NCQA

Green Circle Life Expands Availability of Healthy Weight for Life Program for the SmartFHR™ Platform

Retrieved on: 
Tuesday, April 16, 2024
Technology, Professional Services, Health, Pharmaceutical, Health Technology, Health Insurance, Data Analytics, Software, Fitness & Nutrition, Human Resources, Telemedicine, Virtual Medicine, Snack, ROI, Pharmacy, NCQA, AutoZone, HR, Eli Lilly, Insurance, Compensation, Partnership, Weight loss, Doctor of Philosophy, Quality assurance, Pharmacotherapy, Prescription, Obesity, Exercise, Life, Novo Nordisk, Diet, GCL, Workforce, National Committee, Quality of life

HWFL is an employer-offered weight management program designed to work with individuals to set realistic goals, attain and maintain their desired weight through lifestyle changes.

Key Points: 
  • HWFL is an employer-offered weight management program designed to work with individuals to set realistic goals, attain and maintain their desired weight through lifestyle changes.
  • The program, which provides private, personalized coaching, encourages users to engage in physical activities, nutritional adjustments and monitor weight outcomes.
  • Dinesh Sheth, founder and CEO of Green Circle Life, emphasized, “Health and wellness are at the forefront of HR challenges, and obesity is a national epidemic.
  • Healthy weight is not a 'one and done' 'one size fits all' proposition but rather a constantly evolving journey.

InfoMC and OptMyCare Forge Partnership to Drive Innovation in Next-Generation Risk and Care Management

Retrieved on: 
Thursday, April 25, 2024
Case management, NCQA, Risk, Certification, Health, Partnership, HEDIS, Organization

CONSHOHOCKEN, Pa., April 25, 2024 /PRNewswire-PRWeb/ -- InfoMC Inc., a pioneer in medical management and behavioral health technology, and OptMyCare, a healthcare analytics company, today announced a partnership to integrate their technology solutions to optimize care orchestration and quality performance. This integration enables actionable insights to be delivered at the point of care, mitigating risk and improving health and financial outcomes for individuals and populations across all of your lines of business.

Key Points: 
  • Our integrated technology delivers insights that improve operational efficiency and cost containment to make health management a more predictable process.
  • "Our collaboration provides the care team with additional context, analyzing traditional healthcare data together with care management input to provide a comprehensive picture of every member's health," said Saravanan Bala, CEO of OptMyCare.
  • This integration delivers actionable information across Incedo's utilization management and case management workflows, providing a deeper understanding of risk, care gaps, and evidence-based preventative measures to improve decision-making and drive better outcomes.
  • Real-time risk assessment and highly targeted behavior modification and disease mitigation strategies help care teams minimize disease progression and prevent members from advancing into higher risk categories.

Capital Rx Earns Accreditation from the National Committee for Quality Assurance (NCQA)

Retrieved on: 
Wednesday, April 10, 2024
NCQA, PBM, Medicaid, Quality assurance, Entrepreneurship, Accreditation, Patient, PBA, Doctor of Pharmacy, National Committee, PAT, Organization

NCQA Accreditation is a voluntary review process, and Capital Rx proved that the necessary systems, processes, and personnel are in place to meet the NCQA's strict quality standards.

Key Points: 
  • NCQA Accreditation is a voluntary review process, and Capital Rx proved that the necessary systems, processes, and personnel are in place to meet the NCQA's strict quality standards.
  • "I am proud of Capital Rx earning NCQA's Accreditation in Utilization Management," said AJ Loiacono , Co-Founder and CEO of Capital Rx.
  • NCQA Standards recognize that organizations that apply for accreditation have open access networks, can improve service quality, and utilize customized structures to meet purchaser needs.
  • Further, NCQA Utilization Management Accreditation helps reinforce that organizations making utilization management decisions are following objective, evidence-based best practices.

Manifest MedEx Joins NCQA’s Digital Content Services Early Adopter Program

Retrieved on: 
Tuesday, April 9, 2024
Data Management, Health, Technology, Software, General Health, Networks, HealthNet, Certification, NCQA, CQL, Hospital, HL7, Human services, Elevance Health, Medicaid, Blue Shield, Medicare, CMS

Manifest MedEx, California’s largest nonprofit health data network, announced today it will participate in the NCQA Digital Content Services Early Adopter Program to advance digitized quality measurement initiatives and help shape NCQA’s framework and approach to enabling the practical and flexible use of digital quality measures across the full spectrum of value-based care use cases, including quality reporting for health plans.

