MEDICAID
Medicaid Population Health Solution
Purpose-built to support high-quality, proactive care with appropriate cost controls and state-by-state regulatory compliance.
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.
Secure, Validated, Trusted
HELIOS is the HITRUST certified cloud platform for care, disease, utilization and population health management. Absolute commitment to information security underpins our proven track record in supporting the world's largest healthcare organizations.

WHITE PAPER
Strategies To Unlock Medicaid Population Health
Delivering equitable, cost-effective, and value-based care experiences to Medicaid beneficiaries can be challenging, especially for those moving from fee-for-service (FFS) to managed care. In this white paper, we provide five managed care strategies that are easy to execute for payers looking to simplify the delivery of care, provide equitable access, and reduce costs.
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