Patient attribution models have gained increased importance with the advent of ACOs and other models in which organizations and clinicians are paid based on patient outcomes — but, according to the National Quality Forum, there are roughly 150 attribution models in use today across federal programs and in the private sector.
To address narrow the field and help stakeholders choose the best model based on evidence, NQF released Tuesday the Attribution Model Selection Guide and a report on attribution. The report, funded by HHS, was put together by a committee of 26 stakeholders.
The Attribution Model Selection Guide includes the following questions:
- What is the context and goal of the accountability program?
- How do the measures relate to the context in which they are being used?
- Which units will be affected by the attribution model?
- How is the attribution performed?
They came up with the following recommendations to improve standardization, transparency and accuracy among attribution models:
- Use the Attribution Model Selection Guide to evaluate the factors to consider in the choice of such a model.
- Attribution models should be tested.
- Attribution models should be subject to multistakeholder review.
- Attribution models should attribute results to entities who can influence care and outcomes.
- Attribution models used in mandatory public reporting or payment programs should meet minimum criteria.
"It's critical that we can accurately identify who is responsible for patients' care as we work to improve value without sacrificing quality," said Helen Darling, NQF's interim president and CEO.