Government and Community Programs
Public health programs and community-based organizations face complex challenges — from regulatory oversight and resource constraints to coordinating care across diverse populations and service providers. Helios® by Elligint Health helps organizations streamline care coordination, improve program visibility, and deliver connected services across healthcare, community, and home-based settings.
Many government and community programs operate alongside health plans and value-based care initiatives — requiring technology that connects clinical care, social services, and program oversight within a single operational framework.
Helios supports organizations serving Medicaid and Medicare Advantage populations, as well as community organizations and home-based care providers, enabling whole-person care across medical, behavioral, and social needs while maintaining accountability and compliance.
Purpose-Built for Public Programs and Community Care
Government and community programs often serve some of the most complex and vulnerable populations. These programs must balance care coordination, social services, compliance requirements, and operational efficiency — often across multiple agencies, providers, and community partners. With Helios, organizations can:
- Coordinate care across medical providers, behavioral health services, and community organizations
- Support whole-person care through integrated clinical, behavioral, and social determinants data
- Manage care teams, outreach programs, and service coordination across multiple organizations
- Track program performance and population outcomes through real-time operational dashboards
- Support telehealth, mobile outreach, and digital engagement tools for community-based care teams
- Reduce administrative burden through automated workflows and centralized documentation
Supporting Diverse Public Health Programs and Care Delivery Models
Helios is designed to support a wide range of government and community care programs.
Government programs operate under strict regulatory oversight while serving diverse populations with complex needs. Helios provides the operational infrastructure needed to manage program requirements while supporting care teams and community partners. From care coordination and program oversight to compliance tracking and reporting, Helios helps organizations deliver effective services while maintaining accountability across programs and stakeholders.
Medicare Advantage
Medicare Advantage programs require careful coordination across care management, utilization management, and regulatory reporting. Helios supports Medicare Advantage organizations with configurable workflows designed to align with plan-specific models of care, quality programs, and operational requirements.
Care teams can manage care gaps, care coordination activities such as transitional care management (TCM), chronic care management (CCM), and principal care management (PCM), along with screening and assessment programs through automated workflows and configurable triggers. Helios also supports authorization rules and day-limit management specific to Medicare requirements while capturing the data needed for NCQA, ODAG, and CDAG reporting. Together, these capabilities help plans streamline operations while improving quality performance and member outcomes.
Medicaid
Modern Medicaid programs require coordination across medical, behavioral, and social services while navigating complex state-specific regulations. Helios supports Medicaid organizations and Medicaid Managed Care Organizations (MCOs) with flexible workflows that integrate SDOH drivers, eligibility monitoring, and care coordination tools designed for diverse populations and program structures.
The platform captures and tracks eligibility history, supports configurable enrollment and eligibility rules, and provides automated alerts when eligibility status changes or members approach disenrollment. Embedded workflows also help care teams address social determinants of health through assessments, service authorization, and community resource coordination. Helios supports specialized Medicaid program needs such as Managed Long-Term Care (MLTC) authorization and transportation management, helping organizations reduce barriers to care while maintaining compliance with evolving CMS, NCQA, and state Medicaid requirements.
Community Organizations & Home-Based Health Providers
Care doesn’t always happen in the clinic. Helios supports care for individuals in community and home settings through telehealth, behavioral health tools, service planning, and outreach capabilities. Through integrations with ecosystem partners such as findhelp.org and Unite Us, care teams can identify and connect individuals with local resources that address food security, housing support, transportation, and other social needs.
Helios also supports home-based care programs through centralized service planning, provider coordination, and integration with remote patient monitoring (RPM) tools. Real-time alerts and automated tasking help care teams respond quickly to changes in a member’s condition, enabling more proactive care while maintaining clear visibility across home-based services.
One Platform. Endless Impact.
- One system for care and utilization management
- 90% configurable to align with programs and workflows
- Out-of-the-box workflows for Medicare Advantage, Medicaid, HCBS programs
- Real-time operational insights that prioritize and drive action
- Increased productivity & reduced administrative burden
- Over 13M lives managed and industry-leading retention
Delivering Coordinated, Accountable Public Health Programs
Helios helps government agencies, health plans, and community organizations bring clinical care, social services, and program oversight together within a single operational platform. With configurable workflows, advanced analytics, and an extensible partner ecosystem, organizations gain the visibility and coordination needed to manage complex populations while maintaining compliance and accountability.