Helion
Helion is a healthcare technology and services subsidiary of Highmark Inc. that helps health plans and post-acute care providers (skilled nursing facilities and home health agencies) reduce readmissions, improve quality metrics, and manage value-based reimbursement through its Helion Arc Technology platform and Network Management services across Pennsylvania, New York, West Virginia, and Delaware.
- Company typePrivate
- Founded2016
- HeadquartersPittsburgh, United States
- Headcount51–100
- GTM typeB2B
- OfferingSoftware
What Helion does
Helion is a healthcare technology and services company that operates as a wholly-owned subsidiary of Highmark Inc., focused on transforming post-acute care — primarily skilled nursing facilities and home health agencies — through a combined software platform and high-touch network management offering. The company serves two primary customer segments: health plans/payers seeking to reduce upstream and downstream post-acute costs, and post-acute care providers seeking to improve quality metrics, ranking, and reimbursement; patients are a tertiary beneficiary of better care coordination. Its core technology, the Helion Arc Technology platform, is a knowledge-based capability suite that ingests OASIS questionnaire data, claims data, and Helion-collected proprietary data (including five years of OASIS assessments) to deliver automated utilization management authorizations in seconds, real-time risk stratification via predictive analytics, and self-service performance scorecards spanning readmissions, ED utilization, PCP follow-up, and micro-market rankings. This is paired with a Network Management service that employs dedicated Network Performance Managers across Pennsylvania, New York, West Virginia, and Delaware to build and condition high-performing provider networks and design value-based reimbursement programs.
Helion monetizes through a combination of subscription/recurring technology fees and managed services revenue from payers and post-acute providers, with a value-based reimbursement overlay that aligns provider incentives to quality metrics. Go-to-market is direct enterprise and partnership-based sales to health plans and provider networks, supported by case-study-led content marketing and a corporate website lead-capture flow. Pricing is not publicly disclosed and contracts appear to be relationship-driven rather than transactional. The company was founded in 2016, is headquartered in Pittsburgh, Pennsylvania, and operates with 51–100 employees. There are no disclosed funding rounds, M&A activity, or external investor ownership; Helion is funded and controlled inside the Highmark enterprise.
Helion firmographics
Firmographics- Name
- Helion
- Legal name
- Helion
- Website
- https://helion.health
- Company type
- Private
- Founded year
- 2016
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Short description
- Helion is a healthcare technology and services subsidiary of Highmark Inc. that helps health plans and post-acute care providers (skilled nursing facilities and home health agencies) reduce readmissions, improve quality metrics, and manage value-based reimbursement through its Helion Arc Technology platform and Network Management services across Pennsylvania, New York, West Virginia, and Delaware.
- Ownership category
- akta.pro rank
Helion industry classification
Industry- Product category
- Post-Acute Care Technology and Network Management
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Management Consulting Services (54161)
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370), Services-Computer Programming Services (7371), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Data Aggregation, Interoperability & APIs for RPM (FHIR/IoMT Gateways) (HLACAFAO)
- akta.pro secondary industries
- Healthcare Provider ERP (Hospital Operations, Supply Chain, Finance) (HDAEAEAH), Health Economics & Outcomes Research (HEOR) (HLAIAKAB)
Keywords
Where Helion is headquartered
LocationHeadquarters
- HQ city
- Pittsburgh
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Helion business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Operations, Marketing or Sales
Revenue model
- Value-Based Reimbursement Programs: Helion generates value by helping providers earn incentives for providing better care through quality-based metrics. Their solutions create optimized cost and opportunities for providers to earn incentives.
- Healthcare Technology and Services Fees: Revenue generated from providing technology solutions, data analytics, network management, and consulting services to payers and providers in the post-acute care space.
Go-to-market motion1 record
Distribution channels2 records
Marketing channels3 records
Helion product offering
Product offeringCore offering
Helion sells a healthcare technology platform and managed network services to payers and post-acute care providers. The Helion Arc Technology platform delivers automated authorizations, real-time patient assessments, and performance analytics built on a proprietary database of five years of OASIS assessments and claims data. Network Management provides a high-performance network optimization system with dedicated Network Performance Managers who coach providers on quality, care transitions, and value-based reimbursement.
Product overview
Helion is a healthcare technology and services company offering a platform-plus-modules architecture consisting of two core components: Helion Arc Technology (a knowledge-based capability suite for care delivery and administration) and Network Management (a proprietary high-performance network optimization system). Helion Arc Technology provides automated authorizations, real-time patient assessments, and performance analytics, while Network Management delivers network conditioning, care transition architecture, provider development, and network optimization capabilities. Together, these solutions enable payers and post-acute care providers to manage value-based care and improve patient outcomes.
Differentiator
Problem solved
Functional benefit
Brands
- Helion Arc Technology: A knowledge-based capability suite for home and community care that delivers insights to enable enhanced care delivery and administration, including automated authorizations, real-time patient assessments, and performance analytics.
