Six provider attribution methodologies necessary for success

Ryan Rubino discusses why attributing patient performance to a provider is more complex than you may think, and six methods for attribution that are all valuable.

What business problems are you trying to solve?

To understand the nuanced requirements related to provider attribution, it’s important to understand what business use cases must be supported. This boils down to what question are you trying to answer:

• How are your providers performing?
• How do you attribute patient performance to a provider?
• How are you grouping providers?
• What metrics are you trying to calculate?
• What business object are you working to achieve?

The answers to these questions are all different from provider attribution standpoints — it's critical to understand which methodology will help you understand and evaluate your performance.

Six common approaches for provider attribution methodologies

Seeing that multiple business use cases are important, it’s also important to have multiple ways to attribute patient performance to a provider to support these use cases. The following are six common approaches for attributing patient performance to a provider:

1. Clinical: The provider assigned to the patient in the EHR
2. Rendering: The provider that saw the patient during an encounter
3. Plan Assigned: The provider assigned to the patient by the health plan
4. Cost Derived: The provider who rendered to an individual the most primary care services by cost
5. Event Derived: The provider who rendered the most, or most recent, primary care services to an individual over a specific period of time
6. Functional: An algorithmic approach to determine which provider is most actively involved in the patient's health
   

The main takeaway is that attributing patient performance to a provider may be quite a bit more complex than you’d expect, and it could be challenging to support this properly with in house analytics teams. If you’d like to learn more about how Arcadia supports this, please feel free to reach out to me.

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