NCQA Innovation Award Winners: Delivering Quality and Value

October 22, 2024 · Becky Kolinski

In honor of Healthcare Quality Week, NCQA is celebrating the accomplishments of our Innovation Award winners. Each year, NCQA recognizes health care organizations for implementing leading-edge strategies that improve both quality and value, drive integration across the care delivery system and support person-centered care.

NCQA congratulates this year’s winners:

• Elevance Health.
• UniCare Health Plan of West Virginia.
• Vanderbilt University Medical Center.

We’re excited to share their success stories.

Improving Maternal and Neonatal Outcomes Through Value-Based Care Solutions

To improve maternal health outcomes, Elevance Health employed OB practice consultants to serve as the primary point of contact for OB-GYN specialty practices. These consultants collaborate with clinicians through in-person and virtual touchpoints to explain available programs for members and to share data on outcomes, c-sections, preterm birth rates and gaps in care to inform clinical decision making. This program drives meaningful engagement at the clinician level to achieve desired maternal health outcomes and enable success in value-based care.

Results

Since the program’s inception, 33 OB practice consultants have collaborated with more than 2,400 providers across 25 Medicaid markets, leading to a 5% reduction in total birth costs, a 5% saving in maternal first-year costs and a 10% saving in baby first-year costs.

Listen to the Quality Matters Podcast, A Win for Value-Based Care in OB-GYN, to hear the story behind this award-winning program.

SWAT H2O—Access to Clean, Safe Drinking Water

UniCare Health Plan of West Virginia developed SWAT H2O to provide immediate relief and resources after lead contamination was discovered in Harrison County in 2021. UniCare participated in lead screening events targeting Harrison County, and provided $25 gift cards for the first 50 attendees to encourage participation. UniCare also joined clean water strategy meetings organized by the West Virginia Department of Health and Human Resources, Bureau of Public Health, and were included in the state’s early response action plan. In early 2023, UniCare was called on to deploy SWAT H2O in response to elevated lead levels in tap water affecting Mineral County, where it helped plan a back-to-school lead screening event, coordinating with local churches to provide transportation for Medicaid members.

Results

Lead screening increased from 197 in 2020 to 235 in 2022 in Harrison County, and from 105 in 2022 to 132 in 2023 in Mineral County.

Breaking Down Health Equity Barriers with Care Bundles

Vanderbilt University Medical Center and Vanderbilt Health Employer Solutions developed MyHealth Bundles, a value-based approach to managing common and costly health conditions. Employers pay a predetermined fee for bundled services, and Vanderbilt assumes full risk for delivering an excellent clinical outcome. One example is the MyWeightLossHealth Bundle, which includes all services needed for a successful weight loss journey—at no out-of-pocket cost to employees. Each bundle features care navigation, nutrition, exercise, psychological support and one-on-one assistance from patient navigators.

Results

Participating employees have lost more than 7,000 pounds combined, and co-morbidities such as diabetes and heart disease have seen dramatic improvement. Utilization of the employee benefits plan increased from 3% to 11%, leading to cost savings and higher employee satisfaction.

Award Submission and Selection Criteria

Submissions span six focus areas: behavioral health, delivery system design, health equity, integration of care, patient and family engagement and use of technology.

Winners are selected by a panel of NCQA executives, board and committee members, who review and score the entries based on the following criteria.

• Innovation and creativity.
• Sustainability.
• Scalability.
• Impact on intended audience.
• Solution distinct from existing approaches.
• Quantitative data to show results or impact.
• Potential for cost impact.
• Potential for quality impact.
• Added value for payer, clinician or patient.

Learn more about the NCQA Innovation Award submissions and winners here