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.

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.

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.

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.


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.

What HELIOS Solutions Do You Need for Medicaid?

From population health management and chronic disease cohorts to integrated workflows for long-term care and home health, HELIOS empowers Medicaid plans to optimize care management and deliver value across the continuum of care.

Not sure how HELIOS can meet your specific Medicaid needs? Take this quick assessment to find out and get access to videos tailored to your use case.

Customize Your HELIOS Platform

The power of HELIOS is in it’s singular design. Answer seven short questions to find out which HELIOS solutions are a good fit for your population health needs.

Step 1 of 8

What populations is your organization interested in managing (select all that apply)

What populations is your organization interested in managing (select all that apply)(Required)