MEDICAID
Medicaid Population Health Solution
Purpose-built to support high-quality, proactive care with appropriate cost controls and state-by-state regulatory compliance.
Medicaid payors have to deliver care that’s unique to their program requirements, processes, and rules for care and utilization management. With experience across multiple state programs and for some of the largest Medicaid payors with complex care needs, VirtualHealth’s HELIOS® solution provides unparalleled flexibility, automations, and tools to enable high-quality care for vulnerable populations across the country.
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
Medicaid Solution Features
Single Unified Platform For CM, DM, Population Health & UM
Whole-Person Views
Comprehensive Population Analytics & Reporting
SDOH Data & Analysis Integrations
Health Equity and SDOH Resources and Tools
Smart Targeted Assessments For Social And Behavioral Health
Population & Cohort Level Analysis Capabilities
Configurable, Automated Workflows
Advanced Population Stratification & Risk Scoring
Real-Time Data Feeds & Task/Case Assignments
Automated Care Plan Recommendations
Advanced Utilization Management with Automated Prior Authorization
Integrations with Leading SDOH, UM & Quality Analytics Partners
Mobile Application for Care Management in the Field
Pre-Built & Customizable Quality Reporting Dashboards
Behavioral Health, Home Health & LTSS Features, Customizations
Disease & Chronic Care Management Tools for Higher Complexity Populations
Proven Leaders In Medicaid Care Management
For years, HELIOS has been a leading choice platform for all kinds of organizations and a driving innovator in the field. Independent research and head-to-head comparisons confirm that HELIOS is the leader among medical management platforms servicing Medicaid clients.
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.
Comprehensive LTSS Support
We support the most complex LTSS programs across the country, from assessment to authorization to service planning to EVV and reconciliation. All are completely configurable and fully compliant.
Delivering For 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.
Home Health 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.
PDF GUIDE
Discover the Power of HELIOS Solutions
Download our quick product guide to learn about our family of HELIOS healthcare solutions. HELIOS is 90% configurable and supports care management, disease management, care coordination, LTSS, behavioral health, utilization management, and data interoperability – all within one single platform.
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