Headquartered in Pittsburgh, Pennsylvania, Helion, an indirect wholly-owned subsidiary of Highmark Health, delivers solutions to health plan payers to advance health and healing in the home by transforming the network of providers and nurses to optimize outcomes, provide better value, and enhance the customer experience.
The foundation of Helion's strategy is centered on enabling patients to receive care in the least restrictive and most desirable environment, such as the home.
Helion's vision is a future where the home is embraced as the keystone of the care continuum. Its mission is to empower patients, providers, and payers to advance health and healing in the home through informed collaboration.
In 2021, Helion provided services in four states Pennsylvania, Delaware, West Virginia, and New York which included collaborating with over 450 home health and skilled nursing facilities. Helion products and services include a suite of data- and analytic-driven services that bring evidence and insights to the home and community care network. Additionally, it offers a network optimization system that provides a path to true value-based care and optimized network performance. These two key components work together to unlock the potential of home and community care for payers and providers so they can deliver prevention, condition management, and healing helping providers elevate what they do and positively impact the entire care continuum.
Advancing the work to bring care into the home
Helion is responsible for delivering solutions to advance health and healing in the home through innovative technology to optimize outcomes, provide better value, and enhance the customer experience.
To meet the home and community care needs of both payers and providers, Helion's goal is to partner with providers to enable members to receive care where they are most comfortable the home. A foundational element to this success includes partnering with both payers and providers to elevate the way the industry traditionally thinks about reimbursement in these settings.
In 2021, Helion advanced the way payers and providers interact by launching a new episodic reimbursement program to home health providers in Pennsylvania. "By elevating the way that we think about reimbursement, providers are rewarded for providing best-in-class care to the members in the communities we serve, in the setting people prefer most a win-win for all," said Nick Stupakis, vice president, Commercial Services, Helion.
Episodic reimbursement may not be new to the health care industry, but Helion's adopted approach is an advancement in what has been seen historically in the industry.
"Helion continues to be committed to transforming the home and community care market, helping providers to deliver better outcomes and, ultimately, a better experience for the people we serve," said Stupakis. "The successful episodic reimbursement adoption through strong partnerships with providers lays the foundation to expand the program to other home and community care settings in the upcoming years. Helion continues to work closely with payers and providers to advance health and healing in the home and enable patients to receive care in the least restrictive and most desired environment."
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Over 80% of home health agencies in the networks Helion serves are in a value-based arrangement.
Approximately 85% of home health visits are driven to high-performing networks.
Insight: Advancing Health and Healing in the Home
“The successful episodic reimbursement adoption through strong partnerships with providers lays the foundation to expand the program to other home and community care settings in the upcoming years. Helion continues to work closely with payers and providers to advance health and healing in the home.”