Key Points: 
  • Manifest MedEx, California’s largest nonprofit health data network, announced today it will participate in the NCQA Digital Content Services Early Adopter Program to advance digitized quality measurement initiatives and help shape NCQA’s framework and approach to enabling the practical and flexible use of digital quality measures across the full spectrum of value-based care use cases, including quality reporting for health plans.
  • Hosted in Manifest MedEx’s cloud environment, these digital measures take advantage of FHIR® and Clinical Quality Language (CQL), an expression language curated by HL7 that CMS, NCQA, and others have adopted for digital quality measures.
  • “Our participation as a pioneer and Early Adopter of NCQA’s Digital Content Services demonstrates our commitment to advancing digitized quality measurement initiatives to help streamline and reduce costs for HEDIS measure updates and certification and accelerate health care’s transition to a digital measurement ecosystem,” said Jason Buckner, Chief Information Officer, Manifest MedEx.
  • Manifest MedEx has participated in NCQA’s digital quality transformation programs since 2021 when it joined the first cohort of the NCQA Data Aggregator Validation program.

UniCare Health Plan of West Virginia First in the State to Earn NCQA Health Equity Accreditation Plus

Retrieved on: 
Thursday, March 21, 2024
Professional Services, DEI (Diversity, Equity and Inclusion), Health, Health Insurance, Social Services, General Health, Andrew Kohut, Disease, NCQA, Transport, Health equity, Diabetes, Mortality, Gender identity, Overalls, Medicaid, UniCare, Quality assurance, Language, Hypertension, Accreditation, National Committee, Nursing

UniCare Health Plan of West Virginia recently earned the National Committee for Quality Assurance (NCQA) Health Equity Accreditation Plus, a recognition of UniCare’s leadership in developing solutions to enhance access equitable, high-quality healthcare.

Key Points: 
  • UniCare Health Plan of West Virginia recently earned the National Committee for Quality Assurance (NCQA) Health Equity Accreditation Plus, a recognition of UniCare’s leadership in developing solutions to enhance access equitable, high-quality healthcare.
  • “NCQA’s Health Equity Accreditation Plus recognizes our unwavering dedication to eliminating health disparities and ensuring access to high-quality care for everyone,” said Tadd Haynes, President, UniCare Health Plan of West Virginia.
  • “This milestone positions UniCare at the forefront of advancing health equity through our innovative and impactful programs and personalized care to improve the whole health of our members.”
    NCQA Health Equity Accreditation Plus builds upon the Health Equity Accreditation designation UniCare received last year, when it was recognized among the first Medicaid plans in the nation to create a strategic framework that prioritizes health equity based on race, ethnicity, language, sexual orientation, and gender identity.
  • “Organizations earning the Health Equity Accreditation Plus like UniCare Health Plan of West Virginia are leading the way in bridging this gap, and NCQA salutes their commitment.”

Anthem Blue Cross and Blue Shield Recognized for Significant Improvements in Key Quality of Care Measures

Retrieved on: 
Tuesday, March 12, 2024
Practice Management, Insurance, Managed Care, Health, Hospitals, Professional Services, Health Insurance, Other Health, Well, NCQA, Child, Health equity, Risk, Patient satisfaction, Elevance Health, Quality, Medicaid, Quality assurance, Pharmacy, Access, Medicine, Service, National Committee, Health insurance

According to the latest New York State Department of Health’s Consumer’s Guide to Medicaid and Child Health Plus Managed Care Plans, Anthem Blue Cross and Blue Shield saw a significant jump in ratings in multiple, high priority categories.

Key Points: 
  • According to the latest New York State Department of Health’s Consumer’s Guide to Medicaid and Child Health Plus Managed Care Plans, Anthem Blue Cross and Blue Shield saw a significant jump in ratings in multiple, high priority categories.
  • Overall, Anthem was one of the highest scoring Medicaid plans in New York, achieving increases for both Cardiovascular and Maternal Care, while Adult Care increased from 2 to 5 Stars.
  • More stars translate to better healthcare for the 555,000 Medicaid enrollees served by Anthem.
  • We work tirelessly with our members, their providers and the communities where they live to ensure that each and every member receives the highest quality of care,” said Mark Levy, President and CEO Anthem Blue Cross and Blue Shield.

Priority Health Executive Named Top Woman Leader in Health Care by National Outlet

Retrieved on: 
Monday, March 11, 2024
Professional Services, Health, Consumer, Women, Insurance, Health Insurance, General Health, NCQA, Growth, Woman, Environment, Health equity, Policy, News, Spectrum Health, Senior, Newsroom, Medicaid, Quality assurance, Population health, Modern Healthcare, Multimedia, Medicare Advantage, Priority, Accreditation, National Committee, Management

View the full release here: https://www.businesswire.com/news/home/20240311383262/en/

Key Points: 
  • View the full release here: https://www.businesswire.com/news/home/20240311383262/en/
    Joyce Chan Russell, Senior Vice President of Government Markets at Priority Health.
  • (Photo: Business Wire)
    This national recognition honors women executives who are helping develop policy, leading change and making advancements across all sectors of the health care industry.
  • In her role at Priority Health, Chan Russell oversees the individual, Medicare Advantage and Medicaid businesses, as well as population health and health equity.
  • “Since joining Priority Health in 2021, Joyce has consistently demonstrated exceptional leadership through her ability to balance the pace of change with our desire to innovate,” said Praveen Thadani, president of Priority Health.

