Value-based care, measured and won
Newbula’s risk and quality suite turns claims, pharmacy, and encounter data into worklists your team can act on — protecting risk-adjusted revenue and closing quality gaps before deadlines.
Risk adjustment
Know your RAF position and exactly which charts move it.
MRA analysis
Medicare risk adjustment scoring across your panel with payment-year semantics and blend configurations handled correctly.
HCC optimization worklists
Suspected and historical HCC gaps become prioritized worklists with a confirm-and-capture workflow.
Data imports
Bring in plan financials, claims, and pharmacy files with mapped, repeatable imports.
Quality measures
HEDIS tracking
Daily-refreshed HEDIS measure rates with member-level gap lists, backed by claims evidence.
Transitions of care (TRC)
A dedicated workflow for the TRC measure: discharges, follow-ups, and documentation in one queue.
Part D adherence (PDC)
Medication adherence tracking that flags members drifting below PDC thresholds while there is still time to act.
CMS Stars rating
Track your Star measures and see which improvements move the overall rating.
MLR financial analysis
Medical loss ratio dashboards built from your plan financial imports — revenue, claims, and pharmacy in one view.
License manager
Organization licenses and certifications tracked with expiration reminders.
From raw files to closed gaps
- 1
Import plan data
Load eligibility, claims, pharmacy, and financial files with saved mappings per payer.
- 2
See the gaps
Dashboards score RAF, HEDIS, and Stars; worklists rank the members and codes worth acting on.
- 3
Work the lists
Coders confirm HCCs, care teams close quality gaps, and outreach campaigns engage the members involved.
- 4
Watch the numbers move
RAF, measure rates, and MLR update as your work lands — with traceability behind every figure.
Turn risk and quality into a managed process
See how Newbula unifies patient management, outreach, and risk analytics for your organization. Get started in less than a week.
Free onboarding and training included.