Skip Navigation

Data & Analytics

Data to decisions, fast.

AdobeStock_148435018-web

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

50+ Years

Medicaid-Focused data expertise

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

Additional solutions making healthcare more efficient and effective.

Medicaid Enterprise Systems

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

Learn More

Human Services & Public Health Solutions

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

Learn More

Systems Integration & Interoperability

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

Learn More

Provider Solutions

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

Learn More

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.

Medicaid RD Holistic Insights Driving Improved Outcomes

​​​Integrating Medicaid & Referral Data: Holistic Insights Driving Improved Outcomes

Learn More
How AI & Automation are Shaping the Next Era of Health & Human Services

How AI & Automation are Shaping the Next Era of Health & Human Services

Learn More
How HHS Agencies Can Unlock Data and Tap Into AI

How HHS Agencies Can Unlock Data and Tap Into AI

Learn More
Explore All Insights

How can we support you?

Start the conversation today.

Contact Us