TN MEDICAID MARKET
Tennessee
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
Plans in this market 23
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | Alexian Brothers Community Services | not reported | 270 (2024) | 100.0% calculated | not reported |
| not reported | Volunteer State Health Plan (BlueCare) | not reported | 510,990 (2018) | 14.9% calculated | not reported |
| not reported | Volunteer State Health Plan (TennCare Select) | not reported | 65,908 (2018) | 1.9% calculated | not reported |
| not reported | Volunteer State Health Plan (BlueCare) | not reported | 541,901 (2024) | 13.1% calculated | 16 sanctions, 707 appeals resolved |
| not reported | Volunteer State Health Plan (TennCare Select) | not reported | 35,676 (2024) | 0.9% calculated | 9 sanctions, 190 appeals resolved |
show all 23
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Centene | Magellan Health Services | not reported | 1,291,060 (2019) | 36.1% calculated | not reported |
| Centene | Magellan Health Services | not reported | 1,241,741 (2018) | 36.2% calculated | not reported |
| not reported | DentaQuest | not reported | 821,212 (2017) | 23.5% calculated | not reported |
| not reported | DentaQuest USA Insurance Company | not reported | 1,433,797 (2024) | 34.6% calculated | not reported |
| Elevance | AmeriGroup | not reported | 395,495 (2017) | 11.3% calculated | not reported |
| Elevance | Amerigroup | not reported | 376,283 (2018) | 11.0% calculated | not reported |
| Elevance | Amerigroup | not reported | 531,686 (2023) | 10.4% calculated | not reported |
| Elevance | Wellpoint | not reported | 429,231 (2024) | 10.4% calculated | 25 sanctions, 1,210 appeals resolved |
| UnitedHealth | OptumRx | not reported | 1,275,105 (2024) | 30.8% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan | not reported | 429,505 (2024) | 10.4% calculated | 28 sanctions, 1,009 appeals resolved |
| UnitedHealth | UnitedHealthcare Community Plan | not reported | 433,202 (2018) | 12.6% calculated | not reported |
| not reported | Alexian Brothers Community Services | not reported | 280 (2016) | 100.0% calculated | not reported |
| not reported | Amerigroup | not reported | 455,806 (2016) | 11.8% calculated | not reported |
| not reported | DentaQuest USA Insurance Company | not reported | 889,454 (2016) | 23.1% calculated | not reported |
| not reported | Magellan Health Services | not reported | 1,403,823 (2016) | 36.5% calculated | not reported |
| not reported | UnitedHealthcare Community Plan | not reported | 486,019 (2016) | 12.6% calculated | not reported |
| not reported | Volunteer State Health Plan (BlueCare) | not reported | 541,335 (2016) | 14.1% calculated | not reported |
| not reported | Volunteer State Health Plan (TennCare Select) | not reported | 72,929 (2016) | 1.9% calculated | not reported |
CMS reported enrollment
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
Program of All-Inclusive Care for the Elderly (PACE)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Alexian Brothers Community Services | Alexian Brothers Community Services | Alexian Brothers Community Services | Hamilton County | CMS reported 270 (2024) | 100.0% | -14 (-4.9%) | 0.0 pts | 2022: 286; 2023: 284; 2024: 270 |
Program of All-Inclusive Care for the Elderly (Program of All-inclusive Care for the Elderly (PACE))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Alexian Brothers Community Services | Alexian Brothers Community Services | Alexian Brothers Community Services | Hamilton County | not reported | not reported | not reported | not reported | 2016: 280; 2017: 289; 2018: 281; 2019: 285; 2020: 273 |
| Alexian Brothers Community Services | Alexian Brothers Community Services | Alexian Brothers Community Services | Hamilton county | not reported | not reported | not reported | not reported | 2021: 271 |
TennCare II (Comprehensive MCO + MLTSS)
TennCare II (Comprehensive MCO + MLTSS) 9
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AmeriGroup | Amerigroup | Elevance | Statewide | not reported | not reported | not reported | not reported | 2017: 395,495 |
| Amerigroup | Amerigroup | Elevance | Statewide | not reported | not reported | not reported | not reported | 2016: 455,806; 2018: 376,283; 2019: 413,056; 2020: 429,010 |
| DentaQuest USA Insurance Company | DentaQuest USA Insurance Company | DentaQuest USA Insurance Company | Statewide | not reported | not reported | not reported | not reported | 2016: 889,454; 2018: 803,164; 2019: 845,034; 2020: 862,017 |
| DentaQuest | DentaQuest USA Insurance Company | DentaQuest USA Insurance Company | Statewide | not reported | not reported | not reported | not reported | 2017: 821,212 |
| Magellan Health Services | Magellan Health Services | Centene | Statewide | not reported | not reported | not reported | not reported | 2016: 1,403,823; 2017: 1,262,221; 2018: 1,241,741; 2019: 1,291,060 |
show all 9
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| OptumRx | OptumRx Holdings, LLC | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2020: 1,312,229 |
| UnitedHealthcare Community Plan | UnitedHealth Group | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2016: 486,019; 2017: 440,860; 2018: 433,202; 2019: 428,878; 2020: 432,404 |
| Volunteer State Health Plan (BlueCare) | Blue Cross Blue Shield Association | Blue Cross Blue Shield Association | Statewide | not reported | not reported | not reported | not reported | 2016: 541,335; 2017: 507,160; 2018: 510,990; 2019: 526,171; 2020: 539,110 |
| Volunteer State Health Plan (TennCare Select) | Blue Cross Blue Shield Association | Blue Cross Blue Shield Association | Statewide | not reported | not reported | not reported | not reported | 2016: 72,929; 2017: 65,751; 2018: 65,908; 2019: 69,297; 2020: 63,792 |
TennCare III (Comprehensive MCO + MLTSS)
TennCare III (Comprehensive MCO + MLTSS) 7
