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

Resource Profile: RiskAdjustmentCodingGapMeasureReport - Detailed Descriptions

Active as of 2024-05-16

Definitions for the ra-measurereport resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MeasureReport
Definition

This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model.

ShortThis is a risk adjustment coding gap report.
2. MeasureReport.extension:clinicalDataCollectionDeadline
Slice NameclinicalDataCollectionDeadline
Control0..1
TypeExtension(Risk Adjustment Clinical Data Collection Deadline) (Extension Type: date)
Must Supporttrue
4. MeasureReport.status
Must Supporttrue
6. MeasureReport.type
ShortThe type code is fixed to 'individual' for a risk adjustment coding gap report
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Fixed Valueindividual
8. MeasureReport.measure
ShortThis references a measure that represents a risk adjustment model, such as CMS-HCC V24.
Typecanonical(Risk Adjustment Model Measure)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
10. MeasureReport.subject
Control1..1
TypeReference(US Core Patient Profile)
Must Supporttrue
12. MeasureReport.date
Definition

This is the date when the risk adjustment coding gap reports were generated by payers' back end systems such as legacy system, FHIR server, risk adjustment engine. For example, a payer may generate risk adjustment coding gap reports for members quarterly or at a different frequency.

ShortWhen the report was generated
Control1..1
Must Supporttrue
14. MeasureReport.reporter
Definition

Organization that generated the MeasureReport

ShortOrganization that generated the MeasureReport
Control1..1
TypeReference(US Core Organization Profile)
Must Supporttrue
16. MeasureReport.period
ShortClinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes.
Control1..1
This element is affected by the following invariants: ra-1
TypePeriod
Must Supporttrue
Invariantsra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
18. MeasureReport.period.start
Control1..1
Must Supporttrue
20. MeasureReport.period.end
Control1..1
Must Supporttrue
22. MeasureReport.group
Definition

Condition Categories and detailed information for the coding gap.

ShortA group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
Control0..*
Must Supporttrue
24. MeasureReport.group.id
Control1..1
Must Supporttrue
26. MeasureReport.group.extension:ccType
Slice NameccType
Control1..1
TypeExtension(Risk Adjustment Condition Category Type) (Extension Type: CodeableConcept)
Must Supporttrue
28. MeasureReport.group.extension:dxCode
Slice NamedxCode
Control0..*
TypeExtension(Diagnosis Code) (Extension Type: CodeableConcept)
Must Supporttrue
30. MeasureReport.group.extension:evidenceStatus
Slice NameevidenceStatus
Control0..1
TypeExtension(Evidence Status) (Extension Type: CodeableConcept)
Must Supporttrue
32. MeasureReport.group.extension:evidenceStatusDate
Slice NameevidenceStatusDate
Control0..1
TypeExtension(Risk Adjustment Evidence Status Date) (Extension Type: date)
Must Supporttrue
34. MeasureReport.group.extension:hierarchicalStatus
Slice NamehierarchicalStatus
Control0..1
TypeExtension(Hierarchical Status) (Extension Type: CodeableConcept)
Must Supporttrue
36. MeasureReport.group.extension:confidenceScale
Slice NameconfidenceScale
Control0..1
TypeExtension(Confidence Scale) (Extension Type: CodeableConcept)
Must Supporttrue
38. MeasureReport.group.extension:ccRemark
Slice NameccRemark
ShortRemark added to a Condition Category
Control0..*
TypeExtension(Condition Category Remark) (Complex Extension)
Must Supporttrue
40. MeasureReport.group.code
Definition

Condition Category (CC) code for a Risk Adjustment Model.

ShortCondition Category (CC) code for a Risk Adjustment Model
Control0..1
BindingFor example codes, see Sample CMS Hierarchical Condition Category
(example to http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc)
TypeCodeableConcept
Must Supporttrue
42. MeasureReport.group.stratifier
44. MeasureReport.group.stratifier.code
Control0..1
46. MeasureReport.evaluatedResource
Definition

An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of an Condition Category (CC) gap.

ShortAn evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
Must Supporttrue
48. MeasureReport.evaluatedResource.extension:groupReference
Slice NamegroupReference
Definition

This id references the MeasureReport.group.id, which allows linking a supporting resource to a specific Condition Categories coding gap.

Control0..*
TypeExtension(Group Reference) (Extension Type: string)
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. MeasureReport
Definition

This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model.


The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.

ShortThis is a risk adjustment coding gap report.Results of a measure evaluation
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
2. MeasureReport.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MeasureReport.extension:clinicalDataCollectionDeadline
Slice NameclinicalDataCollectionDeadline
Definition

This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer.

ShortThis is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered.
Comments

This is an extension to represent the clinical data collection deadline

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Risk Adjustment Clinical Data Collection Deadline) (Extension Type: date)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MeasureReport.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. MeasureReport.status
Definition

The MeasureReport status. No data will be available until the MeasureReport status is complete.

Shortcomplete | pending | error
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from MeasureReportStatushttp://hl7.org/fhir/ValueSet/measure-report-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1)

The status of the measure report.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MeasureReport.type
Definition

The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

ShortThe type code is fixed to 'individual' for a risk adjustment coding gap reportindividual | subject-list | summary | data-collection
Comments

Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

Control1..1
This element is affected by the following invariants: mrp-1
BindingThe codes SHALL be taken from MeasureReportTypehttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1)

The type of the measure report.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valueindividual
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MeasureReport.measure
Definition

A reference to the Measure that was calculated to produce this report.

