Use industry-leading rules engines and intelligent workflows for efficiency gains Did you know that HELIOS already has built-in functionality that helps clients automate and streamline care management, utilization management, and case and disease management? This includes everything from automations for assigning tasks to the right staff member and triaging members to letters, risk flagging, and...
Interoperability is currently a big challenge for healthcare organizations using care management and population health technologies. To put it simply, these technologies lack interoperability (or sufficient interoperability). And it’s hurting member care and engagement. Interoperability is also lacking in utilization management solutions, which contributes to delays in authorizations and getting members the care they need....
Artificial intelligence (AI) is a trending thing in healthcare, and it’s why HELIOS already has built-in integrations powered by AI that clients can leverage. AI is threaded throughout the HELIOS platform in a variety of ways. Specifically for this blog, we’ll focus on how AI is leveraged to power predictive analytics for population health and...
For healthcare organizations, CMS-0057-F outlines the modern healthcare system and offers opportunities to improve care and utilization management In the last couple of years, the Centers for Medicare & Medicaid Services (CMS) have been making strides to increase health data exchange, as well as improve and expand access to care. On January 17, CMS finalized...
For healthcare payors and organizations, the HL7® FHIR® (Fast Healthcare Interoperability Resources 1) standard is crucial to data interoperability efforts. This standard is designed to improve data interoperability by providing a standardized way to exchange and integrate health information from multiple sources stored in disparate systems. And as healthcare payors look for ways to enable...
HELIOS is the most configurable platform for healthcare payors with 90% configurability right out of the box. You may have heard us say this before, but if not, “HELIOS is the most configurable and flexible solution for healthcare management.” But what does that even mean? HELIOS comes 90% configurable out-of-the-box, and that means clients on...
As a new year approaches, the U.S. healthcare industry faces converging factors that signal some significant upcoming changes. An estimated 60% of adults have at least one chronic disease, and 40% suffer from two or more, straining healthcare resources. In 2023, life expectancy declined to 76.4 years, due in part to social inequities and to...
