Solutions

What We Deliver

The Helion solution: a win-win-win, for payers, providers, and patients.

Our solution enables home and community care providers to deliver increasing value, and enables payers to increasingly pay for value. It blends two key components: a knowledge suite to inform the transformation called Care Intelligence, and a high-performance network optimization system to enact it called Performance Intelligence. Each helps our partners uncover upstream and downstream benefits to relieve friction and provide a better experience for members.

Care Intelligence and Performance Intelligence are our response to the gaps we see in post-acute care. Right now, post-acute care doesn’t work well for payers, who are paying more for less. It doesn’t work well for providers, who are underutilized in delivering more complex, impactful care yet still struggle to meet the demands of the work they are doing. And most important, it doesn’t work well for patients, with many having poor experiences. By creating new solutions to improve care and delivery, Helion can help you not only transform home and community care, but the overall health care continuum.

Care Intelligence

Care Intelligence is a knowledge-based capability suite for home and community care, that delivers insights to enable enhanced care delivery and administration.

Today, when it comes to post-acute care, payers and providers don’t have the information they need to make the right decisions or make decisions quickly. Our clinical support tool makes automatic authorizations in seconds instead of days, while still ably supporting exception-based authorizations. Employing insights gleaned from the member’s OASIS questionnaire as well as a proprietary database that incorporates five years of OASIS assessment collections, the tool yields a robust and individualized patient assessment for the member, making appropriate and consistent authorizations fast and easy.

Services

Automated UM
Automated UM

Delivers quality utilization decisions faster with fewer FTEs.

Realtime Stratification
Realtime Stratification

Identifies individual patient care needs and gaps.

Performance Analytics
Performance Analytics

Generates data measuring care quality and cost.

Care Analytics
Care Analytics

Translates a blend of care data into actionable insights.

Performance Intelligence

Performance Intelligence is a library of proprietary, continually updated knowledge and data powering a network enhancement system that provides a path to true value-based care.

Today, assessing the performance of post-acute provider organizations and providers is challenging for payers, and so is improving your performance if you’re a provider. Performance Intelligence is a structured, collaborative process which gives providers the data and coaching they need to stay top-rated and payers the insight into provider performance to make smart decisions with their network that is transparent, predictive, and equitable.

Services

Network Conditioning
Network Conditioning

Elevates the network to the first stage of higher performance.

Provider Development
Provider Development

Equips providers to operate in high performance networks.

Care Transition Architecture
Care Transition Architecture

Optimizes referral patterns and practices.
 

Network Optimization
Network Optimization

Establishes a high performance, risk-based network.

Helion drives results

Our approach works—and continues to work—because we deliver value to payers, providers, and patients. Each group derives positive results.

payer story
Partnership through the pandemic

Helion partnered with a large health plan and their home health network to help them respond nimbly at the start of the COVID-19 pandemic. Working together, and leveraging the relationships Helion had established through its Care Intelligence and Performance Intelligence solutions, they established virtual visits, streamlined authorizations, and updated visit requirements. In less than two weeks, they had implemented new processes that mitigated risks for patients and providers without sacrificing patient care.

provider story
Driving improvements that benefit all

Two high volume skilled nursing facilities (SNF) under the same ownership were in danger of network termination due to consistently poor outcomes and high readmission rates due to disengaged leadership. Helion convinced leadership to commit to an improvement program and worked closely with the SNFs to identify and address gaps. Over a two-year period, the SNFs moved from a tie for 10th place in their market to 1st and 2nd place.

patients story
Building a structure to support true collaboration

When a particularly complicated brain injury case involving multiple readmissions and complex family dynamics threatened a patient’s care, Helion facilitated a root cause analysis meeting between the skilled nursing facility and health plan, and helped create a true collaboration across multiple care teams. The revised interdisciplinary approach mitigated further escalation of an exceptionally complex situation and eased the transition to palliative care.

Increasing Value Over Time

Other companies offer cost-savings that flatline after the first year. But Helion’s Care and Performance Intelligence Tools combine to deliver increasing value over time. That’s part of what makes Helion different. 

value over time chart

Working with Us

We pride ourselves on creating collaborative, pleasant, productive partnerships, and we find solutions that work for you. It’s what sets us apart from our competitors.