Our History
Drawing from decades of experience on healthcare’s leading edge, we’re committed to driving meaningful innovation.
A strong legacy of client service and empowering improved health outcomes.
Formed in 2020 through a divestiture from DXC, then expanded further through the acquisition of HMS, Inc. in 2021 and backed by Veritas Capital, Gainwell Technologies has a history in client service that dates back to the 1960s. Today, Gainwell serves clients across all 50 states, US territories, and the human services and public health ecosystem. Our focus is at the intersection of technology and healthcare – providing unmatched value through our suite of innovative products and solutions created to solve our clients’ most complex challenges.
Gainwell's Key Milestones
1970s
First underwritten Medicaid program through NHIC Corporation in the nation
1990s
First online, real-time Medicaid processing
for multiple claim types and first learning technology to identify Medicaid fraud
Cost Containment & Care Quality Solutions
First DSS to use relational database
management system technologies
2010s
First Medicaid online provider enrollment
Provider Management Solutions
First Medicaid client achieves 99.95%
electronic claims submission
First Healthcare Platform certified under the Medicaid Enterprise Certification Toolkit (MECT)
Dashboard reporting released
with our Healthcare Platform
Rapid Provisioning Infrastructure-as-a-Service
lets CMS provision virtual servers through
a self-service web-based catalog
New module provides Medicare Part A and Part B claims submitters with real-time response for HIPAA 5010 transaction set submissions
How We Serve Medicaid Agencies
Modular payer platform for the future of Medicaid
Applies robotics to Medicaid operations
Molina Medicaid Solutions business acquired, bringing further software and SaaS capabilities
First Provider Service and Program
Integrity Service modules go live
How We Serve Provider Management Organizations
1960s
First Medicaid and Medicare claims processing systems
How We Serve Medicaid Agencies
1980s
First paperless processing for claims resolution and adjustments
2000s
First web-based claims transactions in our healthcare platform
First HIPAA-compliant healthcare platform
Our Solutions
First CMS Enterprise Data Center to support Medicare shared system applications
Medicaid Management Solutions
Maestro Tort and Casualty Case
Management Solution
Coordination of pharmacy benefit claims
Our Pharmacy Benefit Services
Provider credit balance
Achieved CMMI Level 5 appraisal rating for software processes in Part A and Part B Shared Systems contracts
First automated drug rebate processing
How We Serve Pharmacy Benefit Management Organizations
2020s
Gainwell launched
Gainwell acquires HMS, a leader in coordination of benefits and payment information
First CMS certification using
Outcome-based Certification
Gainwell awarded Ohio Single Pharmacy
Benefit Manager contract
First CMS certification using
Outcome-based Certification
Awarded California PHM contract
Implemented first fully modular system
to achieve CMS certification
Our Solutions
Hear from the Gainwell team
“I love that I am making a positive impact on my local community through my work at Gainwell. By helping medical providers get the answers they need, they can deliver better care to their patients.”
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