Led by the state of Tennessee, the Tennessee Healthcare Innovation Initiative (THCII) was created to lower costs and improve health care for Tennesseans. The program is designed to shift the health care system from volume-based to value-based, while protecting our members’ physical and financial health by reducing ineffective or inappropriate treatments. In turn, doctors and hospitals are rewarded for delivering high quality, efficient medical care.
BlueCross BlueShield of Tennessee is expanding the THCII Episode of Care program to State Employee Health Plan (SEHP) and Fully Insured (FI) members who use Blue Network SSM. The performance period for SEHP begins Jan. 1, 2017, and is a Rewards-only program.
The THCII State Employee Health Plan and Fully Insured Program Guide includes important information about the program and offers resources to help you understand how the program impacts your organization.
|How to read an Episode of Care report||
Reports provide performance information for quarterback episodes. This guide is designed to help you understand and act upon the information included in your reports.
|Frequently Asked Questions||THCII State Employee Health Plan and Fully Insured - FAQs|
|Provider Quick Reference Guide||Episodes of Care Quick Reference Guide|
|THCII SEHP Threshold Information||2017 Thresholds
|THCII Fully Insured Threshold Information||2017 Thresholds|
|THCII Risk Adjustment Methodology||Episode of Care Risk Adjustment Methodology|
|THCII Risk Factors and Weights||Episode of Care Risk Adjustment Factors and Weights|
|THCII SEHP Gainsharing Limits||Gainsharing Limits for Episodes of Care|
Please contact your Network Manager with any questions. If you do not know who your Network Manager is, visit www.bcbst.com/providers/mycontact to locate your BlueCross contact.
While BlueAccess for providers is still available, Availity will replace BlueAccess March 2, 2018. Go to Availity.com to register.
BlueCross BlueShield of Tennessee's CAQH/CORE certified real-time benefits, eligibility and claim status system.
Use our directory to find providers and make referrals.