Name: Data & Analytics
Brand: Gainwell Genius™

Analytics designed for Medicaid’s unique challenges.

State Medicaid agencies need specialized data solutions created for regulatory and complex data requirements. Gainwell Genius™ delivers comprehensive data and analytics capabilities for Medicaid programs, providing user-friendly insights and ensuring compliance with federal requirements.

Gainwell’s platform converts your integrated data into useful information for any user. This enables more confident, strategic decisions that drive program impact and improved member outcomes.

Contact us to start the conversation today.

Our Impact

52 State Medicaid Programs
Trusted data analytics partner

Transform

Rural Health in Your State

Gainwell Genius Insights

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Gainwell Genius™ Data Solutions

Build a secure and efficient data infrastructure that helps users save costs and make smarter decisions. Our enterprise data warehouse provides reliable, single-source access to your data through:

Master Data Management – Unified member and provider records
Data Governance – Safe and compliant data management
Real-Time Integration – FHIR and HL7 interoperability standards
Secure Data Exchange – Simplified file transfers and system connectivity

Gainwell Genius™ Insights

Turn data into actionable insights with advanced analytics designed for Medicaid:

Analytics Workbench – Self-service reporting tools and data science toolkit
AI-Powered Modeling – Predictive analytics and machine learning applications
Enterprise Reporting – Streamlined T-MSIS, HEDIS, and compliance reporting
Dynamic Visualizations with Real-Time Data– Instant visibility into program performance
Fraud Detection – Machine-learning powered waste and abuse identification

Provider Analytics

Empower data-driven decisions in real-time with provider focused insights:

Network evaluation and optimization
Provider performance and utilization
Eligibility and enrollment
Prescribing patterns

Pharmacy Analytics

Improve decision making and manage drug spend across pharmacy and medical billing through:

Operational and transaction processing
Provider prescribing and member adherence monitoring
Clinical risk profiles and drug utilization review
Cost containment and financial optimization
Compliance and regulatory reporting

Population Health Management

Use AI, automation, and predictive analytics to make smarter decisions across your programs with:

Population-level health analysis
Risk stratification and member segmentation
Preventative care gap identification
Social determinants of health insights
Program effectiveness measurement

Rural Health Transformation

Showcase early wins when monitoring and evaluating your transformation initiatives with:

Ready-to-go CMS and metrics reporting
Comprehensive, AI-enabled analytics
Whole person insights at point of care
Cross-program insights and reporting
Responsive, agile technical support services

Additional solutions making healthcare more efficient and effective.

Medicaid Enterprise Systems

Modernizing claims, encounters, and financials with intelligent automation and interoperability through Gainwell Enterprise™.

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Human Services & Public Health Solutions

Improving the well-being of communities through person-centered, data-driven approaches with Gainwell Assist™.

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Systems Integration & Interoperability

Accelerating modernization, connectivity, and operational efficiency with Gainwell Connect™.

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Provider Solutions

Delivering seamless experiences for providers to enhance care and optimise efficiencies with Gainwell Provider+™.

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Actionable insights that
empower healthcare progress.

We don’t just provide analytics—we deliver Medicaid intelligence. Our solutions reduce manual effort, accelerate compliance, and demonstrate program impact that can scale for future needs.