Common use of Attribution Methodology Clause in Contracts

Attribution Methodology. 1.1 Attribution Overview 1.1.1 Introduction Attribution will be prospectively conducted for the VMNG Program by DVHA for Members who are enrolled in Medicaid as of November 1st of the year preceding the Performance Year. These Members will be attributed to either the Traditional Attribution Cohort or Expanded Attribution Cohort as follows: a. Attribute Members based on past primary care utilization with Participating Providers to the Traditional Attribution Cohort, as described in Section 1.2. b. Attribute Members not in the Traditional Attribution Cohort who do not have past primary care utilization with health care providers who are not Participating Providers to the Expanded Attribution Cohort described in Section 1.3. 1.1.2 Monthly eligibility checks of Members during the Performance Year On a monthly basis, Fiscal Agent will determine which, if any, Members in the Traditional Attribution Cohort and Expanded Attribution Cohort became ineligible for VMNG Program participation in the previous month due to one of the criteria stated in Section 1.2 or 1.3 as applicable, or as a result of the death of the Member or loss of Medicaid eligibility. An Attributed Member who was previously determined to be ineligible in any given month may regain eligibility in a future month if eligibility criteria are met.