Module 3 · Provider Performance · 3.10
Outlier Detection & Investigation
Distinguish genuine performance variation from data artifacts, gaming, coding anomalies, and random noise — with the statistical and investigative tools to make that call.
5
Detected outliers
3
Open investigations
2
Funnel plots
Outlier alert feed
Funnel plot gallery
Adverse Drug Events / 1,000 · D4 · 95% / 99.7% control limits
HbA1c Control (< 8%) · D1 · 95% / 99.7% control limits
Providers plotted by volume (x) and rate (y). A small-volume provider off-target is less concerning than a high-volume one at the same rate — the funnel narrows as volume grows.