PCPs and P4P

Although it's not directly related to Medicare Advantage and risk adjustment, this article from the New England Journal of Medicine, Care Patterns in Medicare and Their Implications for Pay for Performance, underlines the importance of primary care physicians.

Two assumptions underpin the implementation of pay for performance in Medicare: that with the use of claims data, patients can be assigned to a physician or to a practice that will have primary responsibility for their care, and that a
meaningful fraction of the care physicians deliver is for patients for whom they
have primary responsibility.

At Leprechaun, we assign particular important to PCP charts when looking for documentation of patient risk factors, and PCPs are a key factor in a successful prospective HCC management program.