HealtheFirst

What HealtheFirst does

HealtheFirst is a private SaaS company founded in 2017 and headquartered in Edina, Minnesota (legal jurisdiction Wyoming) that builds HIPAA-compliant, SOC 2 certified case management platforms for healthcare and adjacent service organizations. Its product portfolio is organized around three core offerings — Home Care, Correctional Managed Care, and Utilization Management — plus a Custom Case Management configuration layer and several vertical modules covering Athletic Training, Sports Medicine, Education Management, Special Education Management, Consulting Services, and Incident Management. Underlying technology includes a custom form builder, configurable workflow engine, Electronic Visit Verification with GPS timestamping, smart scheduling, automated 837P claim generation and 278 generation, billing/payroll with clearinghouse integration, audit-grade reporting, and HIPAA-compliant messaging and video. Infrastructure is operated through a managed services partner (HIPAA Vault) and the platform integrates with InterQual, Plexis, Stripe, and external clearinghouses.

The business model is a hybrid sales-led and product-led subscription SaaS: a $500/month base subscription (unlimited staff, forms, services, storage, archived patients, 24/7 support) plus tiered per-patient unit pricing ($5/patient/month for patients 51-300 and $4/patient/month for 301+), with no setup fees and a 60-day cancellation notice. Go-to-market combines self-serve onboarding, Calendly-scheduled demos, and a content marketing engine targeting state Medicaid waiver programs across 40+ US states. Leadership is founder-led and family-involved (CEO Steve Clute, CTO Joe Pacilio, CSO Greg Clute), supplemented by a clinical and operations advisory bench drawn from Mayo Clinic, Yale-trained physicians, and former PwC talent.

Name

HealtheFirst

Legal name

HealtheFirst

Website

https://healthefirst.com

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

1–10 employees

Short description

HealtheFirst is a private SaaS company that sells HIPAA-compliant, SOC 2 certified case management platforms to home healthcare agencies, correctional facilities, utilization management organizations, and several adjacent verticals (athletics, education, consulting) on a $500/month plus per-patient subscription.

Ownership category

akta.pro rank

Product category

Healthcare Case Management Software

NAICS

Home Health Care Services (621610), Health Care and Social Assistance (62)

SIC

Services-Prepackaged Software (7372), Services-Health Services (8000)

akta.pro industry

PRIMARYHLACAAAG

Nursing, Clinical Notes & Documentation Workflow Tools

Healthcare & Life Sciences/Digital Health & Health IT/Electronic Health Records (EHR/EMR) & Clinical Documentation

SECONDARYHLACAAAJ

Clinical Forms, Templates & Digital Consent (eSignature)

Healthcare & Life Sciences/Digital Health & Health IT/Electronic Health Records (EHR/EMR) & Clinical Documentation

SECONDARYHLACAJAJ

Governance, Risk & Compliance (GRC) + HIPAA/HITRUST/ISO Readiness

Healthcare & Life Sciences/Digital Health & Health IT/Healthcare Cybersecurity, Identity & Privacy

SECONDARYHLACAEAA

Patient Portals & Self-Service Access

Healthcare & Life Sciences/Digital Health & Health IT/Patient Engagement, CRM & Experience Platforms

Keywords

• Case management software
• Healthcare SaaS platform
• HIPAA compliant software
• Home care management
• Utilization management system

Headquarters

HQ city

Edina

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, Infrastructure, Marketing or Sales, Operations

Revenue model

1. SaaS Subscription - Base Access: Monthly subscription model with base access starting at $500/month. Includes unlimited staff members, digital forms, services, storage, and archived patients plus 24/7 support tickets and knowledgebase access.
2. Per Patient Fee: Tiered per-patient pricing: First 50 patients free, patients 51-300 at $5/patient/month, patients 301+ at $4/patient/month. Scales with customer growth.

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels5 records

Core offering

HealtheFirst provides a HIPAA-compliant, SOC 2 certified SaaS case management and business operating system built for healthcare and service organizations. The platform delivers customizable workflows, scheduling, electronic visit verification, billing/payroll, secure communication, reporting, and patient portals. Its core products are Home Care, Correctional Managed Care, Utilization Management, and Custom Case Management, with additional vertical modules for athletic training, education, consulting, and incident management.

Product overview

HealtheFirst is a HIPAA-compliant, SOC-certified SaaS case management platform offered as a unified system with multiple specialized modules. The core portfolio consists of three main products (Home Care, Correctional Managed Care, and Utilization Management) plus Custom Case Management, all built on the same adaptable platform. Additional vertical-specific modules include Athletic Training, Sports Medicine, Education Management, Consulting Services, Incident Management, and Special Education Management, allowing organizations to use a single platform across diverse service categories or select specific modules tailored to their industry.

