Recently, the TMA’s AMA delegation spent time in Chicago at the organization’s annual meeting. A topic of discussion that generated concern from physicians is that the amount of shared savings and bonus payments received by physicians and medical practices seems to be diminishing. Physicians rely heavily on these payments because of falling payment rate from government and commercial payers. The impact is especially being felt by private group practices in rural communities.

In 2024, TMA expressed its concern about the TennCare MCOs shared savings programs “moving the goalposts” with regard to measures, like vaccine rates, that physicians cannot control. The TennCare Bureau’s response was that part of the payment to physicians per covered life is intended for outreach and patient education. But measures like that one can mean the difference between a physician making or missing the ability to receive quality bonuses.

If you or your medical practice have experienced reduced shared savings or bonus payments from programs like TennCare or Medicare Advantage or from commercial health insurance companies with which you contract, TMA would like to know about it. Please send your concerns to Legal@tnmed.org with a brief description of the program or insurance company and the impact on your practice.