Value-Based Care Software That Turns Risk Contracts Into Results
Helios® by Elligint Health is value-based care software built to be the workflow engine for value-based care. Risk-bearing entities, from ACOs and clinically integrated networks to independent physician groups, use Helios to turn risk and care gap insights into care management action that helps manage total cost of care and improve quality performance. Helios supports more than 13 million covered lives across all 50 states.
What Is Value-Based Care Software?
Value-based care software is the technology risk-bearing entities use to improve quality and manage total cost of care for the members attributed to them. Under a value-based contract, a health plan attributes members to a provider organization, and that organization shares in the savings when quality improves and total cost of care comes in under target. The software brings together four capabilities: risk prediction to spot who’s heading for trouble; analytics to track cost, utilization, and quality; a care management workflow to act on it; and member engagement to reach people between visits.
Picture the population as a pyramid. Most members need preventive care, such as screenings, vaccines, and annual wellness visits. Above them are rising-risk members, with chronic conditions starting to trend the wrong way. At the top are complex members whose care costs the most. At every level, social risk such as housing, food, and transportation shapes cost alongside medical risk, so seeing both shows where care management will make the biggest difference.
Helios is the workflow engine for value-based care software. Helios CM and Helios UM run care management, care coordination, and utilization management, with built-in texting to reach members between visits. Helios integrates with risk modeling solutions, and Advanced Analytics, sold alongside Helios, tracks cost and utilization trends and open care gaps across your population.
The Pressures Value-Based Organizations Face — and How Helios Responds
Value-based contracts reward organizations for outcomes, not volume. That only works when care teams can see every member’s risk, every open care gap, and every contract’s performance in time to act.
Rising-Risk Members and Total Cost of Care
The members who drive the most cost next year are often the ones who look stable today, like a diabetic patient whose A1C is starting to climb. Impactability scoring narrows that group to the members care management can actually help. Advanced Analytics tracks cost and utilization trends like ER visits and readmissions, and Helios integrates with risk modeling solutions, so care teams can step in while it’s still preventable.
Member Data Split Across Systems
Claims, clinical records, hospital admissions, and social needs data often live in different systems. Helios brings them into a 360° member view, with real-time admission, discharge, and transfer (ADT) alerts, so care teams know when a member moves through the hospital without stitching records together by hand.
Quality Measures That Decide Shared Savings
In most value-based contracts, quality scores determine how much of the savings you keep, and most of those scores come down to preventive care: screenings, vaccines, and wellness visits. Advanced Analytics surfaces open care gaps across your population, so care teams know where to focus outreach before the measurement period closes. Helios gives them the care coordination workflows and member texting to follow through.
More Downside Risk, Less Room for Error
As contracts move from upside-only shared savings to downside risk, organizations owe money when costs run over target, which leaves less room for error. Used together, Advanced Analytics shows where cost and quality performance is slipping, and Helios gives care teams the workflows to act on it early.
Value-Based Care Software for Every Risk Model
Helios configures to your contracts, populations, and risk arrangements, from your first shared savings agreement to full delegated risk.
ACOs and Clinically Integrated Networks
Coordinate care across independent practices, behavioral health networks, and community providers on one care management platform, with a 360° member view and shared care plans for every care team.
Independent Physician Groups and MSOs
When you’re paid to manage a whole patient panel instead of each visit, you need to know which patients need you most. Helios gives independent physician groups and management services organizations the care management workflow to reach complex and rising-risk patients before they end up in the hospital.
Delegated Care and Utilization Management
Take on care and utilization management delegated by a health plan with audit-ready workflows and documentation that hold up to the plan’s oversight. INTERLINK Health used Helios to earn URAC Accreditation for a delegated program. Read the INTERLINK case study.
Health Plans With Value-Based Contracts
Payers running value-based arrangements need the same visibility from the other side. Advanced Analytics shows which providers and programs are driving performance across your network. Learn how Helios supports health plans and payers.
Other Organizations We Serve
Health Plans/Payers
Unify care management, utilization management, and analytics across Medicare Advantage, Medicaid, and commercial lines of business.
MLTSS Programs
Coordinate HCBS services, long-term supports, and state waiver requirements in one system of record.
Government & Community Programs
Support Medicaid managed care, public health initiatives, and community-based care coordination.
One Platform Built for Value-Based Performance
Helios modules work independently or together. Many value-based organizations start with analytics or care management and add capabilities as they take on more risk.
Helios CM
Care management software with 360° member views, guided care plans, and care coordination workflows, plus built-in texting (Helios Text®) to reach members between visits.
Helios UM
Utilization management software that automates prior authorizations, appeals, and grievances, so delegated groups can manage utilization to the plan’s standards and cut avoidable spend.
Advanced Analytics
Population health management analytics that surface open care gaps, track cost and utilization trends like ER visits and readmissions, and show which providers and programs are driving performance.
Helios Partner Ecosystem
Pre-integrated partners extend Helios with SDOH referrals through findhelp and Unite Us, and Helios integrates with the risk modeling solutions you already use.
Proven Results for Value-Based Care Organizations
The Illinois Health Practice Alliance (IHPA), a statewide clinically integrated network of more than 100 community-based behavioral health providers, needed one view of members spread across separate value-based Medicaid contracts. With Elligint Health’s unified care management and analytics platform, IHPA’s providers improved completed Health Risk Assessments by 45% and completed care plans by 39% within one year, strengthening performance on the quality measures their health plan partners contract on. Browse the Resource Hub for more case studies and expert perspectives.
Related resources
Value-Based Care Software FAQs
Look for four capabilities working together: risk prediction to identify rising-risk members; analytics to track cost, utilization, and quality across your population; a care management workflow to act on what the data shows; and member engagement to reach people between visits. Helios is the care management workflow engine, with built-in member texting, and it integrates with the risk modeling solutions you already use. Advanced Analytics, sold alongside Helios, adds population analytics.
Population health management software analyzes a population to find risk and gaps in care. Value-based care software also acts on those findings, turning insight into care team workflows that reach high-risk members and close gaps. Elligint Health offers both: Advanced Analytics surfaces the insight, and Helios CM and Helios UM serve as the workflow engine that turns it into action.
Helios integrates with the risk modeling solutions you already use, so care teams can bring those insights into their care management work. Advanced Analytics, sold alongside Helios, adds cost and utilization trends and open care gaps across your population.
Helios brings claims, clinical, and social needs data into a 360° member view, along with real-time admission, discharge, and transfer (ADT) alerts. Its FHIR-native interoperability connects with EHRs, claims systems, and partner platforms without disrupting your existing IT ecosystem.
Yes. Helios CM, Helios UM, and Advanced Analytics are available separately, so many organizations start with the capability they need most and add others as their contracts and risk grow.
Ready to Turn Value-Based Contracts Into Results?
Whether you’re entering your first shared savings contract or taking on downside risk, Helios gives value-based organizations one platform to coordinate care and improve cost and quality performance.