Defining Best Practices in Wellness and Digital Patient Engagement: What We’ve Learned So Far

October 2, 2025 · Becky Kolinski

Wellness and health promotion is a growing area of focus in health care—and patient engagement and empowerment are at the center. Everyone has a right to achieve their best possible health, but there’s not always a clear path to get there. There’s a wealth of information, resources and tools, but many people still struggle with their health.

• 76% of adults report having at least one or more chronic conditions that impact their well-being—many that could be addressed through behavior change.
• U.S. adults report feeling physically unhealthy 4 days and mentally unhealthy 5 days in an average month.
• Only 51% of adults and 24% of children meet the guidelines for daily physical activity.

Digital health and wellness tools provide flexibility and accessibility, but they can also present risk. “With so many organizations entering into the digital health and wellness market, we need proof that these solutions actually improve people’s health and well-being,” says Vik Wadhwani, NCQA’s Chief Product and Transformation Officer. “It’s time to take a look at how we define success, and create a shared vision of what a high-quality, high-impact program looks like.”

Innovations in Wellness and Condition Management Working Group

“Health care is a resource constrained environment,” says Wadhwani. “Improving the overall health and well-being of a population has always been about managing health risk, but many organizations focus on patients experiencing the highest risk, instead of engaging with lower risk populations to help them stay healthy.”

NCQA recently invited organizations to join a working group to explore how the health care field should deliver, manage and assess interventions to support wellness, health promotion and condition management. The group included perspectives from payers, employers, vendors and solution providers, industry experts, health systems, clinicians and patients.

“So much of health happens outside the walls of health care. Empowering and supporting people to make healthy choices is key to improving population health and quality outcomes,” says Rachel Harrington, NCQA’s Senior Product Strategist. “We want to help shape the conversation in a collaborative way and understand how quality programs can elevate clinical and business best practice going forward.”

NCQA develops standards, measures and tools to support an integrated, effective, efficient health care quality ecosystem. The working group will help us understand current trends in wellness and condition management, define evidence-based best practices and identify ways that organizations can help people feel engaged and empowered to manage their own health.

What We’ve Learned So Far

The working group met for the first time on September 24. Participants welcomed the opportunity to engage and discuss how they can work together to bridge the gaps between health plans, employers, vendors and health systems to improve the patient experience. Here are some key themes from the conversation.

• Wellness is a continuum. People don’t classify themselves as healthy or sick; they live on a continuum that changes from day to day. Programs should adapt to their changing needs.
• Simplicity is key. Programs should have a simple design, focus on patient activation and engagement and encompass preventive screenings as well as healthy behaviors. As one participant said, “Programs must be engaging enough to become routine.”
• AI is top of mind. Organizations are interested in exploring use cases, such as risk segmentation and personalized engagement, as well as AI guardrails and risk mitigation.
• There’s no substitute for human connection. Technology should support human interaction, not replace it. Participants warned against the desire to “over-automate” and risk alienating staff and patients.
• Data lag is a major pain point. Organizations don’t want to wait for results. Successful programs must include timely data sharing among health plans, employers, health systems and vendors.
• Measurement is challenging. Barriers to measuring patient engagement include limited data access, linking patient goals to longer term outcomes and the need to customize approaches to meet patients where they are.
• Behavior change is the ultimate goal. Metrics that focus on behavior change have more value than technology milestones (e.g., app usage, click rates). As one participant shared, “Tech metrics can help fine-tune the journey, but they aren’t outcomes.”

“We have a diverse group of organizations trying to meet the needs of diverse groups of people, so naturally, there’s going to be spirited discussion and debate,” says Harrington. “The purpose of the working group is to find areas of alignment and build consensus around approaches that will yield the best results for patients.”

What’s Next

The working group will continue to meet over the coming months, so stay tuned for future updates!

Curious to learn more about how wellness programs are designed, implemented and evaluated? Join our upcoming webinar series Whole Care, Better Outcomes: Acting at the Intersection of Wellness and Quality. Each session will share a different case study, and include time for open discussion. Register for the first webinar on October 30, featuring Sharecare.

If your organization is interested in working through the real-world challenges of data flow and measuring outcomes, considering participating in our Learning Collaborative starting this fall. Contact Jeni Soucie, Senior Manager, Product Management, for more information.

Thanks to Our Partners

NCQA appreciates the insights from the participants in the Innovations in Wellness and Condition Management Stakeholder Working Group.