John Trefethen, MFA

Patient attribution in value-based care is a critical and multifaceted process that involves assigning patients to specific healthcare providers or organizations. This attribution is essential for measuring and managing the quality of care, patient outcomes, and financial performance under value-based payment models. There are two primary attribution models: 1. Prospective Attribution: Patients are assigned to providers at the beginning of a performance period, based on historical data or predefined criteria. This method provides providers with a clear understanding of their patient population from the start. 2. Retrospective Attribution: Patients are assigned to providers after care has been delivered, typically based on where they received the majority of their primary care during the performance period. While this model can reflect actual patient behavior, it may be less predictable for providers. When implementing value-based care, it’s important to understand several key factors in patient attribution: 1. Type of Providers: Whether attribution is based on primary care providers only or includes multi-specialty providers. 2. Type of Visits: The distinction between preventive care, specialty care, and acute care in determining attribution. 3. Attribution Period: The choice between look-back, performance, or real-time attribution periods. 4. Hierarchical Assignment: Whether patient choice or historical visit patterns are prioritized in the attribution process. 5. Data Sources Used in the Attribution Model: Whether the model relies on claims data, clinical data, or a combination of both. The accuracy and fairness of attribution are crucial for ensuring that providers are appropriately held accountable for the care they deliver and that patients receive coordinated, high-quality care. Do you know how and where patients are assigned? #valuebasedcare #healthcare #leadership #innovancehealth

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