TennCare, Tennessee’s state Medicaid program, has been honored as a 2025 AWS Champions Award winner for its successful modernization of the Tennessee Eligibility Determination System (TEDS) using AWS services. This initiative represents a monumental shift from legacy, on-premises infrastructure to a scalable, cloud-native platform that now powers eligibility determinations, appeals, long-term care support, and broader Medicaid enterprise services for millions of Tennesseans.

By moving to the AWS Cloud, TennCare dramatically improved system performance, reduced operational complexity, and achieved significant cost savings — all while maintaining the integrity and continuity of critical healthcare services.

Project Overview
At the heart of the modernization was the migration of TennCare Connect, long-term care eligibility, medical appeals, and several other enterprise systems to AWS. These services are essential to Tennessee’s healthcare infrastructure, supporting eligibility processing, enrollment, appeals resolution, and service delivery for the state’s Medicaid population.

The legacy on-premises infrastructure posed a range of challenges, including slow hardware provisioning, limited scalability, expensive disaster recovery and difficulty maintaining modern security standards. By transitioning to AWS, TennCare embraced a flexible, scalable, and high-performing cloud environment that supports more than 1,500 workers and enables them to process 1.6 million transactions per day, all while consistently meeting service-level agreements (SLAs).

Challenges Addressed: From Hardware Limits to Modern Agility
Prior to modernization, TennCare’s systems were housed in aging, on-premises data centers burdened by:

• Long and costly hardware procurement cycles 
• Inflexible compute capacity and resource contention 
• High capital and maintenance costs 
• Complex and expensive disaster recovery strategies 
• Security and compliance overhead managed entirely in-house 
• Inability to quickly adapt to new technology advancements 

These limitations not only hindered performance and innovation but also put operational resilience at risk as demand for Medicaid services grew across Tennessee.

Results: High-Performance, Secure, and Cost-Efficient Operations
The TEDS modernization delivered measurable outcomes and lasting impact:

• $12 million in annual cost savings, driven by reduced infrastructure, maintenance, and staffing overhead 
• 100% data accuracy in migrating 7 TB of production data and 40 million documents, with zero business disruption 
• Improved operational efficiency: batch processing time reduced by 20%, and online transaction times improved by 15% 
• Seamless continuity of services to end users, including eligibility workers, case managers, and applicants, despite the extensive migration and transformation efforts 

These results demonstrate the technical rigor and planning excellence that characterized the TennCare modernization project — ensuring Tennessee residents continued to receive timely and accurate Medicaid services throughout the transformation.

A New Era for Medicaid Service Delivery in Tennessee
By modernizing its Medicaid eligibility systems on AWS, TennCare has positioned itself at the forefront of digital government innovation. The project not only improved performance and resilience, but also demonstrated a scalable, secure model that can support complex health programs for years to come.