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Amerigroup | Amerigroup | Elevance | Statewide | not reported | not reported | not reported | not reported | 2021: 476,541; 2022: 507,736; 2023: 531,686 |
| DentaQuest USA Insurance Company | DentaQuest USA Insurance Company | DentaQuest USA Insurance Company | Statewide | CMS reported 1,433,797 (2024) | 34.6% | -331,215 (-18.8%) | +0.2 pts | 2021: 929,377; 2022: 1,010,326; 2023: 1,765,012; 2024: 1,433,797 |
| OptumRx | OptumRx Holdings, LLC | UnitedHealth | Statewide | CMS reported 1,275,105 (2024) | 30.8% | -319,794 (-20.1%) | -0.3 pts | 2021: 1,438,599; 2022: 1,530,952; 2023: 1,594,899; 2024: 1,275,105 |
| UnitedHealthcare Community Plan | UnitedHealth Group | UnitedHealth | Statewide | CMS reported 429,505 (2024) | 10.4% | -102,088 (-19.2%) | +0.0 pts | 2021: 477,016; 2022: 508,260; 2023: 531,593; 2024: 429,505 |
| Volunteer State Health Plan (BlueCare) | Blue Cross Blue Shield Association | Blue Cross Blue Shield Association | Statewide | CMS reported 541,901 (2024) | 13.1% | -112,704 (-17.2%) | +0.3 pts | 2021: 590,922; 2022: 628,301; 2023: 654,605; 2024: 541,901 |
show all 7
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Volunteer State Health Plan (TennCare Select) | Blue Cross Blue Shield Association | Blue Cross Blue Shield Association | Statewide | CMS reported 35,676 (2024) | 0.9% | -17,616 (-33.1%) | -0.2 pts | 2021: 51,732; 2022: 53,049; 2023: 53,292; 2024: 35,676 |
| Wellpoint | Elevance Health | Elevance | Statewide | CMS reported 429,231 (2024) | 10.4% | not reported | not reported | 2024: 429,231 |
Plan operations (CMS MCPAR)
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
Appeals, grievances, and enrollment share (2024)
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | TennCare | 352 | 163 | 46.3% calculated | 908 | 37.7% | 37.7% |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | TennCare | 92 | 26 | 28.3% calculated | 36 | 2.5% | 2.5% |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | TennCare | 508 | 98 | 19.3% calculated | 203 | 29.9% | 29.9% |
| Wellpoint Tennessee (WPT) | Elevance | TennCare | 610 | 250 | 41.0% calculated | 2,636 | 29.9% | 29.9% |
Sanctions (2024)
Sanctions (2024) 41
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-01-05 | Yes | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-01-05 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-05-03 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-05-03 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-08-02 | No | Yes, remediated |
show all 41
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-03-01 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-02-02 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-03-01 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-02-02 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-03-01 | No | Yes, remediated |
| BlueCare Tennessee (BCT) | Blue Cross Blue Shield Association | Reporting | 2024-07-05 | No | Yes, remediated |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | Reporting | 2024-12-06 | No | Yes, remediated |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | Reporting | 2024-12-06 | No | Yes, remediated |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | Reporting | 2024-03-01 | No | Yes, remediated |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | Reporting | 2024-03-01 | No | Yes, remediated |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | Reporting | 2024-01-05 | Yes | Yes, remediated |
| TennCare Select (TCS) | Blue Cross Blue Shield Association | Reporting | 2024-11-01 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-01-05 | Yes | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-02-02 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-02-02 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-01-05 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-02-02 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Timely access | 2024-08-02 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Timely access | 2024-01-05 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-02-02 | Yes | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Timely access | 2024-03-01 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Reporting | 2024-03-01 | No | Yes, remediated |
| UnitedHealthcare Community Plan (UHCCP) | UnitedHealth | Timely access | 2024-12-06 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-01-05 | Yes | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-10-04 | Yes | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-11-01 | Yes | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-08-02 | Yes | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-12-06 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Timely access | 2024-05-03 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Timely access | 2024-01-05 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-03-01 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-03-01 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-03-01 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-03-01 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-08-01 | No | Yes, remediated |
| Wellpoint Tennessee (WPT) | Elevance | Reporting | 2024-04-05 | No | Yes, remediated |
Award history
- TennCare Managed Care Organizations 31865-00603: upheld. The Division of TennCare issued RFP 31865-00603 for Managed Care Organizations on June 11, 2021. The November 8, 2021 notice of intent named Amerigroup Tennessee, BlueCare Tennessee, and United Healthcare Community Plan. Rhythm Health Tennessee, Inc. protested on November 15, 2021. The Chief Procurement Officer denied the protest on January 13, 2022. On July 15, 2022 the State Protest Committee upheld that decision and denied the protest.
Retrieved 2026-11-03. Sources and scores
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
Plan financials
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.