Validation Institute Certifies Embold Health’s Data Methodology for Identifying High-Performing Providers

Consumers don’t choose their care; they choose their healthcare provider. Because of the variability in provider quality, this choice can have a profound impact on the cost and quality of care. By electing high-quality providers, consumers benefit from better health by reducing their risk of unnecessary procedures and surgeries — proving that the path to better care starts with the right provider.  

Take Dallas-Fort Worth, where data shows more than a 20x difference in hardware removal after low back surgery, highlighting the contrast of providers who default to surgery and those who prioritize conservative care aligned with prevailing guidelines of appropriateness.

Embold Health uniquely identifies and connects members to high-quality providers by leveraging the most comprehensive, patented quality scoring methodology available. As of October 2024, these physician performance metrics have been validated by The Validation Institute.  

The Validation Institute specifically validated Embold’s claim: “Through rigorous data analytics, Embold has developed the gold standard in defensible and actionable doctor ratings that are completely visible to all healthcare stakeholders. The result is higher quality care from providers, more appropriate care for members, and lower overall costs for employers.”

What is The Validation Institute?

The Validation Institute bridges the gap between healthcare solution providers and purchasers by validating performance claims with an un-biased, data-driven approach. This process guides purchasers in choosing the right solution to meet the needs of their population while driving transparency in the marketplace and maximizing cost-savings. The claim assertion process requires companies to meet a rigorous validation of their performance claims, strengthening credibility and trust in the marketplace.  

The Validation Institute evaluates claims in four categories:  

• Savings – Verifying the product can reduce health care spending per case/participant or for the plan/purchaser overall.

• Outcomes – The product or solution has measurably improved an outcome, (risk, events, employee retention, etc.) of importance.

• Metrics – Credible sources and valid assumptions create a reasonable estimate of a program's impact.

• Contractual Integrity – The vendor is willing to put a part of their fees "at risk" as a guarantee.

Key findings certified by the Validation Institute include:

• Embold leverages credible and thorough data sources, methods and processes to calculate provider performance.  

• Only providers who have enough data are scored and resulting scores accurately represent performance.  

• Provider Guide refreshes health and pharmacy claims data annually and does not use data that has any potential to distort the analysis.

Why Does This Validation Matter?

With a vast dataset covering over 230 million Americans, Embold tracks complete care journeys using advanced statistics to ensure fair comparisons. Embold’s measurements cover 21 specialties and 68 sub-specialties, including preventive screenings, chronic condition management, surgical procedures, avoiding unnecessary treatments. and patient outcomes, ensuring a comprehensive evaluation of care quality across all specialties.

While Embold is known for its credibility, thoroughness and transparency, The Validation Institute confirmed that Embold’s Provider Guide uses credible, reliable data sources and applied valid clinical, financial, and outcomes measurements to select high-performing physicians. This validation adds to Embold’s credibility as a leader in measuring provider performance for care appropriateness, effectiveness and cost — a true differentiator across healthcare navigation solutions for health plans and employers, this validation assures Embold can confidently identify high-performing providers for their members, which ultimately leads to better health outcomes and measurable cost savings.  

With solutions for health plans and employers, Embold is improving outcomes and lowering costs by helping members find the right care, the first time. To learn more about Embold’s validated approach to provider quality, download the whitepaper.  

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