What Wellframe’s New NCQA Certifications Mean for Health Plans and their Members

As regulatory and quality expectations intensify, the National Committee for Quality Assurance (NCQA) vendor certification offers health plans a trusted signal that their technology partners can help deliver measurable outcomes for their members. HealthEdge Wellframe™ has now achieved this distinction, demonstrating its commitment to clinical quality, member engagement, and performance improvement.

This achievement not only recognizes the quality and rigor of Wellframe as a digital member engagement platform, but also delivers real benefits to health plans and their members. NCQA’s forward-looking approach pushes health plans to focus on lowering care costs, improving health outcomes, and enhancing the member experience. The NCQA recognitions confirm Wellframe’s commitment to these areas, with the understanding that accomplishing these objectives will require a scalable approach that drives efficiency in population health initiatives.

Why NCQA Certification Matters

In an environment where quality measurement, interoperability, and standardized care practices are rapidly evolving, independent validation by NCQA is more than a badge—it’s an indicator of trust, effectiveness, and alignment with the industry benchmarks that matter most to health plans.

NCQA is widely recognized for setting industry-leading best practice standards in quality measurement. The organization evaluates programs and organizations across the continuum of care, from health plans and providers to digital tools and credentialing bodies.

For digital health solutions like Wellframe, NCQA certification signals that the solution’s evidence-based clinical framework, member engagement processes, and health outcome focused interventions are measured against national best practices.

“HealthEdge® has distinguished itself by earning these certifications for its Wellframe solution. Vendors that have achieved NCQA accreditation and certification statuses by meeting or exceeding our high standards show health plans and others in the industry that they are good partners to support delivering high quality care.”

– Dr. Vivek Garg, President and CEO of NCQA

What Wellframe’s New Certifications Mean for Health Plan Partners

Wellframe earned two NCQA Wellness and Health Promotion certifications: one for Health Appraisals and another for Self-Management Tools.

These certifications validate that Wellframe meets NCQA standards for providing members with accessible, high quality, evidence-based health engagement tools, a distinction that is particularly meaningful as health plans strive to meet quality metrics while supporting members in a more personalized way.

1. Higher Confidence in Quality and Reliability

The Health Appraisal certification confirms that Wellframe enables health plan customers to deliver a digital Health Risk Assessment (HRA) that meets all required NCQA components, scope, and standards. It provides alerts and insights to care teams based on assessment responses.

The Self-Management Tools certification includes NCQA validation that Wellframe’s in-platform health education content meets standards for topics and tools that support member-centric and member-driven care. NCQA reviewed samples of Wellframe’s care programs, goal trackers, educational content, mini-surveys, and encouragement messages. Both certifications confirm that Wellframe regularly updates platform content based on established best-practices, published clinical guidelines, and recommendations from professional organizations. During the survey, NCQA also validated Wellframe’s accessibility for members with disabilities, channels for member and customer feedback, and methods for measuring the platform’s effectiveness.

2. Alignment With Quality Measurement Trends

These certifications also carry operational value. Health plans using Wellframe now qualify for automatic credit during their own NCQA Health Plan Accreditation (HPA) surveys — specifically for Population Health Management Elements A (Health Appraisals) and B (Self-Management Tools). This reduces administrative burden and helps accelerate accreditation preparation, which can meaningfully impact plan operations. And because NCQA is often aligned with the Centers for Medicare and Medicaid Services (CMS) standards, health plans can leverage the NCQA Certification standards to support CMS or state regulatory agency audits.

3. Support for Population Health and Member Engagement Initiatives

Wellframe’s platform is designed to strengthen connections between members and their care teams, promote engagement with personalized content, and deliver timely, actionable health insights. Certification affirms that these capabilities meet the NCQA’s rigorous standards and help position health plans to succeed in their quality and health equity initiatives.

4. Demonstrated Commitment to Privacy and Transparency

As part of the certification process, NCQA evaluated Wellframe’s privacy practices, including data protection policies, access controls, and disclosure protocols. Health plans can be assured that Wellframe meets NCQA’s high standards for handling sensitive member information.

5. Continuous Improvement & Effectiveness Measurement

Wellframe also submitted two quality improvement initiatives to NCQA during the survey process: its Annual Member Content Usefulness Survey and its Care Team Digital Adoption Best Practices program. The outcomes of these initiatives will be reported at recertification in 2027 — reinforcing Wellframe’s investment in ongoing optimization.

Technology Provider vs. Trusted Partner

Beyond the technical achievement, NCQA certification elevates Wellframe’s role as a trusted partner for health plans. Organizations that are recognized by NCQA offer plans a better foundation for:

• Regulatory readiness, reducing risk tied to regulatory audits and accreditation surveys
• Value-based care programs, supporting population health, SDOH initiatives, and preventive care
• Reduced administrative burden, helping teams spend less time validating tools and more time improving outcomes
• Enhanced https://healthedge.com/resources/member-engagement/infographic-improving-member-satisfaction and engagement

“This NCQA recognition is strong validation that Wellframe enables health plans to move the needle on Population Health and Clinical Quality initiatives. The NCQA extensive survey process reinforced the value that Wellframe brings to health plans and renewed our commitment to enhancing trust and credibility with members, payers, providers and regulators.”

– Dr. Sandhya Gardner, General Manager, Care Solutions and Chief Medical Officer of HealthEdge

What Sets Wellframe Apart

Public information suggests that very few digital member engagement and care management platforms have achieved full NCQA certification in wellness, health appraisal, and self-management tool categories. In this context, Wellframe’s achievement stands out as a meaningful level of third-party validation for a digital member engagement solution and signaling that it meets some of the highest independent quality standards available in healthcare today.

Wellframe’s NCQA certifications are a testament to the HealthEdge team’s commitment to quality, evidence-based design, and health plan partnership. It reflects not just what Wellframe does today but how it will continue to help plans improve clinical performance, enhance member experiences, and meet the evolving standards of quality and accountability across healthcare.

Read the full press release to learn more about this announcement and what it can mean for your health plan.