Revella Health

What Revella Health does

Revella Health, Inc. is a privately held, nurse-founded healthcare services company headquartered in Birmingham, Alabama, that contracts with Medicare Advantage and ACA Marketplace health plans to deploy clinical teams into community settings (mini-clinics, health fairs, community events) for face-to-face member encounters. Each encounter combines point-of-care diagnostics, preventive screenings, validated social determinants of health screening, and PCP attribution verification, with the company reporting an average of 4.5 HEDIS care gaps closed per visit and 3,500+ gaps closed per month in production across multiple states. The platform is explicitly engineered for encounter-data-only risk adjustment regulatory models, capturing HCC diagnoses concurrently with clinical care rather than via retrospective chart review, which the company positions as a structural advantage as CMS curtails unlinked chart reviews and in-home assessments that code without care delivery.

The business model is an outcome-based managed services engagement: Revella operates as a quality improvement vendor — explicitly noting it does not need to be included in plan bids — and is paid based on measurable HEDIS gap closure and HCC risk adjustment capture that drive Star Ratings, QRS ratings, and NCQA accreditation outcomes for its health plan customers. Payer ROI on direct reimbursement is cited at 6.2:1, and accurately HCC-coded members are reported to generate $150–$230/month more in capitated revenue. The go-to-market is consultative enterprise field sales targeting health plan executives and quality improvement leaders, using 20-minute Calendly demo bookings, dedicated financial case landing pages, and conference presence (e.g., Rise National 2026 MA Workshop on Stars & Quality), with pilot engagements beginning at a minimum of 500 members per H-Number before conversion to full multi-year contracts. Distribution is B2B2C: once a health plan contracts, Revella deploys clinical teams at network provider practices at no cost and no workflow change to the practice, and the company also offers direct clinical documentation and billing intelligence services to independent practices whose health plans are not yet contracted. Revella was selected into the Techstars Physical Health Fort Worth 2024 accelerator and has raised approximately $718,499 across three disclosed funding rounds between April 2024 and January 2025; one publicly named health plan partner is Ambetter of Alabama (Celtic Insurance Company).

Name

Revella Health

Legal name

Revella Health, Inc.

Website

https://revellahealth.com

Company type

Private

Founded year

2023

Operating status

Operating

Headcount range

1–10 employees

Short description

Revella Health is a nurse-founded healthcare services company that deploys community-based clinical teams to close HEDIS care gaps and capture HCC risk adjustment diagnoses for Medicare Advantage and ACA Marketplace health plans through face-to-face point-of-care encounters.

Ownership category

akta.pro rank

Product category

Healthcare Quality Improvement Services

NAICS

Offices of Physicians (62111)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Health Services (8000)

akta.pro primary industry

Post-Acute Care Networks & Care Management Organizations (HLAFAFAN)

akta.pro secondary industry

Patient Relationship Management (PRM) & CRM for Provider Growth (Marketing/Outreach) (HLACAEAO)

Keywords

• HEDIS gap closure
• Medicare Advantage quality
• Risk adjustment services
• Star Ratings improvement
• Clinical encounter services

Headquarters

HQ city

Birmingham

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Marketing or Sales, Technology or R&D

Revenue model

1. Health Plan Quality Improvement Contracts: Contracts with Medicare Advantage and ACA Marketplace health plans for point-of-care clinical encounter services that close HEDIS gaps and capture risk adjustment diagnoses. Revenue tied to measurable outcomes: gap closure performance and risk adjustment capture driving payer Star Ratings and benchmark factor improvements. Payer ROI on direct reimbursement is cited as 6.2:1. Under NCQA-aligned, HIPAA-compliant operating model.
2. HCC Risk Adjustment Capture: Captures HCC diagnoses during clinical encounters, generating accurate risk scores that translate to $150–$230/month more in capitated revenue per accurately coded member for health plan partners. Revenue derived from improved risk adjustment performance driven by encounter-level clinical documentation.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Revella Health deploys clinical teams into communities to deliver face-to-face clinical encounters that simultaneously close multiple HEDIS care gaps, capture HCC risk adjustment diagnoses with actual clinical care, perform SDoH screening, and verify PCP attribution. The service is sold to Medicare Advantage and ACA Marketplace health plans on an outcome-based contract model, with clinical encounters averaging 4.5 HEDIS gaps closed per member visit.

