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Risk adjustment, quality and member outreach in one place. The same platform scores the gap and makes the phone call.

Request a demoSee a day in Newbula
Quality and riskMeasurement year 2026
78%
Gap closure
214 open, 96 in outreach
1.184
Average RAF, up 0.06 since January
Glycemic status
81%
Blood pressure
69%
Breast cancer screening
74%
Statin adherence
86%
MemberRAFSuspectedNext step
T. Brennan1.42CHF, CKD 3Visit booked
S. Varga0.96Diabetes w/ complicationsCall queued

A month at a health plan

From the payer file arriving to the gap being closed.

Day 1

  1. Files arrive

    Claims, pharmacy and eligibility files are imported and mapped for each payer.

    Imports

  2. Everything is scored

    RAF, HEDIS, Part D adherence and MLR update from the new data.

    Risk and quality

  3. Gaps become lists

    Members with open gaps are grouped by measure, language and PCP.

    Worklists

  4. Members are called

    AI voice agents invite members to book visits and screenings, and transfer when asked.

    Member outreach

  5. Visits capture conditions

    Suspected conditions are queued for documentation at each visit.

    Risk capture

  6. Reports go out

    Financial and quality reports are shared with payers and leadership.

    Reports

What changes

Less typing, fewer calls and nothing lost between systems.

Gaps discovered too lateMeasures arrive at year end.
Measures update with every monthly file.
Outreach that doesn't scaleCoordinators can't call every member.
AI agents call every member with an open gap.
Risk scores without evidenceNobody can explain a score.
Every RAF score shows the conditions and claims behind it.

Included in the health plans suite

Turn on what you need. Every tool shares one patient record.

Risk adjustmentMRA, RAF and HCC with full trace.
HEDIS and StarsMeasure rates against targets.
Part D adherenceStatins, diabetes and RAS medications.
MLR and financialsMedical loss ratio by payer and month.
EnrollmentEnrollment and disenrollment with documents.
Risk captureSuspected conditions to documented ones.
Member outreachAI voice campaigns from any gap list.
Payer importsPer-payer file mappings.
Reports and digestsScheduled and shareable.

Tools your team will use most

The pieces that save the most time, in detail.

Risk and qualityHEDIS, Stars, risk adjustment and MLRLearn moreAI voice agentsCalls, check-ins and callbacks in English and SpanishLearn moreFax and email inboxEvery document read, matched and routedLearn moreMedical centersFront desk, exam room and back officeLearn more

Give your team the day back.

Bring one workflow, like reminder calls or fax intake. We'll walk through it in Newbula with your data.

Request a demoExplore the platform
Or write to hello@newbula.ai