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Pharmacy Solutions

Optimizing Medicaid drug spending while improving patient outcomes.

A smiling pharmacist in a bright pharmacy smiles and holds out a card reader to a brunette customer picking up her prescription.

Maximize Medicaid pharmacy programs.

Gainwell Rx™ Pharmacy Solutions help Medicaid agencies develop and implement strategies that optimize drug spending and improve patient care. Our intuitive interface streamlines processes, enabling faster updates and seamless access to critical information to enhance efficiency and service quality.

With modular solutions that align to your needs, you can control costs and achieve measurable outcomes. Whether you choose our full suite or a single solution, our team ensures you maximize value while meeting program goals.

Contact us to start the conversation today.

25+ Million

Pharmacy Program Members Served

295,000

Pharmacy Program Providers Supported

379+ Million

Pharmacy Claims Processed

Pharmacy Point-of-Sale

Accurately process prior authorizations, claims, and encounters with a modern, user-friendly solution that provides data and analytics to states, providers, members, and managed care entities.

Rebate Administration

Take full advantage of Medicaid drug rebates — including pharmacy and managed care programs, federal and state supplemental programs, and value-based purchasing opportunities — with our cloud-based, interoperable solution.

Preferred Drug List Management

Gainwell designs Preferred Drug Lists (PDL) to deliver financial and clinical value to the client and their members. We focus on lowering overall pharmacy spend and maximizing rebates while promoting safety and improved patient outcomes.

To learn more about how we can administer your PDL and supplemental rebate programs or to access state-specific resources, visit our Preferred Drug List Management portal.

Pharmacy Analytics

Our insights provide demonstrated value by facilitating appropriate and cost-effective medication utilization with better member outcomes around:

  •  Utilization and effectiveness of UM and PDL strategies
  •  Operational and financial impacts and drivers
  •  Member access and provider quality
  •  Care coordination
  •  Population health
  •  FWA and other oversight needs

Customer Experience

Personalized, seamless, and omnichannel interactions with contact center staff equipped with state-of-the-art technology and training.

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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Systems Integration & Interoperability

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

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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.

<p>Hear From Our Pharmacy Leaders on the Gainwell Approach</p>

Hear From Our Pharmacy Leaders on the Gainwell Approach

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Navigating the Future of Digital Therapeutics

Navigating the Future of Digital Therapeutics: Considerations for Pharmacy Benefit Managers

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<p>Pharmacy Solutions Introduction</p>

Pharmacy Solutions Introduction

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Explore All Insights

How can we support you?

Start the conversation today.

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