Embold Health Using Data to Transform Healthcare by Highlighting Top-performing Doctors

Connecting consumers, employers and health plans to doctors who consistently provide high quality care will lead to better outcomes, less inappropriate care and lower costs.

NASHVILLE, Tenn. — Embold Health today announced the launch of a data-based platform designed to identify doctors who consistently provide high-quality care in local communities. In bringing together the largest dataset in healthcare, clinically validated analytics, and the expertise of leading physicians and data scientists, Embold shines a light on top-performing doctors, giving people access to better care and all doctors the opportunity to improve. 

“Data informs so many of the decisions we make today, everything from what route we take to work to where and what we eat,” said Embold CEO and founder Daniel Stein, M.D. “Yet when it comes to arguably one of our most important decisions – what doctor should I trust to provide my care – we still rely mostly on word of mouth or online directories. Embold takes the guesswork out of identifying top-performing doctors.”

Embold provides its analysis to employers and health plans who will use the data to determine the make-up of their provider networks and guide members to high quality doctors. In addition, Embold will make its analysis directly available to other doctors to help them improve their clinical practice and patient outcomes.

“We know that there is tremendous variation in the quality of medical care within local communities and around the country,” said Dr. Stein. “Throughout my career in medicine, policy and business, I’ve struggled with the fact there is no way for anyone, including doctors, to identify the best providers – those that consistently deliver care that is high quality, medically appropriate and reasonably priced. I started Embold to address this problem, using objective data and full transparency to create meaningful change in the health care system.”

A Bold Approach

Until now, the healthcare industry hasn’t had a rigorous, data-driven, objective mechanism for identifying quality physicians. Consumers instead have relied on an informal patchwork of resources — such as personal recommendations, directories or online ranking systems — to try to find a doctor.

Embold is creating a new standard to measure quality and boldly transform care. With the guidance of a scientific advisory board that includes physicians and data scientists from leading academic institutions across the country, Embold establishes standards through evaluation of the latest research, clinical guidelines and quality measures to identify the factors shown to consistently deliver the best outcomes.

Embold assesses provider performance in three key areas:

  • Appropriateness: Are providers delivering care that is medically necessary and beneficial?
  • Effectiveness: Are providers delivering care in accordance with the latest clinical guidelines, and did patients achieve good outcomes?
  • Cost: Is care being delivered at a reasonable cost?

Through a collaborative agreement with Blue Health Intelligence® (BHI®), Embold analyzes de-identified patient data sets and uses its own sophisticated analytics and quality standards to evaluate quality at the provider level. BHI’s national data repository represents the largest, most current, and uniform data set in healthcare.

Research shows an estimated $640 billion in wasteful medical spending is driven by doctors who do not follow the latest evidence-based guidelines or deliver unnecessary or low-value care.1 Embold’s analysis identifies practice patterns that may result in costly and potentially harmful care.

For example, research shows pregnant women should receive a certain level of prenatal care, avoid an induction or C-section if possible, and go home with no complications or infections. However, actual practice patterns for uncomplicated pregnancies vary widely. In one Texas market, physicians perform C-sections on nearly half of all low-risk pregnancies, compared to just 14% among top-performing doctors. In that same market, complication rates for low-risk pregnancies range from 1.2% to as high as 7.8%, and the total cost of care varied from about $10,400 to more than $19,000.

“The worst kind of treatment someone can receive is the treatment they didn’t need in the first place,” said Arnold Milstein, M.D., MPH, professor of medicine at Stanford University and co-chair of Embold Health’s scientific advisory board. “By focusing on appropriateness of care, Embold helps patients achieve outcomes that they want at a lower cost – partly by avoiding services likely to cause more harm than benefit, and partly by encouraging services likely to make a real difference in patients’ lives.”

Download Embold Health’s Methodology Whitepaper.

A Commitment to Transparency

Embold was founded on the premise that physicians share a universal desire to help patients by delivering the highest quality care. However, many lack the information and tools they need to reliably assess and continually improve their performance.

Moreover, as the science of medicine rapidly evolves, there is often a delay in getting new knowledge into physicians’ hands. As a result, some providers continue to rely on outdated practices that may lead to unnecessary care and, often, poorer outcomes.

That is why, in addition to sharing data directly with its employer and health plan partners, Embold will make its analysis available to doctors to support their continuous improvement.

“As a physician, I know most providers wake up in the morning wanting to give their patients the highest quality care. Yet, very few are receiving transparent, objective, data-driven feedback on their clinical performance,” said Dr. Stein. “By sharing detailed information on how they are performing on the measures that truly matter, we can provide physicians with the information and tools they need to compare and enhance their performance.”

About Embold Health

Bringing together the largest dataset in healthcare, clinically validated analytics and the expertise of leading physicians and data scientists, Embold shines a light on top-performing doctors, ensuring that people receive better care and all doctors have the opportunity to improve.

Learn more at emboldhealth.com.

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1 Institute of Medicine. Best care of lower cost: The path to continuously learning healthcare in America. Washington, DC: The National Academies Press 2013. Updated for 2017 expenditure data.