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Data & Analytics

Data to decisions, fast.

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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

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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.

Connected Insights for a Stronger Medicaid Future

Connected Insights for a Stronger Medicaid Future

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Transforming Rural Mental Health: Precision Analytics That Make Resources and Actions Count

Transforming Rural Mental Health: Precision Analytics That Make Resources and Actions Count

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Gainwell Genius Insights Overview

Gainwell Genius Insights Overview

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RHTP Awards Are Here. Do You Have a Data Plan to Match?

RHTP Awards Are Here. Do You Have a Data Plan to Match?

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Unlocking Value in Medicaid: The Business Case for Whole Health

Unlocking Value in Medicaid: The Business Case for Whole Health

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The Role of Analytics in the Future of HEDIS: A Medicaid Perspective

The Role of Analytics in the Future of HEDIS: A Medicaid Perspective

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Real-Time Immunization Data, Real-World Impact

Real-Time Immunization Data, Real-World Impact

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From Insight to Impact: Preparing States for the Rural Health Transformation Ahead

From Insight to Impact: Preparing States for the Rural Health Transformation Ahead

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Better Analytics for Better Mental Healthcare

Better Analytics for Better Mental Healthcare

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Gabby AI Case Study thumbnail

GainwellAI – Gabby Use Case

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Gainwell Go

Gainwell Go

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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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Explore All Insights

How can we support you?

Turn insight into action to advance your Medicaid program with comprehensive data management and analytics solutions.

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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