UMass Memorial Health Expands Use of Get Well Platform for Social Determinants of Health (SDOH) Screening and Navigation

Retrieved on: 
Tuesday, March 12, 2024
Well, Andrew Kohut, Health, UMass Memorial Health, NCQA, Joint Commission, Caregiver, Health equity, Partnership, Patient, Hospital, Electronic health record, Get, SDOH, Quality assurance, EHR, Medicare, CMS, National Committee

BETHESDA, Md., March 12, 2024 /PRNewswire/ -- Get Well, the global leader in consumer digital patient engagement, today announced that UMass Memorial Health will implement Get Well's Health Equity Social Determinants of Health (SDOH) Screening Solution across the organization. As part of the Get Well 360 platform, the Get Well Health Equity SDOH Screening Solution captures patients' SDOH needs, integrates the data into Electronic Health Records (EHRs), and navigates patients to appropriate resources and community-based organizations (CBOs).

Key Points: 
  • In response, Get Well announced in 2023 the rollout of a health equity solution, which includes SDOH screening and navigation.
  • UMass Memorial Health, Central Massachusetts' largest not-for-profit health care system, will use Get Well's SDOH Screening and Navigation Solution to support care for their more than 50,000 patients in the hospital and 300,000 in outpatient care.
  • "We're incredibly excited to deepen our partnership with UMass Memorial Health," said Michael O'Neil, CEO of Get Well.
  • Get Well Community Navigators will monitor the texts for any questions or needs and connect them with resources such as FindHelp or route them to UMass Memorial Health social workers.

Carenet Health Acquiring Health Dialog, Enhancing Clinical Team and Advancing Insights-Driven Platform Dedicated to the Business of Healthcare

Retrieved on: 
Wednesday, March 6, 2024
Insurance, Human Resources, Hospitals, Professional Services, Health Insurance, Practice Management, Health, Data Analytics, Pharmaceutical, Rite Aid, Acquisition, URAC, ROI, Health Dialog, Patient, NCQA, National Committee, HITRUST, Quality assurance, Nursing

Carenet Health, a trusted partner in helping organizations simplify and power the business of healthcare, is excited to announce it is acquiring Health Dialog, a worldwide leader in delivering clinical decision support offerings.

Key Points: 
  • Carenet Health, a trusted partner in helping organizations simplify and power the business of healthcare, is excited to announce it is acquiring Health Dialog, a worldwide leader in delivering clinical decision support offerings.
  • This acquisition enables Carenet to leverage its combined platform, analytics and clinicians to deliver greater efficiency and outcomes-based financial performance for clients.
  • Health Dialog provides personalized population health services to health plans, providers, employers and pharmaceutical manufacturers.
  • Carenet is acquiring all assets of Health Dialog from Rite Aid, including a world-class clinical staff, vital population health programs and robust data analytics and modeling capabilities with proven ROI.

WellRight HRA Earns Re-Certification from NCQA for Wellness and Health Promotion Accreditation

Retrieved on: 
Wednesday, February 21, 2024
Mental Health, Apps, Applications, Technology, Human Resources, Fitness & Nutrition, Health Technology, Professional Services, Software, General Health, Health, Diabetes, Anxiety, Workplace, HRA, Medicine, HIPAA, Risk assessment, Certification, Wellness, NCQA, National Committee, Quality assurance, Depression

WellRight, a corporate wellness leader delivering customizable and complete wellness programs, announced that its Health Risk Assessment has once again received the National Committee for Quality Assurance (NCQA) Measure Certification™ for the Wellness and Health Promotion Accreditation program.

Key Points: 
  • WellRight, a corporate wellness leader delivering customizable and complete wellness programs, announced that its Health Risk Assessment has once again received the National Committee for Quality Assurance (NCQA) Measure Certification™ for the Wellness and Health Promotion Accreditation program.
  • WellRight’s HRA captures the critical components of an individual’s health and wellbeing utilizing evidence-based, best-in-class validated tools to improve health and wellness outcomes.
  • WellRight’s HRA earned the NCQA certification for its comprehensive, streamlined, and person-centered incorporation of customer feedback.
  • “We are honored to achieve certification for our Health Risk Assessment and further our long-standing relationship with NCQA,” said Neepa Patel, Chief Executive Officer at WellRight.