TennCare outlines waiver savings, long-term care investments and workforce plans in FY25–26 budget pitch

TennCare Director Steven Smith on behalf of the agency presented the department’s proposed fiscal priorities and budget drivers to the Senate Commerce & Labor Committee, saying the program seeks to use recent shared savings under the TennCare 3 waiver to expand long-term care supports and invest in workforce retention.

The presentation summarized why the budget matters: TennCare provides Medicaid coverage in Tennessee and has been using a 10‑year waiver (TennCare 3) that shares savings with the state when the program controls cost growth. Smith said shared‑savings dollars produced by TennCare 3 have funded prior expansions and that the agency is proposing further investments for home- and community‑based services (HCBS), nursing facilities and workforce incentives.

TennCare framed the spending plan as fiscally responsible reinvestment. Smith told senators the waiver has produced “nearly $1,000,000,000” of shared savings in the first three years of the agreement and that the agency used $100,000,000 of year‑three savings for…