Product overview

Revella Health offers a single unified clinical service rather than a modular platform. The core offering deploys clinical teams into communities to deliver face-to-face clinical encounters that simultaneously close multiple HEDIS gaps, capture risk adjustment/HCC diagnoses with actual clinical care, perform SDoH screening, and generate the data needed for Star Ratings improvement. The company provides point-of-care diagnostics, preventive screenings, and PCP attribution verification during a single member visit, averaging 4.5 HEDIS gaps closed per encounter. Services are deployed at health plan-contracted provider practices at no cost to the practice, and the company also offers clinical documentation, billing intelligence, and quality measure reporting for independent practices.

Differentiator

Problem solved

Functional benefit

Products and services

• Revella Health Clinical Services

Quantifiable outcome

• 4.5 HEDIS gaps closed per member encounter (in production average)
• +5 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature6 records

Scale indicators6 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• Astrana Health: Astrana Health is a leading MA-focused MSO providing risk adjustment, quality management, and care coordination to Medicare Advantage plans. It addresses the same buyer (MA quality leaders) with a much larger capitated and delegated care footprint, making it the closest scaled analog to Revella's encounter-based HEDIS/HCC model.
• Agilon Health: Agilon Health is a value-based care enabler that partners with primary care physicians to manage MA populations, combining risk adjustment capture with quality gap closure and care management. It serves the same MA plan quality buyers with a broader capitated PCP partnership model that contrasts with Revella's community-encounter deployment.
• Oak Street Health (CVS Health): Oak Street Health is a national MA-focused primary care provider acquired by CVS Health that delivers in-clinic care designed to close HEDIS gaps and capture HCC diagnoses for senior members. It is comparable as a clinical-care-driven approach to MA quality, though it relies on brick-and-mortar clinics rather than Revella's community-encounter deployment model.
• VillageMD (Walgreens Boots Alliance): VillageMD is a value-based primary care platform with significant MA exposure via Summit Health and CityMD. It addresses similar quality and risk adjustment use cases for MA plans through PCP-led care, representing a scaled primary-care-led alternative to Revella's community-encounter approach.

Direct peers

• Signify Health (CVS Health): Signify Health is a national in-home health assessment vendor acquired by CVS Health that sends clinicians into member homes to capture HCC diagnoses and close quality gaps for MA plans. It is Revella's most direct functional competitor, differing primarily by operating in the home rather than community settings and by historically capturing risk without always delivering clinical care.
• Matrix Medical Network: Matrix Medical Network is an in-home and mobile clinical assessment provider serving MA, ACA, and Medicaid plans with risk adjustment and quality gap closure services. Like Revella, it competes on the ability to reach members that traditional provider networks miss, with overlap in the same payer buyer and the same HCC/HEDIS outcome contracts.
• Healthmap Solutions: Healthmap Solutions is a population health management vendor focused on kidney disease that delivers clinical interventions and risk adjustment capture for MA plans. It targets the same quality and risk leaders with an outcomes-based model similar to Revella's, though concentrated in a single therapeutic area.
• Integra Connect: Integra Connect provides value-based care technology and services including risk adjustment, quality improvement, and care management for health plans and provider groups. It targets the same MA plan buyers with risk adjustment and Stars enablement, positioning it as a direct adjacent competitor.

Emerging players

• Cotiviti (Pulse8): Cotiviti operates Pulse8, a risk adjustment and quality analytics platform serving MA and ACA plans. While primarily software/analytics, it competes for the same health plan quality budgets and is increasingly layering in clinical enablement, making it adjacent but emerging as a competitor to Revella's encounter model.
• Advata Inc. Advata is a healthcare data and analytics company focused on risk adjustment, quality, and clinical intelligence for health plans and providers. It is an emerging competitor in the MA risk adjustment and quality measurement space with partial functional overlap to Revella's HEDIS/HCC capture capability.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/revellahealth

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds4 records

Investors2 records

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 Revella Health