Hospitals & Health Networks looks at the process of assigning patients to physicians in population-health programs in what is called “attribution”:
• To measure the quality and cost of care, payers identify which provider is accountable for which patient. It can be a messy process.
• Most payers attribute patients to primary-care physicians, but a patient with chronic or urgent conditions may see a specialist physician more than a PCP.
• PPO patients can move from provider to provider at will.
• Most attribution depends on retrospective data, usually from the prior 12 months. But that makes it difficult for physicians to predict and address patient needs in the year ahead.
• Nonetheless, some population-health experts say attribution data can improve outcomes.
As H&HN notes, “no matter how attribution is set up, it has the potential to create physician frustration and resistance, especially if it affects the amount of supplemental payments for patient coordination and management, or if doctors are penalized based on results from other providers a patient may see.’