WHO WE SERVE

Optimize Value-Based Care with Next-Generation Technology

VirtualHealth’s HELIOS® platform helps health plans and health systems manage the value-based care transition with the most advanced suite of care coordination tools on the market.

12+ Million

Managed lives through HELIOS

Up to 93%

Increase in care team efficiency

 

Up to 92%

Care team productivity gains

 

37 Million

Total interactions in HELIOS

As the healthcare industry continues its pivot to value-based care, delivering effective care management for members has never been more critical. However, many organizations struggle to make the operational and process changes needed to deliver the right care to the right member at the right time.

Our HELIOS family of technologies create an ecosystem of care within a single unified platform to provide population health, care management, case management, care coordination, utilization management, and disease management for millions of members.

Who We Support

From large-scale community-based populations to facility-based cohorts with intellectual and developmental disabilities (IDD), HELIOS has been leveraged to manage the full continuum of care. We’re proud to serve some of the nation’s largest Medicare and Medicaid payors, as well as community health plans across the country. We also work with specialty care and home health providers who focus on specific health services and needs.

 

Medicare Advantage

Purpose-built for Medicare Advantage populations to provide personalized, connected care experiences, meet regulatory requirements and maximize financial return, operational efficiency, Star Ratings, and member satisfaction.

Medicaid

Designed for modern Medicaid programs, HELIOS is the acknowledged leader in Medicaid medical management platforms for supporting whole-person high-quality care, state-specific regulatory compliance, and cost controls, with a proven ROI of more than 80%.

Health Care Plans

Optimize your commercial plan with exceptional utilization management, integrated care management, workflow automation, and operational efficiency. The HELIOS platform offers unmatched flexibility for quickly and easily executing strategic initiatives.

Health Systems

Improve value-based care outcomes with comprehensively integrated CM and UM solutions that drive better care, reduce risk, close care gaps, and eliminate costly errors.

Accountable Care Organizations (ACOs)

Reach at-risk communities and members easier with advanced population health insights, SDOH criteria and tools, risk-stratification, care gap identification, disease management workflows, and more.

Home Health Care Organizations

Empower and support care for individuals in the community with a broad range of home health capabilities along with native telehealth, service planning, and schedule management tools.

Key Advantages Of HELIOS

Clients have deployed HELIOS to reduce unnecessary ER visits and avoidable hospitalizations, improve health equity, manage chronic conditions, administer community resources for social determinants of health, align with national quality strategy, and improve utilization management programs.

One Unified Platform for CM, DM and UM

HELIOS is a single, easy-to-use, cloud-based platform for care management, disease management, and utilization management, and it’s been proven to improve care manager efficiency by up to 83%.

Mobile App for Care Management in the Field

Uniquely designed to support populations with members who need long-term supports and services, home health or behavioral health services, HELIOSgo brings all the best-in-class features and intuitive design of the HELIOs platform to care managers in the field.

Rapid FHIR Interoperability

Consolidate CM, UM, telehealth, and FHIR data in HELIOS for improved efficiencies and higher caseloads. All data integrations in HELIOShub are FHIR-compatible OOB and compliant with CMS interoperability rules.

Integrated Behavioral Health for Whole-person Care

HELIOS provides whole-person views, comprehensive assessments and collaborative workflows that empower teams to proactively address both physical and behavioral needs, while HELIOSgo supports behavioral health management on the go and in the field.

Analytics and Resources for SDOH & Health Equity

Leverage our ecosystem of partners to utilize integrations within HELIOS that can help identify and address social determinants of health (SDOH) with predictive analytics, health education resources and connections to community programs and services.

Improved Care Coordination

Power care team collaboration as individuals transition between acute care settings, long-term facilities, and the community with event-driven triggers, real-time admission, discharge and transfer (ADT) feeds, automated notifications and tasks, built-in HIPAA-compliant telehealth tools and more.

Comprehensive LTSS Management

Access a comprehensive solution suite uniquely designed for LTSS management including fully integrated transportation management, 90% configurability to tailor workflows and service authorizations to state-specific regulations, quality metrics, HCBS access and quality control with closed-loop data and community resources.

Optimal Disease and Chronic Care Management for Higher-Complexity, High-Risk Patients

HELIOS has a configurable set of disease management workflows and capabilities designed to improve the health of those living with chronic conditions while reducing unnecessary utilization and avoidable complications, such as emergency room visits, while allowing for quick adaptations as disease management programs expand and evolve.

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