The Arcadia “Connection”: Functional Providers
February 29th, 2016 | Arcadia ConnectionsThe Arcadia Connection is a recurring feature in Network News that keeps you up to date with news about the Arcadia Analytics Dashboard and connects you with information about workflow improvements and best practices that improve measure performance.
What is Functional Provider?
Users of the Arcadia Analytics dashboard frequently question why the dashboard lists for a given patient both a “functional” provider and a “clinical” provider. While the clinical provider will match the patient’s PCP that is listed in the EMR, the functional provider listed can be different, as it is derived from an algorithm designed to determine the provider who sees the patient most frequently. Here is the definition of functional provider from the Arcadia Analytics User Guide:
Functional Provider is based on Arcadia’s Primary Care Provider attribution algorithm for a patient over the past 18 months. This attribution method is designed to be the best possible use case for all the reports in Arcadia Analytics. It is a combination of the Plan and Clinical attribution methods, and uses an encounter based four-cut analysis to resolve conflicts. A breakdown of the logic is below:
Functional Algorithm Description:
First Pass:
1. If only 1 data source is in Arcadia Analytics, use patient’s source PCP (Clinical or Plan).
2. If all Clinical and Plan PCPs match, use patient’s Clinical PCP.
3. If PCPs do not match across the data sources, move to the Four Cut Method.
Four Cut Method:
1. If the patient has only seen one provider in the last year, use this PCP.
2. If the patient has seen one provider more than any other in the past year, use this PCP.
3. In the event of a tie in Cut 2, use the provider who completed the most recent physical exam.
4. In the event that the patient has no physical exam record, use the provider seen most recently for a medical encounter.
Have a question about the Arcadia Analytics dashboard that you would like featured in the Arcadia Connection? Contact LaRon Rowe at [email protected].
