To create a data-fueled organization that improves care coordination and program performance, state agencies need to implement comprehensive analytics solutions that allow for evidence-based decision-making. Gainwell can help you do this with a variety of Advanced Analytics solutions that provide comprehensive diagnostic capabilities to track, trend, benchmark and forecast with predictive modeling options. Our solutions help states implement policy and program changes to improve outcomes.

Uncover Business Value

Create a data-fueled organization

Business, program and care optimization

Lower costs, improve outcomes

How We Can Help

Gainwell can concretely improve your program based on a solid understanding of your data, and we have the technology, people and infrastructure in place to help you implement changes quickly. We can tell you what has happened in your program, what is currently happening and what will happen. Then we can use predictive modeling to model the outcome you want and make it a reality.

Our data lake is extremely deep, which gives us a unique perspective into the market. Our coast-to-coast view of the healthcare system is made possible by the large number of agencies across the country that we are proud to serve. The insights we have, combined with our proven architecture, allow us to deliver the robust analytics capabilities you need.

Analytics can help you change aspects of your program – and even change lives. Imagine identifying members, at the individual scale, whose medical history or behaviors make them a high risk for diabetes. Imagine then being able to create customized outreach programs to those members and their providers, encouraging positive action and improved care, and then tracking that member to follow their improvement over time. Do this at population scale and you’re raising your entire population’s health and lowering your costs at the same time.

Track performance of your MCOs, see which providers are most efficient and discover why, mitigate the opioid crisis … the only limit to what you can do is what you can imagine.

Enterprise Data Warehouse

Gather your data, easily access it and put it to work for you with Gainwell’s Enterprise Data Warehouse (EDW) solution. Our centralized cloud-based platform gives you the power of master data management, business intelligence and transformational analytics offerings that range from basic reporting to advanced predictive modeling.

Advanced Analytics

Claims and Encounters Analytics

Gain the insights you need to better understand Medicaid costs and program disbursements. Gainwell’s Claims and Encounters Analytics solution includes comprehensive offerings that help you optimize program goals and outcomes: MCO Analytics, HEDIS and Quality Measurements, Clinical Risk Profiles, Emergency Department (ED) Utilization, Third-Party Liability and Value-based Payments.

Pharmacy Analytics

Create a complete and integrated view of your agency’s pharmacy services. Our Pharmacy Analytics solution helps you take a closer look at your services, ranging from the evaluation of drug access and prescribing patterns to risk profiles and medication adherence and compliance.

Provider Analytics

Empower your agency to make data-driven decisions with Gainwell’s Provider Analytics solution. You’ll gain insights you need for program optimization, ranging from provider empowerment, network evaluation, provider eligibility and enrollment, and more.

Whole Person Analytics

Gain an accurate and historical point-in-time 360-degree view of your recipients. Our Whole Person Analytics solution provides seamless data integration connecting siloed interagency programs, predictive analytics, and a whole-person view to evaluate your program’s effectiveness and optimize business process efficiency.

We can help. But the next move is yours!

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Additional Insights

The Rise of Advanced Analytics in Medicaid
Using Episodes of Care Reviews To Follow the Patient Journey
Viewing the Opioid Crisis Through a Post-Pandemic Lens