Medicaid

Care Management for Modern Medicaid

Care Management for Modern Medicaid

VirtualHealth has nearly a decade of experience with Medicaid plans, managing millions of Medicaid enrollees across all 50 states on the HELIOS® platform. HELIOS®'s unparalleled automation, comprehensive compliance, and optimal outcomes create the most user-friendly Medicaid care management platform on the market.

Medicaid is Transforming - Is Your Solution Keeping Pace?

The principles of value-based care (VBC) are transforming Medicaid across every state. Success with these new reimbursement models requires a platform like HELIOS®: specifically designed for value-based care and with a proven Medicaid ROI of more than 80%.

From Acute to Social Determinants and
All Points In-Between

With our HELIOS® platform, you get the full picture: physical health, behavioral health, long term care, and social determinants of health. We integrate broadly, well beyond claims, auths, and ADTs, and our risk scores and workflows incorporate all aspects of the enrollee's health.

Download our whitepaper to learn how Lyft and Community Care of North Carolina are driving change by implementing innovative approaches to proactive care.

HELIOS®: the Acknowledged Leader in Medicaid

Independent research and head-to-head comparisons confirm that HELIOS® is the leader among medical management platforms servicing Medicaid clients. It is the most comprehensive, configurable, and user-friendly product paired with VirtualHealth's deep consultative implementation services.

HELIOS® is number one in quality, delivery, and long-term vision. But don't take our, or anybody else's word for it - request a demo and see HELIOS® in action!

Disease Management

Medicaid populations are among the most vulnerable. We power personalized programs that provide optimal outreach, education, and support for the most complex and high-risk enrollees.

Disease Management

Behavioral Health

We believe in whole person care. That means placing as much emphasis on behavioral conditions as physical conditions while empowering the interdisciplinary care team to collaborate effectively across both domains.

Care Coordination

Care Coordination

Our first Medicaid client focused on care coordination and trusted HELIOS® to power their operations from A to Z. This partnership was so successful that, within 2 years, a 1,500-member care coordination entity became a 70,000-member full risk Medicaid plan.

Population Health

Our in-context dashboards, configurable views and intelligent reports enable organizations to track staff performance, quality metrics, and enrollee outcomes. Real population health is actionable - request a demo and let us show you how we make that happen!

Care Management in Hand and On the Go

We understand the importance of engaging care managers with enrollees not only effectively, but also safely and securely. That is why we offer built-in secure videoconferencing, chat and file exchange. And that is why we provide the most advanced offline app, so whether in the office or face-to-face, care managers always have what they need at their fingertips.

HELIOS® is for ALL Organizations

  • Spotlight on Managed Care

    Our platform empowers the automation of all facets of managed care - from program referrals to real-time task lists to upstream quality reports. The result? Better outcomes at lower costs.

  • Spotlight on LTSS

    We support the most complex LTSS programs across the country, from assessment to authorization to service planning to EVV and reconciliation. All completely configurable and fully compliant.

  • Spotlight on Dual Eligibles

    We have extensive experience with dual enrollees in both Medicaid and Medicare, from managing coordination of benefits to disenrollment/re-enrollment processing to specialized tracking.

  • Spotlight on Home Care

    We were the first medical management platform to partner directly and integrate fully with home care and EVV vendors. From provider selection to capturing rich data at the point-of-care, we give you the tools to succeed.