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What is attribution?

Attribution refers to a method of determining patient-provider relationships by identifying which providers are responsible for the majority of a patient’s care. Most payors require that a single provider be assigned the role of attending provider, who is then assumed to be the attributed provider.

Attribution is an important component of population-based payment (PBP) models, which require providers to accept responsibility for managing the full continuum of care for their patients. This extends beyond a single visit, from preventative care to end-of-life care.

Different attribution methods assign the patient-provider relationship at different points in the care journey. For example, the Merit-Based Incentive Payment System (MIPS) is retrospective and assigns physicians their attributed patients at the end of the year. Next Generation ACO is prospective, so physicians know beforehand which patients are attributed to them for the next two years.

In both these cases, the goal is to associate a patient with specific conditions and needs to a physician, attributing the patient's outcomes to the physician's incentive rewards.

One of the challenges with attribution is that multiple providers may serve as candidates for the patient, but only a single provider must be attributed. Sometimes, the patient is attributed to the physician who provided most of the total care, while in other cases, patients are attributed to the physician who provided most of their primary care.

How does attribution improve healthcare?

By attributing one primary physician to a patient who becomes responsible for the patient's complete continuum of care, the patient sees better care and outcomes. The patient-provider relationship can become stronger in that the provider can learn and understand the patient’s full medical history and needs and is incentivized to provide complete and quality care to the patient.