TennCare has added new compliance measures for its managed care organizations to make sure they’re helping improve the health of enrollees.
The measures were first used in 2004, but more were added this year. A report published last month, shows that the majority of the MCOs improved across most of the categories.
The Health Plan Employer Data and Information Set or HEDIS, looks at how well the MCOs are doing things like immunizing children, getting women in for prenatal care and even advising patients on smoking cessation.
TennCare Medical director Wendy Long says the data helps the bureau gauge the success of treating diseases like diabetes and asthma.
“They’re both very prevalent in the TennCare population and what we see in this data is that we seem to be doing quite well in terms of treating asthma, really better than our counterparts in other parts of the country, but we definitely have room for improvement when it comes to diabetes care. And there we’re below the national average on virtually all of the diabetes measures.”
According to the report roughly 88-percent of those on TennCare are treated with proper medications for asthma, but only 71-percent have their blood screened for glucose problems which helps monitor diabetes.
MCOs aren’t penalized for performing poorly on any indicators, but starting next year, TennCare is offering a 3-cent per person, per month bonus for MCOs that improve.
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