TennCare is the State of Tennessee’s health care insurance program, esigned to expand health insurance to the uninsured through the state’s Medicaid program by utilizing managed care. Launched in 1994 by then-Governor Ned McWherter, it was hoped the program would solve of the state’s biggest problems: access to affordable health care insurance and a Medicaid budget that was fast consuming the largest portion of the state’s budget. It was one of the nation’s first Medicaid “waivers,” with the overarching requirement that the program be “budget neutral,” or require no greater federal funding than the previous Medicaid program. The state sought to accomplish this by replacing the Medicaid fee-for-service payment method with a managed care model. At the time, managed care was fairly new to Tennessee health care providers.