Customer Stories
Modernizing Medicaid Data at Scale
Problem
Policymakers, analysts, and state partners depend on Transformed Medicaid Statistical Information System (T-MSIS) for timely, accurate Medicaid data to inform policy, improve patient outcomes, and combat fraud, waste, and abuse. However, legacy processes and architecture caused delays and limited responsiveness. Engineers were burdened by time-intensive validations and deployments, while infrastructure inefficiencies strained operations. Centers for Medicare and Medicaid Services (CMS) needed a more automated, scalable foundation to meet the evolving needs of 85 million beneficiaries who rely on Medicaid for care.
Solution
To modernize T-MSIS, eSimplicity automated complex data validations, reengineered deployment pipelines, and optimized cloud operations. We built a scalable rule-checking framework, applied infrastructure-as-code and CI/CD automation, and implemented cost-saving FinOps practices. These improvements accelerated delivery, reduced manual effort, and gave CMS real-time visibility into system health and data quality across the entire Medicaid enterprise.
Outcomes
eSimplicity’s modernization of T-MSIS turned a manual, high-risk system into a scalable, resilient platform. With 99.76% uptime and streamlined operations, CMS now processes over 12 petabytes of Medicaid data each year, responds more quickly to policy needs, prevents waste, and focuses on improving care for more than 85 million beneficiaries.
MEASURABLE IMPACT
We produce results for our customers
State Medicaid partners, policy analysts, and oversight bodies rely on timely, high-quality data from T-MSIS to support critical decisions and detect fraud, waste, and abuse across all 50 States, Territories, and the District of Columbia. However, the system’s reliance on manual validation, deployment, and operational processes made it difficult to deliver data at the speed and scale required. These inefficiencies created friction for both end users and engineering teams, slowing cycle times, increasing operational risk, and limiting CMS’s ability to respond quickly to policy needs.
T-MSIS lacked the automation, observability, and flexibility necessary to support continuous, high-volume submissions, especially during peak reporting periods. Manual checks on complex data quality rules consumed significant engineering time, and deployment processes required substantial coordination to avoid service disruption. Meanwhile, unoptimized cloud infrastructure introduced excess overhead both in terms of cost and maintainability.
Without intervention, these challenges would have continued to erode CMS’s ability to deliver timely, reliable, and policy-aligned data products. To ensure the platform could meet growing expectations and maintain near-continuous availability, CMS needed a more resilient, automated, and cost-efficient foundation that could scale with the evolving needs of Medicaid.
Process & Solution
To address delays, complexity, and cost in T-MSIS operations, eSimplicity modernized the platform with a focus on automation, performance, and ease of maintenance. We replaced slow, manual data checks with a fully automated validation pipeline capable of handling millions of records across hundreds of data domains. This rule-checking framework—integrated directly into our CI/CD workflows—now flags data quality issues earlier and faster, improving CMS’s ability to monitor and act on State submissions in near real time.
We rebuilt the delivery infrastructure using Terraform for infrastructure-as-code and deployed services as Docker containers in AWS Fargate. Jenkins, GitHub Actions, and AWS CodePipeline were used to automate deployments, with built-in gates for code quality (SonarQube), container scanning (Dockle), and pre-deployment policy enforcement (TFSec). These controls standardize releases across environments and reduce the chance of human error.
To reduce cloud storage waste and costs, we applied FinOps principles using AWS-native tools. We automated the cleanup of unused or outdated data in S3, applied right-sizing policies for compute resources, and aligned storage lifecycles to usage patterns—automatically moving infrequently accessed data to lower-cost storage classes.
All improvements are monitored through the T-MSIS Operations Dashboard (OD), which consolidates logs, alerts, and deployment history into a central view for engineers and CMS stakeholders. This observability enables quick troubleshooting, full traceability of platform changes, and more informed governance.
Outcomes
eSimplicity’s modernization of T-MSIS has transformed it into a resilient, future-ready platform that CMS can depend on to power Medicaid oversight. By eliminating manual bottlenecks and automating core processes, we unlocked faster data processing, improved system stability, and reduced operational burden, enabling teams to focus on insight-driven improvements instead of upkeep.
Today, T-MSIS sustains 99.76% uptime while processing more than 12 petabytes of Medicaid and CHIP data annually across all 50 States, four Territories, and the District of Columbia. These improvements have strengthened CMS’s ability to monitor data quality, detect issues earlier, and make timely, evidence-based decisions that affect care for more than 85 million beneficiaries.
T-MSIS is now a scalable, observable platform with the automation and governance needed to support CMS’s evolving Medicaid mission. These outcomes mark a critical step forward in building a modern data foundation for public health programs.