The Health Care Payment Learning and Action Network (HCPLAN) on May 13, 2016 released the White Paper of 10 recommendations to guide the patient attribution process as the US health care system moves toward Population Based Medicine (PBM). HCPLAN identifies 3 guiding principles to support these recommendations and include:
- Providers will accept full responsibility for managing the entire trajectory of health from prevention to end-of-life care, demonstrating coordinated, comprehensive patient-centered care management.
- Develop a method to identify the patient, provider and delivery system accountability for the total cost of care, quality and outcomes for a specific patient population.
- Identify primary care providers as the principle starting point for managing a patient population across the entire trajectory of care.
The HCPLAN White Paper provides 10 recommendations to guide the patient attribution process, and include:
- Patients are encouraged personal choice in determining their primary care provider.
- Patient attestation that is missing will require a claims/encounter-based approach.
- Definition of eligible providers will occur at the beginning of the performance period.
- Patients will be provided transparent information about their attribution.
- Primary care providers will be prioritized in claims/encounter-based attribution.
- Subspecialty providers will be considered in the absence of primary care encounters.
- A single approach system will be used for attribution, performance measurement and financial accountability.
- Patient attribution will be used nationally for commercial products.
- Commercial, Medicare, and Medicaid populations will be aligned with adjustments.
- Providers should receive clear, actionable information about patients attributed to them, regardless of prospective or current attribution.
Health Care Payment and Learning Action Network (2016). Accelerating and Aligning Population Based Payment Models: Patient Attribution, Final White Paper