Differentiator

Problem solved

Functional benefit

Products and services

• Home Care Comprehensive case management platform for home healthcare agencies offering scheduling, workforce management, secure communication, billing, payroll, patient portal, visit verification, encounter templates, and 278 generation.
• Correctional Managed Care Case management solution designed for correctional facilities to track and guide inmate healthcare with color-coded encounter types, autocomplete fields, and direct access to inmate journey documentation.
• Utilization Management All-in-one care platform customized for utilization review workflows with customizable call scripts, nomenclature, encounter types, integrated InterQual decision support, and automatic 278 generation.
• Custom Case Management Adaptive case management platform that scales to diverse organizational needs with custom form builder, workflow creation, documentation, scheduling, billing, audit support, and electronic visit verification.
• Athletic Training Sports medicine management solution for athletic trainers enabling athlete scheduling, pre-appointment forms, custom training plans, progress charting, and secure communication.
• Sports Medicine Solution for athletic trainers and physical therapists to manage documentation, accountability, and analysis for athletes in clinics and schools.
• Education Management Platform for educational institutions featuring teacher and student portals, test scheduling, learning plan management, support ticketing, and email notifications for assessments.
• Consulting Services Project and consulting management solution with custom project templates, tracking visualizations, simplified payroll, Stripe-based invoicing, reporting, analytics, and support ticketing.
• Incident Management Incident reporting and crisis management solution for recording incidents, managing responses, and maintaining HIPAA-compliant documentation across schools, offices, and healthcare centers.
• Special Education Management Case management approach for K-12 schools coordinating multiple resources to support student success with individualized learning tools.

Quantifiable outcome

• ROI 'fantastic' and 'company grown exponentially' for agencies managing 150 cases
• +3 more outcomes

Named customers7 records

Segments6 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

Feature12 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• HIPAA VaultcoreTechnology or IntegrationHIPAA Vault is a managed services provider specializing in HIPAA compliance and system security. They provide server hosting and managed services for HealtheFirst's infrastructure, managing day-to-day operations. HIPAA Vault undergoes regular third-party audits and maintains certifications including NIST, HIPAA, HITECH, SOC 2, and SOC certifications.
• Home Health Association of Utah (HHAU)minorStrategic or Co-development PartnerPartner organization listed on HealtheFirst's leadership team page, representing home health agencies.
• Hei Global HealthminorStrategic or Co-development PartnerPartner organization listed on HealtheFirst's leadership team page, focused on global health solutions.
• ACMA (American Case Management Association)minorStrategic or Co-development PartnerProfessional association partner supporting case management professionals and organizations.
• VNA ColoradominorStrategic or Co-development PartnerVisiting Nurse Association partner providing home health services in Colorado.
• Hill MurrayminorStrategic or Co-development PartnerPartner organization listed on HealtheFirst's leadership team page.
• InterQualcoreTechnology or IntegrationReady-made integration with InterQual for utilization management decision support, allowing seamless data integration with HealtheFirst's platform.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• WellSky: WellSky (formerly Kinnser) is the largest SaaS platform for home health, hospice, and post-acute providers, offering case management, scheduling, billing, and EVV. It is the closest direct competitor to HealtheFirst's Home Care and Utilization Management modules in the Medicaid HCBS and home health buyer segment.
• MatrixCare: MatrixCare (owned by ResMed) provides EHR and care management for skilled nursing, home health, hospice, and senior living. It overlaps directly with HealtheFirst's case management, scheduling, and clinical documentation capabilities for post-acute agencies.
• Netsmart Technologies: Netsmart serves behavioral health, home health, hospice, and correctional healthcare with an integrated EHR and case management platform. Its correctional healthcare suite is a particularly direct competitor to HealtheFirst's Correctional Managed Care product.
• Axxess: Axxess is a Texas-based home health technology company offering agency management, EHR, billing, and EVV. It targets a very similar SMB-to-mid-market home health and hospice customer as HealtheFirst and competes head-to-head on per-patient pricing models.
• KanTime: KanTime provides post-acute care software spanning home health, hospice, palliative care, and behavioral health with EVV and billing workflows. It overlaps closely with HealtheFirst on case management, scheduling, and Medicaid waiver billing functions.
• Forcura: Forcura is a healthcare workflow and document management platform for home health, hospice, and post-acute providers. Its workflows for referrals, document routing, and secure communication compete with HealtheFirst's customizable workflow and secure messaging features.
• Homecare Homebase: Homecare Homebase (an HCHB / Hearst Health business) is the dominant EMR for large home health and hospice agencies, with deep clinical, scheduling, and billing capabilities. It competes for the same enterprise home health and waiver-program customers that HealtheFirst targets.
• ClearCare (WellSky Personal Care): ClearCare, now part of WellSky's Personal Care platform, is a software + EVV solution for personal care services and Medicaid HCBS waiver programs. It directly competes with HealtheFirst's home care and EVV features for the personal-care agency segment.
• CentralReach: CentralReach provides EHR, practice management, and clinical solutions for behavioral health, applied behavior analysis (ABA), and IDD services. It is comparable to HealtheFirst's utilization management and custom case management modules in adjacent human-services verticals.

Broad incumbents

• Epic Systems: Epic is the dominant enterprise EHR for hospitals and large health systems, with growing ambulatory, home health, and post-acute extensions. HealtheFirst occasionally integrates with Epic-adjacent systems (advisor Dr. Jason Fratzke led Mayo's enterprise EHR transition) and competes for case management scope within IDNs.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks7 records

Key highlights7 records

Customer concentration

• Xx.com/HealtheFirst
• YouTubeyoutube.com/channel/UCmuqhFWh2lpYwI6uH4cGHEQ
• Facebookfacebook.com/healthefirst
• LinkedInlinkedin.com/company/healthefirst

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

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 HealtheFirst