AMMS Helps Tennessee Drive D-SNP Enrollment

Tennessee needed support to strengthen its integrated care model for residents dually eligible for Medicare and Medicaid. Too often, this population faces fragmented care and complex benefit coordination.

The state turned to Altarum Medicare-Medicaid Services for States (AMMS) to help it meet evolving Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) regulations and better serve its residents.

Challenge: Obstacles to Integration

Despite existing D-SNP structures, Tennessee faced capacity issues and restrictive eligibility policies that kept enrollment low. For example, restrictive eligibility policies prohibited community-dwelling members who were not receiving long-term services and supports (LTSS) from enrolling in a Fully Integrated D-SNP (FIDE SNP).

Solution: AMMS Integration Strategy

AMMS worked with Tennessee to design and implement a comprehensive strategy to support integration, growth, and quality improvement:

• Developed a workplan to expand enrollment and align; quality programs across Medicare and Medicaid. For example, AMMS helped the state remove the restriction on community-dwelling, non-LTSS members;
• Provided on-the-ground technical assistance to refine D-SNP operations and ensure compliance;
• Built state staff capacity through tailored training and surge staffing support; and
• Convened quality and data experts to support integration across agencies, which would improve care coordination and reduce avoidable utilization.