Novillus

What Novillus does

Novillus is a healthcare technology company that builds a workflow and analytics platform for health plans and provider groups to manage quality, risk adjustment, and provider data accuracy programs. The platform is built around three integrated modules: Care Gap Management Application (CGMA), which manages the Quality and Risk care gap lifecycle across Medicare, Medicaid, Commercial, and ACA lines of business and includes a purpose-built omnichannel CRM for provider engagement; Curate, an AI-powered chart abstraction solution using HIPAA-compliant NLP and clinical reasoning to perform first-level chart review with reported 95% average accuracy and a 77% reduction in unnecessary chart reviews; and Clean, a provider directory accuracy solution that verifies provider data directly with sources to support CMS No Surprises Act compliance. The technology stack combines proprietary AI for unstructured clinical document processing with workflow automation, real-time KPI tracking, and provider-facing portals, and integrates with existing health plan quality and risk engines to avoid forcing technology replacement.

Novillus generates revenue through subscription-based enterprise SaaS contracts sold to health plans on an annual billing cycle, with quote-based pricing that is not publicly disclosed. The go-to-market motion is direct enterprise field sales augmented by strategic consulting partnerships (notably Rex Wallace Consulting, announced May 2024) that extend reach into mid-market health plans focused on CMS quality measures and Medicare Star Ratings. The company serves two primary customer segments: health plans (Medicare Advantage, Medicaid managed care, Commercial, ACA) and provider groups/IPAs. Prior to the April 2025 acquisition by Reveleer, Novillus operated as a private company founded in 2015 and headquartered in Portland, Oregon, with 11-50 employees. The acquisition combined Novillus with Reveleer's value-based care platform, yielding a combined entity serving 72 million covered lives across 86 healthcare organizations in the U.S.

Name

Novillus

Legal name

Novillus

Website

https://novillus.com

Company type

Private

Founded year

2015

Operating status

Acquired

Headcount range

11–50 employees

Short description

Novillus is a healthcare technology company that provides a SaaS workflow platform for health plans and provider groups to manage quality, risk adjustment, and provider data accuracy programs across Medicare, Medicaid, Commercial, and ACA lines of business.

Ownership category

akta.pro rank

Product category

Healthcare Payer Workflow Software

NAICS

Computer Systems Design and Related Services (54151)

SIC

Services-Prepackaged Software (7372)

akta.pro primary industry

Clinical Document & Data Exchange (C-CDA, CCD, Direct Messaging) (HLACABAI)

Keywords

• Care gap management
• AI chart abstraction
• Provider data accuracy
• Health plan workflows
• Risk adjustment analytics

Headquarters

HQ city

Portland

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Healthcare Technology SaaS Platform: Subscription-based access to Novillus's health plan performance improvement platform including Care Gap Management, AI Chart Processing, and Provider Data Accuracy solutions. Revenue derived from health plan licensing and usage of the platform across quality, risk adjustment, and provider engagement workflows.

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels4 records

Core offering

Novillus provides a healthcare workflow platform for health plans that unifies quality and risk adjustment care gap management, AI-powered chart abstraction, and provider directory accuracy into a single integrated solution. Its three core offerings are the Care Gap Management Application (CGMA), the Curate AI chart processing module, and the Clean provider data accuracy solution, all supported by purpose-built omnichannel CRM for provider engagement.

Product overview

Novillus is a health plan workflow platform comprising three integrated modules: Care Gap Management Application (CGMA) for care gap lifecycle management, Curate for AI-powered chart abstraction and review, and Clean for provider directory accuracy. The platform unifies quality and risk adjustment workflows for Medicare, Medicaid, Commercial, and ACA lines of business, with integrated provider engagement and financial incentives.

Differentiator

Problem solved

Functional benefit

Products and services

• Care Gap Management Application (CGMA) A workflow platform enabling health plans to manage the Quality and Risk care gap lifecycle across all lines of business (Medicare/Star Ratings, Medicaid, Commercial, ACA). It provides real-time gap display, performance dashboards, audit support, targeted outreach via omnichannel CRM, satisfaction surveys, and engagement analytics for provider group collaboration and integrated financial incentive management.
• Curate An AI-powered chart abstraction solution that performs 1st-level review of medical charts quickly and accurately from any source, unifying quality and risk gap abstraction into a single-pass workflow. Uses HIPAA-compliant AI to achieve 95% average accuracy and reduce unnecessary chart reviews by 77%, doubling validator capacity.
• Clean A provider directory information accuracy solution that delivers 100% continuously verified provider data to meet CMS compliance requirements including the No Surprises Act. Features omnichannel outreach, direct data collection from providers, and attestation management achieving 92% provider CSAT.

Quantifiable outcome

• 95% average accuracy on AI chart review
• +5 more outcomes

Named customers2 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability7 records

Feature4 records

Partnerships

One partnership is on record.

• Rex Wallace ConsultingcoreStrategic or Co-development Partner · 20 May 2024Strategic partnership announced May 20, 2024 to better serve health plans focused on improving CMS quality program measures. RWC offers the Novillus Care Gap Management Application (CGMA) platform as part of their quality improvement consulting services. RWC provides industry expertise in health plan quality, Medicare Star Ratings, provider engagement, and health equity, while Novillus provides the technology platform for data-driven workflows and gap closure acceleration.

Scale indicators9 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Health Catalyst: Health Catalyst is a broader healthcare data and analytics enterprise platform with quality, risk, and population health offerings. While it spans a wider portfolio including provider systems, its payer-side quality and risk capabilities overlap with Novillus's platform.
• Optum (UnitedHealth Group): Optum operates a massive healthcare services and analytics portfolio including risk adjustment, quality, and provider data solutions. While much larger and broader than Novillus, its payer-facing analytics capabilities compete for similar health plan technology budgets.

Direct peers

• Edifecs: Edifecs specializes in healthcare data interoperability and clinical document exchange, including C-CDA processing - directly comparable to Novillus's Curate AI chart processing and clinical document workflow capabilities for health plans.
• Inovalon: Inovalon is a healthcare data analytics platform serving health plans with quality, risk adjustment, and provider data solutions - directly comparable to Novillus's care gap management and AI chart abstraction offerings for Medicare Advantage, Medicaid, and Commercial populations.
• Apixio: Apixio (acquired by Centene) offers AI-powered clinical data extraction and risk adjustment analytics for health plans. Its chart abstraction capabilities directly compete with Novillus's Curate solution for payer-side quality and risk workflows.
• Cotiviti: Cotiviti provides payment accuracy, risk adjustment, and quality improvement solutions for health plans. Its quality and risk workflow products compete directly with Novillus's CGMA platform, serving similar payer customers with analogous value-based care offerings.
• ZeOmega: ZeOmega provides a population health management and care management platform for health plans and payers. Its care gap identification and workflow capabilities overlap with Novillus's CGMA product for value-based care delivery.
• Reveleer: Reveleer is a value-based care technology platform that acquired Novillus in April 2025. It offers risk adjustment, quality improvement, and clinical intelligence solutions to health plans - directly overlapping with Novillus's CGMA, Curate, and Clean modules and serving the same payer customers.
• MedInsight (Milliman): MedInsight provides healthcare analytics and benchmarking for payers and providers, with risk adjustment and quality measurement capabilities that compete with Novillus's CGMA and Curate offerings in the value-based care market.
• Arcadia: Arcadia is a healthcare data platform serving payers and providers with quality measurement, risk adjustment, and care management analytics. Its quality and risk workflows compete with Novillus's CGMA and Curate for health plan customers.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/novillus

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

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 Novillus