Tennessee health plans continued to show declining enrollment as the "jobless recovery" began in early 2010, and health plans are anticipating a renewal season that will see increasing numbers of employers moving to higher deductible plans and account-based plans. Meanwhile, Tennessee's dominant insurer, BlueCross BlueShield, has begun the process of contracting with the state's emerging "medical home" practices, all of whom are just beginning the transformation to the patient-centered care management model. E-prescribing is growing in Tennessee, as it is across the country, and more plans are tying incentives to wellness programs to encourage healthy behaviors and health assessments.