Da Vinci Risk Adjustment Implementation Guide
2.0.0-preview - STU2 United States of America flag

Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions

Change Log

The Risk Adjustment Implementation Guide was developed under the Davinci Project

Version 2.0.0

  • Applied: Added references to report generation overview and methods (FHIR-40988)
  • Applied: Fix Group.Type to person (FHIR-40995)
  • Applied: Make Group.actual fixed to true (FHIR-40996)
  • Applied: Remove or better define reason for meta.profile requirement (FHIR-40997)
  • Applied: Need to remove mandatory requirement in meta.profile (FHIR-40935)
  • Applied: Improve wording in remediation guidance (FHIR-40989)
  • Applied: Large number of technical corrections (FHIR-41140)
  • Applied: Add capabilitystatement-expectation extensions (FHIR-40993)
  • Applied: Add more guidance on what is expected in annotations (FHIR-40991)
  • Applied: Provide more guidance on the expectations on Task termination (FHIR-40990)
  • Applied: Add better description of scope/use/limitations/workflows to all Structure Definitions (FHIR-40998)
  • Applied: Added examples tab to all Profiles under FHIR Artifacts ([FHIR-40992] https://jira.hl7.org/browse/FHIR-40992)
  • Applied: Group annotation extension was renamed to Condition Category Remark (ccRemark). Also added section to describe how Patch could be used instead of sending back the full report (examples included) ([FHIR-41332] https://jira.hl7.org/browse/FHIR-41332)

Version 2.0.0-ballot

  • The 2.0.0-ballot includes the following changes to support new functionalities:
    • The Guidance page in STU1 is now broken into two pages, General Guidance and Report Generation, with new content
    • New pages: Report Generation, Report Query, Remediation, and Report Annotation
    • New profiles and extensions, see Profiles
  • It also introduces Digital Condition Category as DRAFT content for review:

Trackers Applied for 2.0.0-ballot

  1. Applied: Add “data collection period” to Glossary (FHIR-37672)
  2. Applied: Corrected CMS-HCC model to HHS-HCC model (FHIR-37745)
  3. Applied: Corrected Category misspelling (FHIR-38205)
  4. Applied: Corrected Condition misspelling in Suspect Type Value Set (FHIR-38206)
  5. Applied: Corrected Venn Diagram misspelling in DCC content page (FHIR-39300)
  6. Applied: Make “Example CMS Hierarchical Condition Category Value Set” a true sample (FHIR-39371)
  7. Applied: Remove “Code System” and “Value Set” from names and titles of code system and value set (FHIR-39374)

Version 1.0.0

Ballot Comments Applied: Summary (Jira Issue)

  1. Applied: Bind example value sets where ever possible instead of creating complicated element definitions (FHIR-34774)
  2. Applied: Missing Must Support, $report comment, & extension comment (FHIR-35139)
  3. Applied: Clarify provider-driven v. payer-driven approach to coding gaps (FHIR-35324)
  4. Applied: Keep group.population and group.stratifier in as optional (FHIR-35221)
  5. Applied: “Hierarchical Condition Categories (HCCs) with less severe HCCs superseded (ignored) if evidence of higher severity HCCs is present” statement is not accurate description. (FHIR-34773)
  6. Applied: Group usage in bundles missing from guidance (FHIR-34710)
  7. Applied: Over-specific precondition for patient resource logical id (FHIR-34708)
  8. Applied: Cardinality confusion for MeasureReport.group.code (FHIR-34711)
  9. Applied: Extracted diagnosis data element missing background (FHIR-34696)
  10. Applied: Figure 1-2 Workflow for Medicare Advantage Population, Phase One misses the preceding step where provider sends initial diagnostic/condition codes before risk coding report is generated. (FHIR-34778)
  11. Applied: plural possessive (FHIR-34695)
  12. Applied: actor names (FHIR-34698)
  13. Applied: Typo in Intro (FHIR-34501)

Other Changes Applied: Summary (Jira Issue)

  1. Applied: Remove extension-reporterGroup extension from RA Coding Gap MeasureReport (FHIR-36850)
  2. Applied: Noted several errors in example data (FHIR-35773)
  3. Applied: US Core 3.1.1 Alignment (FHIR-35924)
  4. Applied: Add language to acknowledge physician burden reduction (FHIR-35323)
  5. Applied: Correct MeasureReport.group.stratifier.code cardinality due to error in base resource (FHIR-36053)
  6. Applied: Title for HCC 18 should be “Diabetes with chronic complications” not “Diabetes without complications” (FHIR-35774)
  7. Applied: Add more details to the description of the evaluatedResource element (FHIR-35980)
  8. Applied: Change to Condition Category (CC) gap instead of HCC gap in SuspectType definitions (FHIR-36024)
  9. Applied: Typo in 1.4 Scope text (FHIR-35971)
  10. Applied: Example MeasureReport01 Group vs EvaluatedResources Data Conflict (FHIR-37345)
  11. Applied: Example MeasureReport01 HCC Code Consistency (FHIR-37348)
  12. Applied: Example MeasureReport04 HCC Code Consistency (FHIR-37351)
  13. Applied: Example MeasureReport06 Links Different Patient Than EvaluatedResource (FHIR-37354)
  14. Applied: Example MeasureReport01 Group vs Condition Data Conflict (FHIR-37347)
  15. Applied: Example MeasureReport02 Group vs Condition Data Conflict (FHIR-37350)
  16. Applied: Example MeasureReport05 Encounter and Condition Link Consistency Issue (FHIR-37353)
  17. Applied: Example MeasureReport04 Group-013 Condition May Not be Applicable (FHIR-37352)

Version 0.1.0

Initial content for STU1 ballot.