Since its inception, Medicaid has faced challenges in engaging and retaining providers. Many of those challenges stem from the program’s inherent complexity and lower reimbursement rates — systemic issues that every provider must navigate. Implementing even simple policy changes can be cumbersome because of the time-consuming and expensive hard-coding required…

H.R. 1 is bringing sweeping change to Medicaid across eligibility, financing, and service delivery. Medicaid agencies across the country are acting now to begin implementing the new program integrity measures. One provision in H.R. 1 is particularly concerning for states: community engagement verification. This is the requirement to verify that…

State Medicaid agencies increasingly recognize that provider system modernization is more than a technology upgrade. It’s also a strategic investment in network adequacy and member access to care. When these systems make it easy to join and participate in a Medicaid network, providers benefit from streamlined processes — and Medicaid…

Explore the transformative power of AI in healthcare with Gainwell Technologies. This webinar dives into real-world applications of AI that are helping organizations overcome resource constraints, streamline Medicaid and healthcare operations, and deliver better outcomes. Learn from industry leaders as they share success stories, practical strategies, and lessons learned in…