VirtualHealth

What VirtualHealth does

VirtualHealth, operating as Elligint Health, is a private U.S. healthcare technology company founded in 2016 and headquartered in Edison, New Jersey. It builds the Helios platform, a connected system for intelligent medical management targeting U.S. health plans, payers, and value-based care organizations, with secondary use in LTSS and government programs. The platform combines an operational foundation (Helios CM for care management and Helios UM for utilization management, the latter aligned with CMS-0057-F prior authorization timelines), an intelligence layer (Advanced Analytics surfacing risk, quality gaps, and performance insights across clinical, operational, and financial data), and an AI-ready capability expansion through the Helios Partner Ecosystem and a Clearinghouse module for transaction processing. KLAS Research rated Helios a top performer in 2025, supporting over 13 million covered lives.

The company's go-to-market is enterprise field sales targeting health plans that need to scale value-based care operations without proportional headcount growth. Its stated value proposition centers on automating care and utilization workflows, accelerating prior authorization decisions under CMS-0057-F, identifying high-risk members earlier via predictive insights, and maintaining audit-ready compliance. Revenue is generated through recurring subscription licensing of the Helios platform modules to enterprise customers; no pricing tiers or per-member-per-month rates are publicly disclosed. Capital formation to date totals approximately $23.55 million across three rounds (2016, 2017, 2019), all led by Edison Partners, with no subsequent external funding round on record. Leadership is led by founder and CEO Adam Sabloff, with a CXO bench covering client, commercial, financial, technology, and clinical operations functions.

Name

VirtualHealth

Legal name

Elligint Health

Website

https://virtualhealth.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

51–100 employees

Short description

VirtualHealth (dba Elligint Health) provides the Helios care management, utilization management, and analytics platform to U.S. health plans, payers, and value-based care organizations, supporting over 13 million covered lives.

Ownership category

akta.pro rank

Product category

Healthcare Payer Software (Care Management & Utilization Management)

NAICS

Computer Systems Design and Related Services (54151), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Health Services (8000), Services-Computer Processing & Data Preparation (7374)

akta.pro primary industry

Chronic Condition Virtual Care & Disease Management (Payer-Sponsored) (HLALACAE)

akta.pro secondary industry

Care Navigation, Referral & Digital Front Door Platforms (HLALABAH)

Keywords

• Care management software
• Utilization management platform
• Health plan analytics
• Value-based care software
• Population health management

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations, Infrastructure

Revenue model

1. Healthcare Payer Software Platform: Elligint Health generates revenue through licensing their Helios platform (care management and utilization management modules) to health plans. The platform supports operational workflows, analytics, and compliance capabilities at scale across member populations.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

VirtualHealth (operating as Elligint Health) sells the Helios platform, a connected care management and utilization management system for health plans and value-based care organizations. It combines configurable care management workflows (Helios CM), utilization management workflows (Helios UM), advanced real-time analytics, and AI-enabled partner technology integrations, supporting care planning, risk stratification, prior authorization, compliance, and population health management across member populations.

Product overview

Elligint Health offers the Helios Platform — a connected platform for intelligent medical management that combines three core capabilities: an Operational Foundation (Helios CM and Helios UM modules), an Intelligence Layer (Advanced Analytics), and AI-Ready Capability Expansion (Partner Ecosystem integration). The platform supports care management, utilization management, disease management, and population health management through configurable workflows, automated decision support, and real-time analytics across clinical, operational, and financial domains. The product ecosystem also includes a Clearinghouse module for healthcare transaction processing.

Differentiator

Problem solved

Functional benefit

Brands

• Helios CM: Care management solution within the Helios platform, featuring configurable workflows, intelligent care planning, assessments and risk stratification, transitions of care, chronic disease management, and referral tracking.
• Helios UM
• Advanced Analytics
• Helios Partner Ecosystem

Products and services

• Helios CM (Care Management) Configurable care management module that streamlines workflows for health plans via intelligent care planning, assessments, risk stratification, transitions of care, chronic disease management, and referral tracking with intelligent automation at scale.
• Helios UM (Utilization Management) Utilization management module for health plans that manages prior authorization, configurable routing and tracking, grievances and appeals, medical necessity review, and automated decision support aligned with CMS-0057-F timelines.
• Advanced Analytics Analytics module that turns data into direction, surfacing risk, quality gaps, and performance insights in real time while delivering performance intelligence across clinical, operational, and financial domains.
• Clearinghouse Module supporting healthcare transaction processing and data exchange capabilities for health plans operating on the Helios platform.

Quantifiable outcome

• Supports over 13 million covered lives
• +2 more outcomes

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability4 records

Feature5 records

Partnerships

One partnership is on record.

• Helios Partner EcosystemcoreTechnology or IntegrationHelios Partner Ecosystem enables specialized technology providers to integrate their solutions directly into Helios care management and utilization management workflows. This allows Elligint Health to offer AI-enabled clinical decision support, risk forecasting models, and other advanced capabilities through partner technology integration rather than building all capabilities internally.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• ZeOmega: ZeOmega offers the Jiva population health management platform to health plans, combining care management, utilization management, and analytics—directly comparable to Helios in payer-focused workflow scope and AI-driven risk stratification.
• Medecision: Medecision's Aerial platform delivers care management, utilization management, and member engagement for health plans and payers—closely overlapping with Helios CM and UM functionality and serving a similar enterprise payer buyer.
• Altruista Health: Altruista's Guiding Care platform is a care management and population health solution used by Medicaid managed care plans, Medicare Advantage plans, and ACOs—overlapping directly with Elligint's payer and value-based care segments.
• HealthEdge: HealthEdge provides payer-focused software including care management, utilization management, and member engagement—competing head-to-head with Helios for the same health plan IT modernization budgets.
• SCIO Health (now emids): SCIO provides care management, utilization management, and analytics services and software for health plans—historically a direct competitor in payer medical management workflows before joining emids.

Broad incumbents

• Salesforce Health Cloud: Salesforce Health Cloud offers care coordination, utilization management, and member engagement as part of a broader CRM platform—overlapping with Helios functionality but embedded in a general-purpose CRM suite aimed at payers and providers.
• Microsoft Cloud for Healthcare: Microsoft's healthcare offering bundles data, analytics, and care management capabilities using Azure and Dynamics—competing broadly for payer IT spend but as part of a much larger enterprise cloud portfolio rather than a dedicated care management product.
• Cotiviti: Cotiviti provides payment accuracy, risk adjustment, and quality analytics to health plans—overlapping with Elligint's advanced analytics and quality measurement capabilities and targeting the same payer procurement teams.

Emerging players

• Arcadia: Arcadia is a healthcare data and analytics platform serving payers, providers, and ACOs with population health management—adjacent to Helios Analytics and competing for value-based care analytics budgets.
• Innovaccer: Innovaccer's Health Cloud unifies patient data and supports population health, care management, and analytics for payers and providers—emerging as a competing converged platform for value-based care organizations.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/VirtualHealth_
• Facebookfacebook.com/MyVirtualHealth
• LinkedInlinkedin.com/company/virtualhealth

Revenue estimate

Valuation estimate

Number of profiles

Profiles6 records

Funding overview

Funding rounds3 records

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about VirtualHealth