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Our Solutions

Improving the lives of individuals, providers, and those in health and human services through modern, innovative technology solutions.

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Powerful solutions from a proven innovator.

Across every critical touchpoint in health and human services, we provide innovative technologies that positively impact outcomes for all stakeholders. Our solutions are flexible and scalable, customized to suit your organization’s most complex healthcare challenges.

As a leading provider of digital and cloud-enabled solutions and services in the U.S., we support programs in all 50 states that impact over 60 million Medicaid members. No matter your pain point, we deliver reliable and transformational outcomes.

Contact us to start the conversation today.

50+ Years

Delivering Proven Healthcare Solutions

13,000+

Dedicated Employees to Our Shared Mission

72 Million

Medicaid Enrollees Supported

Improve healthcare costs, patient outcomes, and the provider experience.

Across every person, community, and entity we serve, we remain focused on enhancing patient satisfaction, decreasing costs, and improving health outcomes to positively impact the most lives.

Our comprehensive suite of strategic solutions and services are designed to meet you where you are in your modernization journey.

Medicaid Enterprise

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

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Data & Analytics

Transforming your most complex data into actionable insights with Gainwell Genius™.

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Provider Solutions

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

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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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Pharmacy Solutions

Optimizing medication management to lower the total cost of care while improving patient outcomes with Gainwell Rx™.

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Coordination of Benefits

Providing comprehensive and innovative third-party liability solutions.

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Payment Integrity

Helping plans avoid and recover improper payments while detecting and preventing fraud.

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Care Quality

Enabling quality care and affordability with strategies that balance empathy and efficiency.

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Population Health

Maximizing the power of data, analytics, and technology to transform population health management with Gainwell Whole Health™.

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Verification Solutions

HMS Verification Solutions ensure states verify eligibility, residency, and engagement requirements quickly, accurately, and transparently—protecting coverage for members and their dependents who qualify and stopping waste before it starts.

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Actionable insights that
empower healthcare progress.

We’re passionate about delivering ideas that can help shape the future of
healthcare, using education and transparency to improve health outcomes for all.

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Early FHIR Adoption:
6 Lessons Learned

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How HHS Agencies Can Unlock Data and Tap Into AI

How HHS Agencies Can Unlock Data and Tap Into AI

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Transforming Provider Experiences: Navigating the Journey with Confidence

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Explore All Insights

How can we support you?

Improve healthcare costs, outcomes, and experiences with our complete solution suite trusted in all 50 states.

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Is Your State Ready for What CMS Expects Next With AI?

Federal mandates are accelerating. Interoperability deadlines are here. AI is no longer optional — it's an operational imperative. This 3-minute diagnostic reveals where your Medicaid program stands across the five dimensions that matter most.

15 questions · 5 categories · Takes ~3 minutes