Building the Foundation

Empanelment Guide

Version 3 – June 2026

Supporting Change

Despite the importance of empanelment, both technical and cultural challenges can make empanelment difficult to implement and sustain. Although some challenges may arise, practices can launch, measure and maintain empanelment so that every care team is responsible for a population of patients and the patients in their population know their PCP and care team.

Critical success factors to prepare for empanelment include:

  • Allocating sufficient resources, including:
    • Designating leadership responsibility for managing and maintaining empanelment.
    • Dedicating time for all providers and care teams to learn about the foundational elements of empanelment.
    • Dedicating time for a subset of provider and care team staff to participate in empanelment and panel management workgroups.
    • Making data analytics or business intelligence resources available to develop, validate and refine key empanelment and panel management reports.
    • Redeploying or hiring care team staff to conduct panel management activities.
    • Developing ongoing organizational processes to monitor and improve empanelment and panel management for population health improvement.
  • Reducing part-time staffing for PCPs or creating staffing minimums.
  • Reducing turnover of PCPs and care team staff.
  • Accounting for residency program churn and designing for continuity where possible.[1]
  • Seeking revenue arrangements that reduce dependence on visits and promote payment for population management.
  • Partnering with health plans to address incongruent assignment data.
  • Recognizing and addressing practice patterns that make continuity difficult: high no-shows, high proportion of same-day or urgent appointments, and saturated schedules.

Engaged leadership is the first building block in high performing primary care[2] and drives the success of all transformational efforts. As with many care transformation efforts, the success of empanelment relies on leadership in multiple domains.

Successful practices mobilize leadership on at least three levels:

  • Executive leadership develops and shares a mission-driven strategic vision for change and makes organizational investments in resourcing the change efforts.
  • A clearly designated operational leader with well defined responsibility and authority guides the day-to-day efforts of creating operational change.
  • Clinical and care team champions promote change with their peers by bringing attention, enthusiasm and direct experience to the operational change efforts.

As an initial step, organizational leaders should develop and share a clear and compelling vision for change, including an overview of:

  • What: Clear explanation of the definition and essential components of empanelment.
  • Why: Alignment between empanelment and organizational mission and priorities, for example, describing the connection between empanelment, relationship-driven care and population health.
  • How: Anticipated process, timeline and role implications for empanelment and panel management at the organization.

Change management for initial empanelment should include setting expectations with providers and care teams that the initial goal is not perfection but a good enough starting point to launch an ongoing, collaborative process to improve size, accuracy and management of the panels. Involve care teams with decision-making and implementation of empanelment to promote shared ownership and accountability.[3]

Endnotes

  1. Wajnberg A, Fishman M, Hernandez CR, Kweon SY, Coyle A. Empanelment in a Resident Teaching Practice: A Cornerstone to Improving Resident Outpatient Education and Patient Care. J Grad Med Educ. 2019;11(2):202-6. 
  2. Bodenheimer T, Ghorob A, Willard-Grace R, Grumbach K. The 10 building blocks of high-performing primary care. Ann Fam Med. 2014;12(2):166-71.1. 
  3. McGough P, Chaudhari V, El-Attar S, Yung P. A Health System’s Journey toward Better Population Health through Empanelment and Panel Management. Healthcare (Basel). 2018;6(2).