Next-gen care and utilization management: How Elligint Health uses AI and analytics to transform patient care solutions

The following is the latest in our “Brief interviews with healthcare innovators” series highlighting some of the innovative companies in the Labcorp Venture Fund portfolio. The mission of the Labcorp Venture Fund is to strategically invest in cutting-edge businesses that make healthcare more personalized, accessible and convenient to improve health and improve lives. 

One focus area is on innovators who are using technology to satisfy their mission of improving health system operations and patient experiences while simplifying and reducing the growing duties of physicians, healthcare staff and administrators alike.

Part two of our series features Serena Guzman, Senior Vice President of the Atlantic Division, with the CEO of Elligint Health, Chris Caramanico, a trailblazing company dedicated to simplifying the complexities of value-based care delivery.

Origination of Innovation

Serena Guzman: Can you tell us about the creation of Elligint Health?

Chris Caramanico: Elligint Health began in January of 2025 by fusing HealthEC’s advanced population health analytics capabilities with VirtualHealth’s award-winning Helios® medical management solution. Together, we deliver integrated, data-driven solutions that simplify the complexities facing payers and providers operating under value-based care models. 

Serena Guzman: How did this merger influence your mission?

Chris Caramanico: Many organizations struggle to make the operational and process changes needed to deliver the right care to the right member at the right time because of outdated technology. By merging the two companies, our mission became clear: give payers and providers actionable interventions through precision-driven analytics, automated workflows and unified care coordinated by creating an ecosystem of care within a single unified platform.

Serena Guzman: What inspired this venture into simplifying value-based care?

Chris Caramanico: The healthcare landscape is rapidly evolving, so providers and payers are being asked to collaborate and deliver more value. Yet many still struggle with:

• Operational inefficiencies
• Disconnected data systems
• Administrative burdens that take time away from patient care

Our solutions create an ecosystem that reduces friction and strengthens performance across the entire continuum—from utilization and care management to quality reporting and financial analytics. We use smart automation and data integration to feed our suite of workflows for prior authorizations, care plans and assessments to help solve the systemic problems of:

• Rising costs
• Care fragmentation
• Inefficient utilization management
• Reporting burdens of value-based care

New technology in healthcare

Serena Guzman: That's an ambitious mission. Can you describe your innovative solution and how it works in practice?

Chris Caramanico: Operating seamlessly in the background, our solutions provide insights without requiring human intervention or disrupting clinical workflows. Our uniquely scalable platform brings together computer vision, natural language processing, AI/machine learning, large language models, ultra-wideband tracking and real-time location data to assist health systems with: 

• Disease management
• Utilization management
• Population health analytics
• Integrated care management

This approach allows for real-time decision-making and increased privacy. Using our FHIR-based data hub, we aggregate clinical, claims and other data from diverse sources into a single, comprehensive view.

Serena Guzman: Wow, all in a single view? How does that work?

Chris Caramanico: The Helios ecosystem includes a range of plug-and-play partner apps for quality reporting, clinical decision support, patient engagement and more. This drives efficiencies across the care continuum while ensuring compliance and facilitating seamless adoption. Clients can rapidly configure these tools to their specific needs through our intuitive user interface.

Serena Guzman: How does this approach differ from existing healthcare solutions? 

Chris Caramanico: Unlike siloed, single-purpose tools, our Smart Platform is designed to scale and adapt to multiple disciplines, departments and workflows across the entire healthcare enterprise. This level of agility, connectivity and productivity is truly disruptive.

Helios provides exceptional flexibility, powerful rules engines, customizable workflows and seamless integration capabilities that:

• Stands out for its remarkable 90% configurability
• Can increase care team efficiency by up to 93%
• Accelerates implementation and organization-wide data sharing by 65% compared to non-FHIR approaches

How technological innovation enhanced patient care, efficiency and cost savings

Serena Guzman: It certainly sounds innovative. Can you share some measurable results demonstrating your impact on health systems? 

Chris Caramanico: Absolutely. We've helped health systems deliver compelling gains in efficiency, patient care quality and cost savings: 

• One client reported an 85% increase in care manager efficiency
• Another health system saw care managers take on 92% more cases per month 
• Prior authorization processes are streamlined, with most decisions delivered within 72 hours
• Another client credited Helios with reducing readmissions and closing gaps in health-related social needs
• Overall, clients report better identification and service of complex-care patients leading to reduced readmissions, improved overall health outcomes and cost savings

By tracking productivity and outcomes, our solutions also help assess effectiveness of interventions and programs to make sure we’re making positive impacts on improving patient care and outcomes while reducing costs.

The future of innovation in healthcare

Serena Guzman: Those are impressive results! Looking ahead, what future innovations is Elligint Health pursuing to expand its impact across healthcare?

Chris Caramanico: Most importantly, we're committed to building lasting partnerships across healthcare through responsive service, future-ready innovation and constantly obtaining insights into real-world challenges. Looking ahead, we’re focused on several key areas of innovation:

1. Connected apps: Developing a comprehensive library of self-service integrations with external tools to automate workflows while preserving clinical context.

2. Narrative query language (NQL): Exploring the use of NQL to make data access as intuitive as asking a question, similar to natural-language interfaces found in AI tools.

3. Real-time dashboards: Examining the use of real-time dashboards for sentinel metrics highlighting early health warning signs for proactive intervention.

4. Predictive health: Harnessing AI to detect early signals that portend declining health by analyzing a blend of clinical history, lifestyle factors, genetic markers and environmental data.

We're also tracking emerging trends like CMS's new interoperability mandates, evolving quality measures and AI applications in care management.