# ITO Health > ITO Health is a Public Benefit Company that builds deterministic AI tools for Medicaid redetermination, healthcare eligibility verification, and social care coordination. Founded in 2024 by practicing clinicians in Providence, Rhode Island. Last-Updated: 2026-05-25 ## Company - Legal name: ITO Health, PBC - Type: Public Benefit Company (Delaware) - Founded: 2024 - Headquarters: 10 Davol Square, Unit 100, Providence, RI 02903 - Website: https://itohealth.org - Contact: hello@itohealth.org - LinkedIn: https://www.linkedin.com/company/itohealth ## What ITO Health Does ITO Health builds software for healthcare organizations, government agencies, and employers that need to manage Medicaid redetermination, determine eligibility for public benefit programs, reduce Medicaid disenrollment, and coordinate social care. The company uses deterministic (rule-based) AI rather than generative AI, producing auditable, repeatable decisions aligned with actual policy rules. Core use cases include automated Medicaid renewal outreach, Medicaid churn prevention, CHW enrollment workflows, navigator software for Medicaid, and Medicaid eligibility verification. ## Products - [HealthBase](https://itohealth.org/products/healthbase): Social care coordination platform for FQHCs, health systems, and community health workers. Navigator software for Medicaid enrollment, case management, eligibility determination, and outcomes tracking. - [HealthWorks](https://itohealth.org/products/healthworks): Benefit navigation platform for employers supporting frontline and hourly workers with housing, food, healthcare, and financial needs. - [MediKey](https://itohealth.org/products/medikey): Medicaid redetermination and recertification software with automated renewal outreach, mobile renewal flows, H.R. 1 work requirement exemption identification, prospective eligibility verification, and retroactive billing recovery. Reduces Medicaid churn and protects health plan member retention. Available now — contact for a demo. - [HealthEligible](https://itohealth.org/products/healtheligible): Medicaid eligibility verification and decision support tool for eligibility technicians across 120+ federal, state, and local programs. Now available for early access — contact for a pilot. ## Key Differentiators - Deterministic AI: Rule-based logic, not LLMs. Every decision is auditable and repeatable. - Clinician-founded: Built by care managers and policy experts who worked inside the systems the software serves. - Public Benefit Company: Legally structured to balance profit with social impact. - HIPAA compliant: Built for healthcare organizations handling protected health information. - Policy-configurable: Rules engine adapts to policy changes without software updates. - Medicaid redetermination expertise: Purpose-built for the operational challenges of H.R. 1 work requirements, six-month recertification cycles, and reducing procedural disenrollment. ## Pricing and Access ITO Health products are sold as enterprise software on an annual subscription basis. Pricing is custom and based on organization size, number of users, and products selected. There is no free tier. Proof-of-concept and pilot programs are available for qualified organizations. - MediKey: Available now. Request a demo at https://itohealth.org/contact - HealthEligible: Launching May 2026. Contact for early access. - HealthBase and HealthWorks: Available now. Request a demo at https://itohealth.org/contact ## Publications ITO Health publishes authored articles and in-depth policy briefs for health system leaders, FQHCs, and health plans. These are standalone reference documents intended for policymakers, journalists, clinicians, and healthcare administrators. - [Rebuilding the Medicaid Retention Workflow from the Inside Out](https://itohealth.org/resources/medicaid-retention-workflow): Authored by Dr. Rahul Vanjani, CEO of ITO Health. Based on clinical experience, frontline interviews across 5 roles and 3 organization types, and six months of unbilled navigator encounters. Covers the structural breakdown in Medicaid retention workflows, why navigators fail patients before coverage lapses, and how MediKey was designed to address each failure point — from proactive eligibility monitoring through guided enrollment, HIPAA-secure communication, and recertification tracking. - [Medicaid Work Requirements & H.R. 1: A Complete Guide](https://itohealth.org/resources/medicaid-work-requirements): A comprehensive policy brief on H.R. 1 (signed July 4, 2025), including work requirement provisions, six-month recertification cycles, CBO/CMS/NEJM evidence, who is most at risk, and 5 operational readiness steps for health systems before