Products and services
- Helion Arc Technology A knowledge-based capability suite for home and community care that delivers insights to enable enhanced care delivery and administration. It includes automated authorization decision support, real-time patient assessments using clinical algorithms, and self-service performance analytics. It is built for health plans, payers, and post-acute care provider organizations seeking to reduce administrative cost and improve quality.
- Network Management A proprietary high-performance network optimization system that delivers a path to true value-based care for payers and post-acute providers. A dedicated Network Performance Manager works with providers to improve quality outcomes, optimize referral patterns, and reduce total cost of care. It is delivered to health plans and post-acute care provider organizations.
Quantifiable outcome
- 30-day readmission rates reduced by up to 21% and 16% at SNFs
- +8 more outcomes
Companies that use Helion
Customer profileNamed customers6 records
Segments3 records
Ideal customer profiles2 records
Helion technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability4 records
Feature10 records
Helion partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- Highmark Inc.coreHelion is owned, made available, and maintained by Highmark Inc. and/or by its subsidiaries or affiliates. Helion operates as part of the Highmark enterprise, providing post-acute care technology and services solutions.
Scale indicators1 record
Recent moves1 record
Expansion highlights4 records
Helion competitors and assessment
Company assessmentDirect peers
- Homecare Homebase: Homecare Homebase is a dominant home health EHR and operational platform whose analytics and mobile point-of-care capabilities overlap with Helion's home and community care focus.
- PointClickCare: PointClickCare is a leading EHR and care-coordination platform for skilled nursing facilities and post-acute providers, with growing analytics and risk-stratification capabilities that compete with Helion Arc on the provider side.
- WellSky: WellSky is a major post-acute and home-based care technology platform offering analytics, network management, and value-based care enablement — directly overlapping with Helion's payer-facing network management and analytics capabilities.
- MatrixCare (ResMed): MatrixCare provides EHR and operational technology to skilled nursing, home health, and hospice providers. Its analytics modules overlap with Helion's provider-facing performance scorecards and care transition architecture.
- Netsmart Technologies: Netsmart offers EHR and care coordination technology across post-acute and behavioral health, with analytics and value-based care enablement features that compete for the same provider and payer budgets as Helion.
- naviHealth (UnitedHealth Group): naviHealth is a post-acute care management platform owned by UnitedHealth Group that partners with payers and providers to manage post-acute episodes — a closely analogous business model to Helion's payer-provider network approach.
Emerging players
- Trella Health: Trella Health provides post-acute analytics and market intelligence to home health, hospice, and SNF providers, overlapping with Helion's performance data, scorecards, and micro-market ranking capabilities.
- Applied OLAP (Smartsheet / clinician analytics): Applied OLAP provides analytics tooling widely used by home health and hospice agencies for OASIS-based reporting, comparable to the OASIS-driven analytics and reporting capabilities in the Helion Arc platform.
Broad incumbents
- Optum (UnitedHealth Group): Optum is a broad healthcare services and analytics platform that increasingly serves payers and risk-bearing providers with population health and value-based care enablement — an incumbent competitor across adjacent value-based care segments.
- CareCentrix (Walgreens Boots Alliance): CareCentrix is a national post-acute and home-based care management company serving major health plans — a broader, more diversified analog to Helion's payer-facing post-acute network management business.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat3 records
Key risks6 records
Key highlights7 records
Customer concentration
Helion social profiles
Digital presenceHelion financial estimates
Financial estimateRevenue estimate
Valuation estimate
Helion leadership team
Management profileNumber of profiles
Profiles5 records
Helion funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Helion M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Helion
What does Helion do?
Helion sells a healthcare technology platform and managed network services to payers and post-acute care providers. The Helion Arc Technology platform delivers automated authorizations, real-time patient assessments, and performance analytics built on a proprietary database of five years of OASIS assessments and claims data. Network Management provides a high-performance network optimization system with dedicated Network Performance Managers who coach providers on quality, care transitions, and value-based reimbursement.
Is Helion a public or private company?
Helion is a private company. It is classified as corporate owned and is currently operating.
When was Helion founded?
Helion was founded in 2016. It employs 51 to 100 people.
Where is Helion based?
Helion is headquartered in Pittsburgh, United States, in the North America region.
How does Helion make money?
Two revenue lines are on record. Value-Based Reimbursement Programs are the primary driver. The others are healthcare Technology and Services Fees.
Who are Helion's main competitors?
Direct peers on record are Homecare Homebase, PointClickCare, WellSky, MatrixCare (ResMed), Netsmart Technologies and naviHealth (UnitedHealth Group). Emerging players are Trella Health and Applied OLAP (Smartsheet / clinician analytics). Broad incumbents are Optum (UnitedHealth Group) and CareCentrix (Walgreens Boots Alliance).
Does Helion have an API?
No public API is recorded for Helion.
What industry is Helion in?
Helion's product category is Post-Acute Care Technology and Network Management. Its primary akta.pro industry code is HLACAFAO, Data Aggregation, Interoperability & APIs for RPM (FHIR/IoMT Gateways), with a secondary code of HDAEAEAH, Healthcare Provider ERP (Hospital Operations, Supply Chain, Finance). Its NAICS code is 51821 and its SIC code is 7370.