Systems Integration & Interoperability


To achieve modularity, CMS recommends state agencies use a systems integration (SI) platform at the center of their Medicaid Enterprise Systems. This platform will connect the modules and facilitate all data exchanges happening within the ecosystem. With a proven SI platform in place, states can efficiently shift focus to meeting CMS’ interoperability rules and requirements.

As the market leader for Medicaid management systems, Gainwell can help you define comprehensive modernization approaches and deliver ready-to-use frameworks and accelerators to drive modular systems integration and interoperability solutions.

Transform Your Medicaid Enterprise

Achieve complete compliance

Modernize your systems, simply

Future-proof your MMIS

How We Can Help

Gainwell’s cloud-based, modular software as a service (SaaS) takes the heavy lifting out of updating your legacy Medicaid Management Information System (MMIS) and integrating new Medicaid Enterprise System (MES) modules. With our SI Platform, you can leverage our best practices, economies of scale and expertise to enhance your performance and future innovation—while maintaining critical governance and security policies.

Ensuring compliance with the CMS Interoperability and Patient Access final rule is crucial for Medicaid agencies. As an agile, cloud-based platform, our Fast Healthcare Interoperability Resources (FHIR) solution empowers patients to easily access their medical data. It enhances critical data exchanges between platforms and devices, allowing for more effective exchange, access and use of data.

At the heart of our systems integration platform are real-time and near-real-time data exchanges, managed file transfer (MFT), single sign-on (SSO) and identity relationship management. Built-in enterprise architecture capability, operational data store (ODS) and master data management (MDM) mean you’re ready for today’s challenges, and tomorrow’s.

We further support your digital transformation with GainwellGo™. The solution provides a mobile gateway for your members, enabling easier access to key information. As a paperless, digital ID solution, it also delivers cost savings to your enterprise.

Systems Integration

Transform your legacy MMIS and begin to integrate new MES modules with our modern and interoperable standards-based platform. Gainwell’s cloud-based, software as a service (SaaS) Systems Integration solution gives our clients an agile, easy-to-scale solution that promotes strong program governance and standardization of processes, allowing state agencies to fulfill their MES strategies.


Fast Healthcare Interoperability Resources

Satisfy healthcare interoperability requirements, and actually go beyond CMS rules, with our Fast Healthcare Interoperability Resources (FHIR) solution. Patients can lead healthier lives when they can easily access their own healthcare data – and our solution make that possible.

Electronic Data Interchange

Conform to new federal interoperability standards by transitioning to Gainwell’s EDI Interoperability system. Our system supports HIPAA-standard requirements and will deliver greater adaptability and return-on-investment. It streamlines updates in a changing environment by supporting multiple standards such as the current 5010 and future X12 versions—all within the same platform with a single instance.


Gainwell Technologies’ GainwellGo, a mobile digital platform, empowers Medicaid members by providing them with easy access to their health and clinical history, conveniently at their fingertips. This innovative platform presents information in a clear and simple manner, ensuring users can effortlessly navigate and understand their medical data.

We can help. But the next move is yours!

Please fill out the information below to start a no-pressure chat with one of our knowledgeable solutions experts.

Additional Insights

FHIR: Two New Rules in One
Innovations in Patient Access
Interoperability 2.0: Journey Toward Patient Empowerment
Does Your Organization Have the Infrastructure Needed to Deliver on the Interoperability Promise?
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