HealthEdge® Achieves NCQA Health Appraisal and Self-Management Tool Certifications for HealthEdge Wellframe™ Digital Member Engagement Solution

BOSTON--(BUSINESS WIRE)--HealthEdge^® today announced that the National Committee for Quality Assurance (NCQA) has awarded two certifications to the HealthEdge Wellframe™ digital member engagement solution. These new Wellness and Health Promotion (WHP) certifications for Health Appraisals and Self-Management Tools underscore HealthEdge’s commitment to empowering health plans with high-quality and evidence-based solutions that help to better engage and support their members.

With growing demands on health plans to control costs by fostering higher-quality and more proactive care, improving member engagement is a top priority. However, significant discrepancies exist between the level of support health plans believe they’re offering members, and the level of support members feel they’re receiving. According to recent HealthEdge research, 76% of health plan executives say their members see them as a partner in the care journey, but only 50% of healthcare consumers share that belief.

As a component of the comprehensive platform and services HealthEdge delivers to power health plans’ most important value streams, the Wellframe digital member engagement solution strengthens connections with members, delivers actionable health insights, improves member satisfaction and advances efforts to improve measurable clinical outcomes. These new, voluntary certifications from NCQA validate that Wellframe meets industry-leading clinical standards by following best practices.

NCQA is an independent accrediting body that champions healthcare excellence by evaluating the quality of care and services provided throughout the healthcare industry. These standards are purposely set high to encourage Wellness and Health Promotion organizations for continuous enhancement of their quality. No comparable evaluation exists for Wellness and Health Promotion programs.

Many U.S. states require NCQA Health Plan Accreditation (HPA) or allow HPA to substitute for regulatory audits and accreditation surveys. Health plans using Wellframe now qualify for automatic credit during their own Health Plan Accreditation survey, which accelerates accreditation survey preparation while simultaneously reducing the health plan’s administrative burden.

“Our health plan partners have a long-standing evolving interest in improving quality of care and member outcomes. Because NCQA sets rigorous national standards and benchmarks for member engagement, Wellframe’s new NCQA Certifications are being met with tremendous excitement,” said Dr. Sandhya Gardner, General Manager, Care Solutions and Chief Medical Officer of HealthEdge. “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.”

Wellframe achieved Health Appraisal certification for meeting NCQA’s standards related to digitally administered Health Risk Assessment, formally known as the Digital Intake Assessment. This designation confirms that Wellframe™ supports customers administering a health appraisal or assessment that addresses all the components and scope required by NCQA’s standards, provides alerts and insights to care teams about assessment results and updates content using published clinical guidelines and professional organization recommendations. Using Wellframe’s NCQA Certified Health Risk Assessment allows health plans to receive automatic credit for HPA Population Health Management (PHM) Element A – Health Appraisals.

Wellframe achieved Self-Management Tools certification for meeting NCQA’s standards for evidence-based health educational content including ensuring that Wellframe’s content is accessible and usable to members with disabilities. This designation confirms that Wellframe makes updates to content regularly based on the most recent evidence-based clinical guidelines and clinical best-practice. When member populations have Wellframe available, health plans receive automatic credit for Population Health Management (PHM) Element B – Self Management Tools.

These certifications also validate that HealthEdge maintains the highest standards for privacy and confidentiality. NCQA examined HealthEdge’s policies and processes on topics including data protection, information sharing and access controls to ensure that Wellframe takes use and disclosure of sensitive information seriously and works closely with its client organizations to maintain the highest standards for privacy, data protection and information security. Wellframe keeps health plan members informed in an accessible, plain language format about how their sensitive information is collected, used and protected.

NCQA also evaluated how Wellframe measures effectiveness. After scrutinizing member and client experience data, NCQA ensured that Wellframe cross-functionally analyzes reports to identify opportunities for improvement. For the purposes of this survey, Wellframe shared two improvement initiatives with NCQA: Annual Member Content Usefulness Survey and Care Team Digital Adoption Best Practices. During recertification in 2027, Wellframe will report the results of these two improvement initiatives to NCQA to evaluate their effectiveness.

NCQA is the industry standard for health plan clinical quality with core values rooted in measurement, transparency and accountability. Health plans can trust NCQA recognized vendors because those organizations have been scrutinized through the NCQA survey process. NCQA recognized vendors are listed here: NCQA Vendor Report Cards.

“HealthEdge has distinguished itself by earning these certifications for its Wellframe solution,” said Dr. Vivek Garg, President and CEO of NCQA. “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.”

About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.

About HealthEdge
HealthEdge® is trusted to provide the technology and services that power health plans’ most important value streams. With an integrated platform of solutions spanning claims administration, quality improvement, prospective payment accuracy, provider network management, care management, member engagement and risk adjustment, HealthEdge enables health plans to converge their data so they can harness automation and the promise of AI. Combining this next-gen technology with services and expertise gives health plans unmatched capabilities to deliver a future of frictionless and cost-effective healthcare experiences. For more information, visit HealthEdge.com.

Copyright Statement
©2026 HealthEdge Software, Inc. | HealthEdge®, HealthRules®, Integration Plus®, Workflow Plus®, Engagement Plus®, Encounters Plus®, Risk 360® Quality 360™, HealthEdge Source™, GuidingCare®, EDGEcelerate™, Wellframe™, Wellsquared™. HealthEdge and Wellframe logos are registered trademarks or trademarks of HealthEdge Software, Inc. All Rights Reserved.