1. Attribution – How it affects the PPS
The state will use attribution to assign patients to a PPS using two unique attribution methods. This assignment affects only the flow of DSRIP dollars to the PPS. It does not change how or where patients access services.
Attribution for Initial Valuation
Determines: the number of patients used in calculating project scores and the group of Medicaid patients identified for initial performance benchmark development
Initial valuation impacts the total amount of money the PPS could potentially receive throughout the five years of DSRIP
Adjustments may be made if there is a valid reason
Attribution for Performance Measurement
When the PPS is evaluated for completion of metrics and milestones, the assessment will be based on the group of patients attributed to the PPS

2. Attribution for Initial Valuation
Medicaid patients with special health care needs – Developmental disabilities, long term care, behavioral health
Categorized by previous claim codes provided by state agencies
Claims in more than one category: attribution is determined by the order 1. developmental disabilities, 2. long term care, and 3. behavioral health; Regardless of the number of claims in each category.
Provider in multiple PPS’s: attributed to the PPS with the highest number of claims in the highest level of service type
“All Other” Medicaid patients – Three or more claims during a six month period and do not fall under one of the above categories
Same hierarchical method as above based on previous claims
Low-utilizing Medicaid patients – Three or fewer claims during a six month period
Attributed if
If the patient has a primary care provider claim, they will be attributed to the PPS that their PCP is affiliated with
If the patient does not have a primary care provider:
If the PPS selects 11th project (Project 2.d.i), uninsured patients are attributed to the PPS

3. Hierarchical Attribution Chart

4. Attribution for Performance Measurement
This attribution will be determined at the beginning of every measurement year
The patient population attributed to the PPS will form the basis for quality measurement for all population-based measures
Episodic-based measures: Only patients who receive services for that episode of care within the PPS network during the measurement year will be evaluated