Issue Brief: A New Method to Enhance Provider-to-Practice Attribution Using Healthcare Claims Data

May 2024 - As the healthcare system continues to shift towards rewarding value-based care instead of volume-based care, reporting on cost and quality is increasingly important for measuring progress. This reporting may include measuring the quality of care offered by specific providers or by a group of providers who work together at a single practice.

Using all-payer claims databases (APCDs), this reporting requires a process commonly referred to as “attribution” – the process of matching patients to their providers and matching providers to the practices or larger healthcare organizations that submit claims on their behalf.

While patient-to-provider attribution often is relatively straightforward, provider-to-practice attribution is more challenging and requires leveraging the limited provider data available in healthcare claims data – and, when possible, supplementing it with other data sources – to make direct connections between providers and the practices that bill on their behalf.

Onpoint’s new issue brief discusses the challenges inherent to attributing providers to practices using claims data and the innovative approach that our team has developed to create practice rosters that support our clients’ reporting initiatives. Read the full issue brief here....