By Matthew Resnick, MD, MPH, Chief Medical Officer/ Senior VP, Health Plan Business, Embold HealthÂ
LinkedIn: Matthew Resnick
LinkedIn: Embold Health
For many healthcare providers, performance measurement feels like a black box. What does the data measure? Is it accurate? And fundamentally, how should it be used? These questions are especially pressing for specialists, who often operate with little to no feedback once they leave the structured, feedback-rich environment of education and training.
Transparency changes everything.
Today, health plans and employers have an imperative to send members to high-performing providers. Patients want to feel confident they are getting the best possible care. But perhaps most importantly, providers themselves want to know, how am I doing? Without access to timely, relevant performance measurement, even the most dedicated providers find it difficult to identify opportunities to improve. Worse, they may unknowingly perpetuate outdated or low-value practices.
This kind of performance measurement is more than a report card, it’s an invitation to self-reflect and improve.
Why Feedback Stops—and Why It Shouldn’t
In medical school and residency, physicians are steeped in feedback. They’re observed, coached and measured constantly. Once in practice, particularly in specialty care, that feedback disappears. Few know how their outcomes compare to peers, and fewer still can trace how decisions across a patient’s care journey shape long-term outcomes.
The result is an information vacuum. Providers are left to assume they’re doing ‘the right things’ or they rely on anecdotal experience. Without supporting empiric data that spans the full patient journey, from initial diagnosis to treatment, recovery, or recurrence, it’s impossible to see the complete picture in performance measurement and, ultimately, improvement. Missed opportunities stay hidden. Variations in care go unnoticed. And patients suffer the consequences.
From Siloed Data to Patient-Centered Insight
Traditionally, provider performance data has been fragmented, claims, labs, prescriptions and EMR records living in isolation. This fragmentation has long stifled progress in measuring and improving performance. The ability to access data has evolved. We can now connect care events across time and care setting, creating a continuous view of each patient’s healthcare experience.
This journey-based perspective allows for much more than point-in-time measurement. It supports a deeper understanding of differences in patterns of decision-making and how these patterns impact outcomes. Whether it’s a surgeon deciding between procedures or a specialist considering whether imaging is warranted, these choices shape the trajectory of care.
That’s the power of modern quality analytics: not just measuring what happened, but illuminating why it happened and what should happen next.
Creating a Culture of Performance
For data to spark change, it must be trusted. That means methodologies must be rooted in clinical integrity with a commitment to transparency. Providers need to know that their performance is measured fairly, that edge cases are considered and that they have a voice in improving the process. Publishing methodologies in peer-reviewed literature and engaging physicians as both users and contributors to the system are crucial to this trust-building.
When that trust exists, performance measurement becomes empowering. Providers can see where they excel, where they fall short and how small changes in daily decisions can lead to big improvements in outcomes. For some, this clarity can also open new doors, aligning with value-based care models and unlocking new opportunities.
High-performing providers, in particular, stand to benefit. As data reveals their consistent ability to deliver effective, appropriate and efficient care, they gain the confidence and credibility to participate in risk-based arrangements, population health initiatives or specialty-specific value contracts. This shift creates real financial upside, enabling providers to move beyond fee-for-service constraints and into models that reward the outcomes they already deliver. In this way, performance transparency isn’t just about quality improvement, it’s also a gateway to new opportunities in the evolving healthcare economy.
Transparency as a Catalyst for Improvement
Transparency isn’t about calling out underperformance: it’s about giving providers a mirror. A way to see themselves not just as individual clinicians, but as participants in a broader system of care. Armed with the right insights, they can become more deliberate, more effective, and more aligned with the outcomes their patients need most.
Most importantly, feedback enables improvement. When providers receive actionable insights alongside coaching tools, they’re more likely to engage and adapt. That’s because most clinicians aren’t experts in quality improvement, they’re experts in patient care. Giving them tools tailored to help them improve in their craft makes all the difference.
A Better Path Forward
High-performing healthcare systems don’t happen by accident. They emerge when light shines into the gray areas, and the ecosystem connects care decisions to outcomes and trusts providers with the knowledge they need to grow. When that happens, the benefits ripple outward: better outcomes, lower costs, more informed care decisions, and stronger patient-provider relationships.
The future of healthcare hinges not just on having more data, but on using it wisely, transparently, thoughtfully and collaboratively. For providers, performance measurement shouldn’t be an afterthought. It should be a compass.