Embold Edge Enables Employers and Health Plans to Launch an Alternative, Quality-Driven Health Plan Without Network or Carrier Disruption

Embold Health today announced the launch of Embold Edge, the first national quality-driven health plan designed to help employers and health plans reduce healthcare costs by addressing one of the most persistent drivers of both outcomes and spend: variation in clinical quality.

For years, employers and health plans have relied on price transparency, benefit design changes and increased cost-sharing. Yet costs continue to climb, due in large part to variation in clinical quality.

Embold Edge is built on the critical premise that choosing a provider is the most important decision in the care journey. That decision influences the care a patient receives at the initial visit and their future care, including referral patterns, site-of-service selections and costly downstream utilization.

Unlike other alternatives, Embold Edge is designed to influence care decisions at the moment patients choose their provider by leveraging clinically validated provider analytics to optimize appropriateness of care, outcomes, site-of-service selection and price. The plan combines these market-leading analytics with a predictable, copay-based benefit structure that reinforces better care decisions at scale.

By directing members to the right care the first time, Embold Edge helps them avoid unnecessary tests, procedures and follow-up visits that add cost, time and stress. The copays are aligned to reward higher-quality choices, giving members clearer expectations and helping them save money. This quality-driven health plan provides a simpler, more predictable experience for members nationwide and better outcomes for employers and health plans.

“Healthcare has long treated quality and cost as a tradeoff,” said Daniel Stein, MD, MBA, President and Founder of Embold Health. “Our work has consistently shown the opposite. Improving quality, especially at the start of care, reduces waste, improves outcomes and lowers cost. Embold Edge is the first national quality-driven health plan that operationalizes that insight without adding complexity for employers, health plans or members.”

Embold Edge delivers a scalable, quality-first approach to cost control for employers and health plans that can be deployed nationwide. For health plans, Embold Edge can be offered as a white-labeled experience, enabling plans to bring a quality-driven health plan to market faster and at a significantly lower cost than building and operating a comparable offering on their own. For employers, the plan works within existing networks and carrier infrastructure, allowing them to adopt a quality-directed approach without changing carriers, disrupting coverage or forcing members into unfamiliar care models.

Embold Edge is powered by the combined strengths of Embold Health and Quantum Health, bringing together best-in-class provider quality analytics, digital guidance and member navigation with simple, copay-based incentives. These capabilities make it possible to connect quality insight, member guidance and financial incentives at the point of care — enabling a quality-driven, predictable experience for members without adding operational complexity for employers and plans.

“This is not about rebuilding benefits or asking members to navigate more complexity,” Stein added. “It’s about making high-quality care the default and aligning plan design, incentives and experience around that goal.”

About Embold Health

Embold Health helps employers and health plans guide members to higher-quality care, improving outcomes and reducing unnecessary healthcare spending. Through clinically grounded analytics and generative AI, Embold empowers members to make clearer, more confident care decisions across the full care journey. Evaluating 21 specialties and 68 sub-specialties, Embold’s patented and peer-reviewed provider quality score methodology analyzes data from 230+ million individuals across the entire care journey at the individual physician performance level.

Embold delivers clinically grounded analytics, quality intelligence and generative AI that enables clearer navigation and more confident care choices. In 2025, Embold Health joined Quantum Health, the most complete healthcare navigation solution, expanding its ability to bring evidence-based, personalized provider guidance to millions of members at their first moment of need. To learn more, visit emboldhealth.com.

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