Skip to main content
logo Contact us

Pursuing NCQA Accreditation: How Wellframe™ Is Enabling Health Plans to Address SDOH

Published Date
Author Michael Dignan

Now more than ever before, health plans are recognizing the importance of holistic care delivery to improve outcomes and reduce costs. Social determinants of health (SDOH) such as food security, transportation, and housing stability significantly impact member health, making it crucial for payers to adopt solutions that integrate medical and community-based support.

Wellframe, a HealthEdge solution, is taking a major step forward in this effort by pursuing the National Committee for Quality Assurance (NCQA) Wellness and Health Promotion (WHP) Accreditation in 2025.

Why NCQA Accreditation Matters

NCQA is widely recognized for its commitment to quality measurement, transparency, and accountability in healthcare. For health plans, working with NCQA recognized vendors provides several advantages:

  1. Trust and Reliability: NCQA recognized vendors are held to high standards, ensuring their solutions align with evidence-based best practices.
  2. Regulatory Alignment: Recognition helps health plans stay ahead of regulatory requirements from CMS and state Medicaid programs, particularly as policies related to health equity and SDOH rapidly change.
  3. Operational Efficiencies: Health plans partnering with NCQA recognized vendors may benefit from oversight relief and automatic credit in their own NCQA surveys, reducing administrative burdens.
  4. Better Outcomes and Cost Savings: Studies show that coordinated care and strong member engagementlead to improved health outcomes and reduced healthcare costs.

By pursuing NCQA WHP Accreditation, Wellframe is reinforcing its commitment to alignment with NCQA standards. Delivering high-quality, evidence-based digital health management solutions empowers members to engage with their health plan care team and supports health plans in meeting their clinical quality and health equity initiatives.

How Wellframe Supports Person-Centered Community-Based Care

Wellframe is already playing a crucial role in addressing SDOH. The platform integrates digital health management with personalized coaching, helping health plans identify and support members’ social and clinical needs. Some key capabilities include:

  • Health Coaching & Self-Management Tools: Wellframe provides evidence-based resources that can be used by the health plan’s care team during health coaching. Self-management tools are available to help individuals navigate their health journeys, including managing chronic conditions, mental health, and lifestyle changes.
  • Comprehensive Health Appraisals: The platform facilitates health appraisals, which may also be known as health risk assessments, that include questions on social determinants of health, helping to identify members who may need additional support.
  • Personalized Outreach & Engagement: Wellframe’s digital capabilities allow health plans to proactively reach members with tailored interventions, ensuring that populations with new or emerging risk receive the support they need.
  • Community Resource Connections: Through partnerships with organizations such as Unite Us, Find Help, and 988 crisis services, Wellframe helps connect members with community-based organizations that address SDOH.
  • Data Exchange & Integration: Wellframe facilitates data sharing between health plans, providers and members, enhancing care coordination and ensuring that data is meaningful and actionable.

These capabilities already position Wellframe as a powerful tool for addressing health inequities and enhancing member engagement. However, NCQA certification will take these benefits to the next level.

The Impact of NCQA Recognition on Wellframe’s Capabilities

With NCQA accreditation, Wellframe will be able to offer even greater value to health plans, particularly in the areas of quality measurement, engagement, and health equity. Here’s how:

  • Enhanced Standardization & Quality Assurance: NCQA accreditation ensures that Wellframe’s wellness and health promotion programs meet rigorous nationally recognized standards, validating the effectiveness of its health assessments, self-management tools, and member engagement strategies.
  • Improved Regulatory Standing for Health Plans: Wellframe’s WHP Accreditation will provide health plans with automatic credit during NCQA surveys for Population Health standards for Health Appraisals and Self-Management Tools, reducing administrative costs associated with maintaining their own Health Plan Accreditation (HPA).
  • More Robust Measurement of Outcomes: NCQA requires WHP accredited vendors to continuously measure and improve their effectiveness. Wellframe will leverage these insights to refine processes, data collection, and educational content to help ensure greater impact on clinical outcomes
  • Strengthened Member Trust & Adoption: NCQA’s standards are designed to encourage members to engage with their care team and promote a collaborative care model with industry-leading quality benchmarks. This will further boost the effectiveness of Wellframe’s digital engagement strategies.
  • Greater Alignment with Value-Based Care Models: As the industry shifts toward value-based care and shared provider risk arrangements, NCQA accreditation will reinforce Wellframe’s role in helping health plans accurately measure quality and improve overall population health

Overcoming Challenges in Addressing Needs of a Population

While solutions like Wellframe are making strides in addressing specific needs of members, challenges remain. Health plans often face hurdles such as data integration complexities, regulatory uncertainties, and member engagement barriers. However, Wellframe’s approach, coupled with NCQA WHP accreditation, will help mitigate these challenges:

  • Data Silos: Many health plans struggle with fragmented data systems that prevent a holistic view of member needs. Wellframe’s advanced interoperability capabilities improve data sharing across stakeholders.
  • Regulatory Compliance: As Medicaid, Medicare, and commercial payers increasingly incorporate SDOH into quality metrics, NCQA accreditation helps ensure that Wellframe remains aligned with industry best practice and standardized metrics.
  • Member Engagement & Digital Literacy: By leveraging mobile-first strategies and personalized care management, Wellframe helps bridge digital literacy gaps and deliver tailored health support to members.

Looking Ahead: The Future of Wellframe & NCQA Accreditation

As Wellframe progresses toward achieving NCQA accreditation in 2025, health plans can expect even stronger alignment with industry standards and clinical best practice metrics. The combination of Wellframe’s innovative technology, evidence-based content and NCQA-backed credibility will provide health plans with an unparalleled tool to advance population health and address social determinants of health.

Ultimately, Wellframe’s NCQA accreditation will not only enhance the quality and effectiveness of digital health engagement but also reinforce health plans’ ability to deliver holistic, person-centered care. By proactively addressing members’ unique needs, health plans can improve member outcomes, reduce costs, and drive long-term sustainability in an increasingly value-driven healthcare environment.

Wellframe’s pursuit of NCQA accreditation underscores the company’s dedication to improving clinical quality, health industry innovation, and equitable person-centered care.

Do you want to learn more about how your health plan can use digital care management solutions to meet care managers and members where they are? Watch our on-demand webinar.