Gainwell Hosts Roundtable on Medicaid Provider Network Challenges

Event summary

  • Gainwell convened a virtual roundtable on January 30, 2026, to address Medicaid provider network adequacy challenges.
  • The discussion focused on structural barriers limiting provider participation, particularly in rural and behavioral health settings.
  • Key participants included Cindy Beane (former West Virginia Medicaid commissioner) and Lisa Zappia (CEO of Prestera Health Services).
  • Gainwell emphasized incremental improvements to provider engagement without requiring full-scale system modernization.

The big picture

Medicaid programs are facing increasing pressure to maintain network adequacy, particularly in underserved areas. Gainwell's roundtable highlights the growing need for practical solutions that can improve provider participation without requiring extensive system overhauls. This aligns with broader industry trends toward incremental healthcare IT modernization and targeted access improvements.

What we're watching

Regulatory Alignment
How states will balance immediate provider engagement improvements with long-term modernization goals.
Rural Market Focus
The pace at which targeted solutions for rural and behavioral health provider networks will be implemented.
Data Integration
Whether breaking down data silos will significantly improve care coordination and provider participation.