• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to secondary sidebar
  • Skip to footer

  • Opinion
  • Health IT
    • Behavioral Health
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Patient Engagement
    • Population Health Management
    • Revenue Cycle Management
    • Social Determinants of Health
  • Digital Health
    • AI
    • Blockchain
    • Precision Medicine
    • Telehealth
    • Wearables
  • Life Sciences
  • Investments
  • M&A
  • Value-based Care
    • Accountable Care (ACOs)
    • Medicare Advantage

Tennessee Medicaid Program Taps Edifecs to Align Its Payment Reform Solutions

by HITC Staff 07/27/2017 Leave a Comment

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Edifecs

Tennessee Medicaid Program (TennCare) has selected Edifecs to help align its payment model with the Centers for Medicare and Medicaid Services’ (CMS) national payment reform initiatives. TennCare provides healthcare for approximately 1.5 million Tennesseans, covering approximately 20 percent of the state’s population, 50 percent of the state’s births, and 50 percent of the state’s children.

Edifecs’ Payment Reform and Value-Based Care solutions bring scalability to TennCare’s initiatives by providing near-time quality calculations, ongoing visibility into performance, and the capability to apply non-claims based measurement data to performance goals.

Top features of the Payment Reform and Value-Based Care solutions include:

·        Centralized and consolidated platform for all program quality data entry and submissions

·        Near real-time visibility of program metrics via role-specific dashboards, reports, and notifications

·        Flexible quality engine for calculation of program-specific customized clinical and outcomes based-measures

·        Ability to configure, group, monitor, and associate clinical quality values to all episodes in TennCare’s eight phase episode of care initiative

·        Partnership with CNSI, an industry-leading firm specializing in large-scale, mission-critical IT implementations for many state and federal agencies, to integrate MC-Track® for provider compliance and collaboration

These payment reform initiatives will eventually lead to a model in which health care providers are rewarded for high-quality, efficient treatment of medical conditions and the long-term maintenance of their patients’ health. Clinically-focused measurements help drive provider acceptance and participation in value-based initiatives.

These payment reform initiatives will eventually lead to a model in which health care providers are rewarded for high-quality, efficient treatment of medical conditions and the long-term maintenance of their patients’ health. Clinically-focused measurements help drive provider acceptance and participation in value-based initiatives.

“States are taking a more active role in shaping payment terms between managed care companies and healthcare providers, and Edifecs recognizes the criticality of the healthcare industry’s successful transition to value-based,” said Sunny Singh, CEO of Edifecs. “We’re committed to helping our customers make these transitions as smooth as possible, ultimately helping to ensure that payments align with quality outcomes for the many patients affected.”

 

The company recently announced the successful implementation and go-live of the Nebraska Medicaid program’s new electronic data interchange (EDI) platform. Replacing the aging platform mitigates major risks by having transactions with significant volume (inbound claims and encounters) now deployed onto Edifecs’ Smart Trading Platform, a solution specifically designed to simplify data automation and streamline interoperability.

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Tagged With: Edifecs

Tap Native

Get in-depth healthcare technology analysis and commentary delivered straight to your email weekly

Reader Interactions

Primary Sidebar

Subscribe to HIT Consultant

Latest insightful articles delivered straight to your inbox weekly.

Submit a Tip or Pitch

Featured Insights

Digital Health Funding Q3 2025: Choppy Undercurrents Beneath a Steady Surface

Most-Read

Qualtrics Acquires Press Ganey Forsta for $6.75B to Create the Most Comprehensive AI Experience Platform

Qualtrics Acquires Press Ganey Forsta for $6.75B to Create the Most Comprehensive AI Experience Platform

Pfizer and Trump Administration Announce Landmark Agreement to Lower Drug Costs

Pfizer and Trump Administration Announce Landmark Agreement to Lower Drug Costs

KLAS Report: Epic's Native Ambient Speech Tool Reshapes Customer AI Strategies

KLAS Report: Epic’s Native Ambient Speech Tool Reshapes Customer AI Strategies

Epic Unveils MyChart Central and New APIs to Advance Interoperability at Open@Epic

Epic Outlines Roadmap for Next-Generation Data Sharing at Open@Epic

Epic Launches Comet: A New AI Platform to Predict Patient Health Journeys

Epic Launches Comet: A New AI Platform to Predict Patient Health Journeys

RevSpring to Acquire Kyruus Health, Creating a Unified Patient Experience

RevSpring to Acquire Kyruus Health, Creating a Unified Patient Experience

Oracle Confirms Layoffs in Kansas City

Oracle Confirms Layoffs in Kansas City

Philips Future Health Index 2025: AI and Digital Tech Can Help Solve Cardiac Care Crisis

Philips Future Health Index 2025: AI and Digital Tech Can Help Solve Cardiac Care Crisis

Optain Health Secures $26M to Advance AI-Powered Retinal Screening

Optain Health Secures $26M for AI-Powered Retinal Screening

Sutter Health and Epic Launch "Sutter Sync" to Optimize Remote Chronic Care

Sutter Health and Epic Launch “Sutter Sync” to Optimize Remote Chronic Care

Secondary Sidebar

Footer

Company

  • About Us
  • Advertise with Us
  • Reprints and Permissions
  • Submit An Op-Ed
  • Contact
  • Subscribe

Editorial Coverage

  • Opinion
  • Health IT
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Population Health Management
    • Revenue Cycle Management
  • Digital Health
    • Artificial Intelligence
    • Blockchain Tech
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • Value-Based Care
    • Accountable Care
    • Medicare Advantage

Connect

Subscribe to HIT Consultant Media

Latest insightful articles delivered straight to your inbox weekly

Copyright © 2025. HIT Consultant Media. All Rights Reserved. Privacy Policy |