be appropriate, the managed care organization (MCO) and financial administrator would work together to authorize the individual for services. TennCare also determined that it wanted consumer directed workers to utilize a telephonic timesheet system (EVV) rather than standard physical or electronic timesheets. Finally, the program also required supports brokerage services. THE RESULT • Since April 2010, over 1,000 individuals have been referred for participant direction and about 360 are actively receiving services. • On average, another 28 individuals per month start receiving services. • On average, PPL customer service staff members field 1,300 calls per month. • Vital employment of over 300 FTEs providing consumer-directed services. • PPL won a re-bid for the contract. The expectation was that the CHOICES program would be popular because until the CHOICES program, Tennessee offered few home and community-based options for long-term care recipients. Consumer direction numbers could not be predicted but were expected to grow significantly over time. PCG Public Partnerships, LLC | 148 State Street, Tenth Floor, Boston, Massachusetts 02109 | tel: (855) 243-8775 fax: (617) 717-0085 Copyright Public Consulting Group, Inc.