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The attribution process
The attribution process utilizes claims data, a frequently used methodology in value-based programs, because it standardizes PCP assignments.
BCBSND members will be attributed to a PCP by using the following process:
PCP-eligible providers include physicians and mid-level practitioners in the following specialties:
Example attribution scenario
Combined, Medical Group A billed the most evaluation and management (E&M) services (a total of eight), positioning it ahead of Medical Group B, which only billed a total of five E&M services.
Within Medical Group A, Dr. K. billed the most E&M services (a total of four) and is therefore assigned as the member's PCP.