Patient attribution: why the method matters

Area of Science:

• Healthcare Management
• Health Services Research
• Medical Informatics

Background:

• Accurate patient attribution is essential for evaluating healthcare performance.
• Existing patient attribution methods vary, potentially leading to inconsistent performance metrics.
• Integrated healthcare delivery systems face challenges in assigning patients to primary care providers (PCPs).

Purpose of the Study:

• To compare the impact of five common patient attribution methods on healthcare cost, quality, and utilization.
• To assess the concordance of attribution methods with primary care provider (PCP) empanelment.
• To identify variations in patient attribution within an integrated healthcare delivery system.

Main Methods:

• Retrospective analysis of administrative data from Mayo Clinic Rochester (MCR) for 2010-2011.
• Application of five distinct patient attribution methodologies.
• Comparison of attributed patients based on PCP empanelment, quality metrics, utilization, and costs.

Main Results:

• Five attribution methods assigned between 42% and 72% of patients to a PCP.
• Significant variations in healthcare utilization and total costs were observed across different attribution methods.
• Quality measures showed no significant differences based on attribution method.
• Patients with higher primary care visit frequency were more likely to be attributed by all methods.

Conclusions:

• Patient attribution methods influence the measurement of healthcare costs and utilization.
• Quality metrics were less affected by the choice of attribution method.
• Standardization and optimization of patient attribution methods are necessary for reliable healthcare system evaluation and value assessment.