Comprehensive LTSS Management

LTSS populations are among the most complex, requiring a range of physical, behavioral, and home health interventions. HELIOS® provides a unified, comprehensive solution for simplifying and streamlining care for populations requiring long-term services and supports (LTSS).

Enabling a Whole-Person Approach to LTSS Management

LTSS programs generally support individuals with the most extensive and complex clinical and social needs. HELIOS is currently used to support LTSS programs across the country. Its expansive configurability enables clients to quickly tailor workflows and service authorizations to state-specific regulations. 

With the HELIOS platform, care teams can manage far more cases with fewer resources due to an unprecedented level of intelligent automation. 

Key Features and Benefits

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Configurable Role-based Access

Allows care managers, case workers, and clinicians to see a complete picture of a member while providing caregivers and third-party service providers with only the information they need to provide support.

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Single Source of Truth

Provides real-time collaboration and communication across different care teams and settings to improve the accuracy and delivery of care.

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Improve Quality Incentives & SLAs

Meet quality incentives and hit state-mandated SLAs for hospitalizations and transitions of care.

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Reduce Administrative Burden

Use trigger-based automations and customizable workflows for productivity gains of up to 92%.

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90% Platform Flexibility

Configure up to 90% of the platform to remain agile and highly competitive when it comes to state-sponsored programs and waivers without heavy IT support.

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Partnerships with EVV vendors

Direct integrations with electronic visit verification (EVV) vendors support timely reconciliation between services authorized and delivered.

Multiple Market Support

Multiple Market Support

Easily manage member data for one state with the scalability to meet the requirements of multiple US states.

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Quality HCBS Resources

Closed-loop data allows care team to order Home and Community-Based Services like transportation or food and see when they are delivered.

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Advanced Provider Search Capabilities

Ensure that the right providers are selected based on geography, network, language, and other considerations

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More Accurate, Expedient LTSS Care

Streamline the identification and authorization of appropriate services and supports via intelligent analysis of assessments and automated tasking and linking.

A Centralized Solution for Interdisciplinary Care Teams

HELIOS offers a single point of entry for all care team members, acting as a centralized command-and-control for interdisciplinary care teams. HELIOS provides real-time collaboration and communication to improve an LTSS participant’s health and quality of life while maximizing program dollars and care experiences.

From easily administering LTSS-specific assessments and pre-populating service plans, to capturing attestations, auto-generating authorizations, and automating real-time reporting.

See the tools HELIOS provides for long-term care and supports to improve the quality of life for diverse populations in this quick demo video.

Mobile LTSS Management

Effectively caring for LTSS populations requires multidisciplinary collaboration alongside meaningful engagement with both patients and caregivers. From mobile capabilities to one-click telehealth to interdisciplinary care team (ICT) interaction management, HELIOS provides both telephonic and field care managers with capabilities to maximize their reach and impact.

The HELIOSgo mobile app is also uniquely designed with populations requiring LTSS, behavioral health and home health care in mind, making in-the-field and on-the-go care management and coordination easier.

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How to Improve Care for Members with Medicare Who Need Long-term Services and Supports (LTSS)

A significant percentage of members with Medicare over age 65 will likely need some level of LTSS care at some point. This may include activities of daily living (ADL) and/or instrumental activities of daily living (IADL).

Given their reliance on external services and supports, the LTSS population is particularly vulnerable to environmental factors. Activities of daily living are made exponentially more challenging when patient limitations are further impaired by lack of access.

Download our free white paper for ways to proactively address the social determinant of health (SDOH).

Proven Track Record Across Highly Regulated Programs

VirtualHealth was the first medical management technology company of its kind to fully commit to a dedicated module for long-term services and supports (LTSS). Understanding the significant regulatory overhead and regional differences among LTSS programs, VirtualHealth built in the ability to configure every facet of the end-to-end LTSS workflow, from enrollment and assessment to service planning and authorization to tracking and all points in between.

Using HELIOS for LTSS: A Real-World Example

See how HELIOS and HELIOSgo are used to help 86-year-old Juan through a coordinated care approach.

Juan's Care Team

 Juan has a care team consisting of a care manager, a home health aide, a care manager, and a visiting nurse. Juan’s home health aide visits his home to assist him with medications and activities of daily living, including bathing and grooming. Helios enables Juan’s entire care team to gain insight and transparency into the full spectrum of his complex care needs.

Real-time Information

 Through Helios, the care manager remains connected and informed on Juan’s condition. In his last visit, the visiting nurse noted that Juan’s ability to self-care has declined and made a note regarding the changes to his condition in Juan’s care plan.

Automated Workflow

 Helios’ clinically-based calculations and business rules informed the care manager through an automated workflow that Juan was in need of additional home support, and automatically calculated the increase in hours. The care manager then formally requested an authorization for increased service hours with a few clicks in Helios.

Meet Juan

 Juan is an 86 year old male with diabetes and COPD. He uses a wheelchair and requires in-home assistance, but is able to continue living at home with his insurance-provided LTSS benefits. Though Juan’s needs are varied and complex, he is able to enjoy his independence with the right services and supports.

Intelligent Communication

 Helios’ auto-approval rules engine with pre-configured parameters resulted in an automatic approval for this additional support and triggered an auto-generated approval letter to both Juan and the home health provider.

Connect with Us

We understand that choosing medical management technologies can be a big decision. That is why we provide a highly consultative and refined approach that allows you to learn, ask questions, and identify if our HELIOS solutions are a good fit. Click below to set up time to chat with our team or to get more information about any of our HELIOS products.

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