Matching Patients with Their Providers: Lessons on Attribution and Enrollment from Four Multi-Payer Patient-Centered Medical Home Initiatives

Within multi-payer medical home initiatives, it is critical to develop and implement attribution and/or enrollment methodologies that assign participating patients to the practice most responsible for managing their care for two important reasons: the numbers of patients assigned to each practice influences the amount of supplemental PCMH payments paid to practices and which patients are assigned to the practice may affect the practice’s performance on specific cost, quality, and utilization metrics.

This brief, supported by The Commonwealth Fund, presents key considerations for states when developing assignment models: determining the degree of alignment across payers; establishing a means to collect and distribute patient assignment data; assessing the accuracy of the model; and ensuring sustainability. Key considerations presented in this brief were gleaned from challenges and lessons learned from multi-payer initiatives in Maryland, Massachusetts, Michigan, and Rhode Island.

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