TennCare is the state of Tennessee's Medicaid program. In operation since 1994, the program provides health services for nearly 1.2 million adults and children and is the only Medicaid program in the nation to enroll all of its members in managed care. The state began integrating behavioral health into its managed care contracts in 2007 and completed the process in 2009. All physical and behavioral health services, including addiction and substance abuse services, are covered by three MCOs; supportive housing and supported employment services are also covered for patients with SMI. Continuing its efforts to implement a fully integrated service delivery model and to ensure that TennCare members receive all their health care services in a coordinated and cost-effective manner, Tennessee most recently integrated long-term care services into its MCO contracts through its CHOICES program. Tennessee also requires MCOs to be NCQA-certified and uses a health home model in which all enrollees are matched with a PCP who provides patient-centered care. Appendix Table A.3 summarizes the key features of the program.