University of Wisconsin Extended Campus is now Wisconsin Online Collaboratives! This name reflects the partnerships of the 13 universities within the Universities of Wisconsin–our state's premier system of public higher education. Through these partnerships we will continue to support online degrees, certificates and courses–along with support services to you.

Capstone Projects

Predicting Provider Specialty For Nurse Practitioners And Physician Assistants

Program: Data Science Master's
Host Company: Health Innovation Program
Location: Madison, Wisconsin (onsite)
Student: Allie DeLonay

Medicare claims do not include descriptive provider specialties for Nurse Practitioners (NPs) and Physician Assistants (PAs). Missing NP/PA provider specialty information is an issue for both researchers and Medicare’s Accountable Care Organization (ACO) patient attribution logic. Researchers are sometimes forced to exclude NP/PA visits from analyses because it is unclear if the visit is clinically relevant to the research objective. Inpatient attribution, all NP/PAs are considered primary care practitioners even though 73% of NPs/PAs at our local health system work in specialty care. Given that specialty care NPs/PAs are included in attribution, patients can be attributed to the incorrect ACO. NPs/PAs are increasingly caring for patients in both primary and specialty care, so these issues for researchers and ACOs will only continue to proliferate. This analysis had two aims: 1) use Medicare claims data to create a collection of models to predict the provider specialty for NPs/PAs using information from our local hospital’s electronic health record and 2) create a single, easy-to-use model that can be used to find most of the NPs/PAs that work in primary care. The predicted specialties from either aim could be used to update the attribution algorithm to ensure that specialty and primary care NPs/PAs are included only when appropriate. The modeling strategy from aim one predicted the specialty for 80.4% of individual NPs/PAs, 97.4% of individual primary care NPs/PAs, and 94.6% of the NPs/PAs’ associated Medicare claims. The model from aim two identified 84.6% of NPs/PAs that practiced in primary or non-primary care.