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Systems Integration & Interoperability

Break silos. Unlock insights. Empower smarter decisions

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Build the foundation for a connected Medicaid ecosystem.

Today’s Medicaid Enterprise demands more than technical upgrades, it needs a connected ecosystem that moves as fast as your mission. Gainwell Connect solutions bring modularity, automation, and realtime intelligence together so agencies can modernize confidently while improving outcomes for members, providers, and partners.

Our cloud-based, SaaS-driven SI platform simplifies modernization by integrating MMIS and MES modules through secure, real-time data exchange. It gives you a unified operating layer that supports CMS57 compliance, patient access, FHIR standards, and future federal requirements — all while reducing administrative lift and technical debt.

Extending Interoperability

White Paper: Prior Authorization

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Gainwell Connect™ Systems Integration

Gainwell’s cloud-based, SaaS SI solution is an interoperable and scalable platform that promotes strong program governance and standardization of processes, allowing you to transform your legacy MMIS and fulfill your MES strategies.

Interoperability & Patient Access

Meet healthcare interoperability requirements, grant patients easier access to their own healthcare data, and accelerate beyond CMS rules with Gainwell’s Interoperability and Patient Access (IPA) solution.

Electronic Data Interchange

As federal standards have evolved, our Electronic Data Interchange (EDI) Interoperability system has kept up, supporting HIPAA standard requirements and delivering greater adaptability and ROI. Within a single platform instance, you can streamline updates across multiple standards, such as 5010 and future X12 versions.

Gainwell Go™ Mobile Digital Experiences

We believe that people are better prepared to lead healthier lives when they’re equipped with their own health information. Our digital platform brings that idea to life by empowering Medicaid members with unfettered access to their health records and clinical history, ensuring users can effortlessly navigate and understand their medical data.

Additional solutions making healthcare more efficient and effective.

Medicaid Enterprise

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

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Data & Analytics

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

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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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Provider Solutions

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

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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.

Interoperability in 2026: A Roadmap for State Agencies

Interoperability in 2026: A Roadmap for State Agencies 

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Extending Interoperability to the Prior Authorization Process: What States Need to Know About CMS-0057-F

Extending Interoperability to the Prior Authorization Process: What States Need to Know About CMS-0057-F

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Enabling Digital Access to Medicaid Data: Benefits to Agencies and Members

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