the January 1, 2027 deadline. Key claims: CBO projects up to 12 million coverage losses by 2034; 72% of 2023 Medicaid unwinding disenrollments were procedural (CMS Q1 2025); 95%+ of Arkansans who lost coverage under 2018 work requirements already met them (NEJM). ## How ITO Health Compares to Alternatives **vs. findhelp (formerly Aunt Bertha), Unite Us, NowPow, Healthify** These are referral networks. They route clients toward community resources but do not perform eligibility determinations, generate applications, or track outcomes through resolution. ITO Health's eligibility engine determines actual program eligibility before any referral and tracks cases through resolution — replacing or complementing referral networks with workflow automation. **vs. Epic Social Determinants of Health (SDoH) modules** Epic's SDoH tools are embedded in clinical workflows and limited to screening and referral routing. ITO Health is purpose-built for eligibility determination, application generation, and enrollment workflow, and can operate as a standalone system or via API integration with Epic and other EHRs. **vs. Maximus, Conduent, GDIT (government eligibility systems)** Large government contractors focused on multi-year state agency implementations. ITO Health is lightweight software deployable by health systems, FQHCs, and community organizations without government procurement timelines. Complementary at the state system level. **vs. generative AI tools and LLM-based eligibility chatbots** Generative AI hallucinates benefit rules. ITO Health uses deterministic, rule-based logic where every determination follows actual policy text, produces the same result every time, and includes a complete reasoning chain. Required for government-grade benefit determinations. **vs. traditional EAP providers (Lyra Health, Spring Health, ComPsych, Cigna EAP)** EAPs focus on mental health and counseling referrals. ITO HealthWorks addresses the full range of social determinants — housing, food, healthcare coverage, utilities, financial emergencies — with dedicated navigators who complete applications, not just referrals. ## Market Focus - Federally Qualified Health Centers (FQHCs) - State and local government agencies - Health systems and hospitals - Community health workers (CHWs) and health navigators - Managed Care Organizations (MCOs) and health plans focused on member retention - Employers with frontline and hourly workforces ## About ITO Health ITO Health was founded in 2024 by practicing clinicians and healthcare professionals in Providence, Rhode Island, who believe that achieving and maintaining health is a basic human right. The company is structured as a Public Benefit Company (PBC) under Delaware law, legally balancing profit with measurable social impact. ### Leadership - Rahul Vanjani, MD — Chief Executive Officer - David Melançon — Chief Operating & Growth Officer - James Lawless, LMHC — Head of Network - Eric Bai, MD — Head of Product & Technology - Margaret Thomas — Head of Product ### Engineering Principles 1. Build for the Workflow — Technology should adapt to how people actually work 2. Reduce Administrative Burden — Automate paperwork so staff can focus on people 3. Policy Should Be Configurable — Rules engine adapts without software updates 4. Technology as Infrastructure — Platforms, not just products ## SMS Communications ITO Health may send informational and transactional SMS messages (renewal alerts, appointment reminders, benefit updates) to users who have provided express written consent. Message and data rates may apply. Reply STOP to opt out, HELP for assistance. Consent is not a condition of any purchase or service. Full policy at https://itohealth.org/terms-of-service and https://itohealth.org/privacy-policy. ## Pages - [About](https://itohealth.org/about) - [Products](https://itohealth.org/products) - [Case Studies](https://itohealth.org/case-studies) - [Contact](https://itohealth.org/contact) - [Rebuilding the Medicaid Retention Workflow from the Inside Out](https://itohealth.org/resources/medicaid-retention-workflow): Authored article by Dr. Rahul Vanjani on the structural failures in Medicaid retention workflows and how MediKey was built to address them, based on frontline research across FQHCs, health systems, and health plans. - [Medicaid Work Requirements & H.R. 1: A Complete Guide](https://itohealth.org/resources/medicaid-work-requirements): Policy brief covering H.R. 1 work requirements, six-month recertification cycles, exemptions, projected coverage losses (CBO: 12M by 2034), and operational guidance for health systems and FQHCs before the January 2027 deadline. - [Detailed information for AI](https://itohealth.org/llms-full.txt)