MCO Quality Data

This data represents the latest benefits to result from the Bureau's mandate that all MCOs become certified by the National Committee on Quality Assurance (NCQA), which measures quality and performance of healthcare insurance companies.

Although widely used in the commercial market, Tennessee is the first state to require NCQA certification across its Medicaid managed care network.

To review the 2007, 2006 or the 2005 HEDIS reports, please click on the links below:

While we are excited at the increased transparency, these reports demonstrate the need for marked improvement in overall quality by all TennCare Plans.

Going forward, the state intends to increase the ties between performance and financial incentives as we push toward full risk (just achieved in Middle Tennessee 07/26/06). It goes without saying that the state will need to re-evaluate its long-term relationship with those plans that fail to show improvement despite these incentives.