Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Summary: Attribution of Accountability


Accountability for an episode of care could be claimed by a provider prospectively or assigned retrospectively.  Approaches that have been tested in the literature include assignment to individual physicians, hospitals, hospital medical staffs, integrated delivery systems, and physician group practices.  The majority of attribution approaches that have been tested have focused on attribution to a single entity, although several approaches to joint assignment to multiple providers have been tested.  Different assignment methods that have been tested have lead to widely different results on various criteria.  

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