Introducing Medicare and key enhancements: Embold’s 2024 data and methodology update:

In the fast-evolving landscape of healthcare, Embold commits to continued innovation and improvement by regularly advancing our precision analytics and underlying methodology behind our healthcare navigation products.  

Our latest dataset features key updates and methodology enhancements. To learn more about how Embold measures provider quality, read our whitepaper.

Key Updates:

Embold’s claims measurement is now up-to-date and runs through 9/30/2023. The provider demographics, such as medical specialty classifications and locations, have been refreshed, and the latest risk adjustment practices have been implemented. Frequent dataset updates such as these allow Embold’s healthcare navigation products to stay current and effective for directing users to high-quality providers.

In the latest update, Embold added a total of 140,955 newly evaluated providers, bringing the overall number of evaluated providers to 528,150, an increase of 36%. This expansion signifies our commitment to continually enhance and broaden the range of healthcare options available to users.  

Adding Medicare Data:

Embold proudly announces the addition of Medicare data to our existing dataset, resulting in a total of over 200 million covered lives. This allows us to capture a broader picture of provider quality, increasing the ability of our clients, their employees, and their members to find the right care for their needs.

Benefits of Medicare data:

• Broader clinical picture with more measures and subspecialty scores per provider

• Enhanced degree of confidence in provider score with higher denominator* per measure

• Increased coverage with more evaluated providers

• Increased stability with a broader observation sample

Scoring Changes:

In addition to augmenting our dataset, Embold is now comparing all providers to the national benchmark by default. This update enables multi-region and custom comparisons across state lines. A benefit of the nation-wide benchmark is that we can evaluate providers nationally while maintaining the ability to curate high-performing networks of local providers for our clients.

The ranges of scoring categories have also been updated:

• 70-79 scores = Providers who are below Expectation

• 80-89 scores = Providers who meet Expectation

• 90-100 scores = Providers who exceed Expectation

Embold evaluates and scores providers on their appropriateness, effectiveness, and cost of care. For more information about how Embold measures providers, read Embold Health White Paper_2020.pdf (hubspotusercontent-na1.net))

Adding Advanced Practice Providers (APPs):

Previously, Embold only evaluated physicians for specialty care. After implementing client requests, the Spring 2024 production run update now expands evaluations to include nurse practitioners (NPs) and physician assistants (PAs).  

To keep true peer comparison in our provider evaluation, Embold was very intentional about how we incorporated APPs into our evaluation framework. Embold will implement risk adjustment by profession type for all specialties (excluding Primary Care and Pediatrics, who have always included APPs). This will allow us to expand our evaluation to include APPs while maintaining a fair evaluation process for all providers.

Conclusion:

The continuous updating of data and methodologies is not just best practice—it's a necessity. By embracing a culture of perpetual improvement and innovation, Embold proudly ensures our products and analytics remain at the forefront of the industry, ultimately leading to better health outcomes.  

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For media inquiries: marketing@emboldhealth.com  

For additional information: sales@emboldhealth.com

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* Denominator: The total population or episodes eligible for a specific measure. E.g. in measuring the rate of ER visits after a colonoscopy, the denominator would be the total colonoscopies performed.