Several Tennessee-based companies are confident enough about the future of Medicare Advantage programs to launch expansions. Most notable in the group is BlueCross BlueShield of Tennessee, the state’s biggest carrier, which rolls out a MA PPO to more counties in 2010 with plans to have complete coverage in the state come 2011.A smaller reimbursement increase has spurred changes to this year’s Medicare Advantage market. For the coming year, fewer companies are offering MA plans, at least in the four counties that anchor the state’s major metropolitan areas. Aetna, BlueCross, CIGNA, Humana and UnitedHealthcare all submitted bids on the second request for proposals issued last spring to cover the approximately 17,000 members in the Memphis City Schools plans. CIGNA won the contract and its victory over BlueCross may also represent a shift among healthcare purchasers to consider narrower provider networks as healthcare costs accelerate. Tennessee’s Benefits Administration, which manages health plans for the state’s employees, is looking for a pharmacy benefits manager in an effort to increase efficiency and save money. The state also is considering having two, rather than three third-party administrators for health benefits.