Government Health Plans

Optimize Value-Based Care with One Comprehensive System

Operational models for value-based care continue to evolve. Healthcare management solutions must be flexible to adjust to changing program needs. The VirtualHealth solutions suite is the most advanced on the market and provides population health, care management, case management, care coordination, and disease management for millions of members. The HELIOS platform helps clients maximize their program dollars with robust tools that focus on improving quality care metrics.

Pre-validated by the NCQA, the HELIOS solution helps clients achieve Star, CAHPS, and other performance measures while increasing efficiency and productivity.

Clients deploy HELIOS to reduce unnecessary ER visits and avoidable hospitalizations, manage chronic conditions, administer community resources for social determinants of health, align with national quality strategy, and comply with government standards.

VirtualHealth Government Health Plans Medicaid
Medicaid

Effective care management for Medicaid can improve outcomes while lowering costs for some of the nation’s most high-risk and needy members. HELIOS care management allows its users to support program compliance through a highly configurable system with extensive, specialized, state-specific guidelines.

Engage a seamless process to interface with the state system, optimize workflows, and simplify regulatory reporting. Improve quality incentive ratings by proactively addressing care gaps by using clinical methods and leveraging tools that address social determinants of health.

VirtualHealth Government Health Plans Medicare
Medicare

Utilize the HELIOS care management platform to improve Medicare Star ratings. Real-time information, transparency, and comprehensive regulatory reporting ensure compliance with CMS guidelines, improve outcomes, and lower costs.

HELIOS supports chronic care management and provides the care team with specific tools to help their members manage chronic conditions including diabetes, arthritis, heart disease, and mental health.

VirtualHealth Government Health Plans Dual-Eligibles
Dual-Eligibles

Leverage the platform’s proficiency with Medicare and Medicaid to care for complex populations with multiple chronic conditions. The HELIOS care management platform integrates physical health, behavioral health, and social needs for dual-eligible beneficiaries.

Precision member management and bi-directional data exchange ensure services are authorized in a timely manner and integrated into the person-centered care plan. Streamlined care coordination in the HELIOS platform overcomes fragmentations across the care continuum and increases the efficacy of the care team.