ShortThis references a measure that represents a risk adjustment model, such as CMS-HCC V24.What measure was calculated
Control1..1
Typecanonical(Risk Adjustment Model Measure, Measure)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. MeasureReport.subject
Definition

Optional subject identifying the individual or individuals the report is for.

ShortWhat individual(s) the report is for
Control10..1
TypeReference(US Core Patient Profile, Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson, Group)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MeasureReport.date
Definition

This is the date when the risk adjustment coding gap reports were generated by payers' back end systems such as legacy system, FHIR server, risk adjustment engine. For example, a payer may generate risk adjustment coding gap reports for members quarterly or at a different frequency.


The date this measure report was generated.

ShortWhen the report was generated
Control10..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. MeasureReport.reporter
Definition

Organization that generated the MeasureReport


The individual, location, or organization that is reporting the data.

ShortOrganization that generated the MeasureReportWho is reporting the data
Control10..1
TypeReference(US Core Organization Profile, Practitioner, PractitionerRole, Location, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. MeasureReport.period
Definition

The reporting period for which the report was calculated.

ShortClinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes.What period the report covers
Control1..1
This element is affected by the following invariants: ra-1
TypePeriod
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
22. MeasureReport.period.start
Definition

The start of the period. The boundary is inclusive.

ShortStarting time with inclusive boundary
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Control10..1
This element is affected by the following invariants: per-1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. MeasureReport.period.end
Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

ShortEnd time with inclusive boundary, if not ongoing
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Control10..1
This element is affected by the following invariants: per-1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. MeasureReport.improvementNotation
Definition

Whether improvement in the measure is noted by an increase or decrease in the measure score.

Shortincrease | decrease
Comments

This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.

Control0..1
BindingThe codes SHALL be taken from MeasureImprovementNotationhttp://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1
(required to http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1)

Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

TypeCodeableConcept
Is Modifiertrue because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. MeasureReport.group
Definition

Condition Categories and detailed information for the coding gap.


The results of the calculation, one for each population group in the measure.

ShortA group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.Measure results for each group
Control0..*
This element is affected by the following invariants: mrp-1
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. MeasureReport.group.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control10..1
Typestring
Is Modifierfalse
Must Supporttrue
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
32. MeasureReport.group.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MeasureReport.group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 34. MeasureReport.group.extension:ccType
    Slice NameccType
    Definition

    Condition Category type, whether the CC gap is historic, suspected, or net-new

    ShortCondition Category type: historic|suspected|net-new
    Comments

    This extension is to represent risk adjustment Condition Category (CC) type

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Risk Adjustment Condition Category Type) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    36. MeasureReport.group.extension:dxCode
    Slice NamedxCode
    Definition

    Diagnosis code

    ShortDiagnosis code
    Comments

    Diagnosis codes such as ICD-10 for the diagnosis/condition that attributed to the Condition Category.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Diagnosis Code) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    38. MeasureReport.group.extension:evidenceStatus
    Slice NameevidenceStatus
    Definition

    Condition Category gap evidence status

    ShortThis is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|invalid-gap|pending.
    Comments

    This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Evidence Status) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    40. MeasureReport.group.extension:evidenceStatusDate
    Slice NameevidenceStatusDate
    Definition

    When the evidence status changed to either closed-gap, open-gap, or pending.

    ShortWhen the evidence status was changed to either closed-gap, open-gap, or pending
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Risk Adjustment Evidence Status Date) (Extension Type: date)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    42. MeasureReport.group.extension:hierarchicalStatus
    Slice NamehierarchicalStatus
    Definition

    Hierarchies applied to a Condition Category (CC) status

    ShortHow hiearchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable
    Comments

    This extension hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Hierarchical Status) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    44. MeasureReport.group.extension:confidenceScale
    Slice NameconfidenceScale
    Definition

    Coding gap confidence scale

    ShortConfidence scale for a coding gap
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Confidence Scale) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    46. MeasureReport.group.extension:ccRemark
    Slice NameccRemark
    Definition

    Remark about a Condition Category

    ShortRemark added to a Condition Category
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Condition Category Remark) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    48. MeasureReport.group.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    50. MeasureReport.group.code
    Definition

    Condition Category (CC) code for a Risk Adjustment Model.


    The meaning of the population group as defined in the measure definition.

    ShortCondition Category (CC) code for a Risk Adjustment ModelMeaning of the group
    Control0..1
    BindingFor example codes, see For codes, see Sample CMS Hierarchical Condition Category
    (example to http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. MeasureReport.evaluatedResource
    Definition

    An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of an Condition Category (CC) gap.


    A reference to a Bundle containing the Resources that were used in the calculation of this measure.

    ShortAn evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.What data was used to calculate the measure score
    Control0..*
    TypeReference(Resource)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. MeasureReport.evaluatedResource.extension:groupReference
    Slice NamegroupReference
    Definition

    This id references the MeasureReport.group.id, which allows linking a supporting resource to a specific Condition Categories coding gap.

    ShortThis references the MeasureReport.group.id.
    Comments

    This is an extension to reference a Condition Category (CC).

    Control0..*
    TypeExtension(Group Reference) (Extension Type: string)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

    Guidance on how to interpret the contents of this table can be found here

    0. MeasureReport
    Definition

    This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model.

    ShortThis is a risk adjustment coding gap report.
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
    mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
    2. MeasureReport.id
    Definition

    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

    ShortLogical id of this artifact
    Comments

    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

    Control0..1
    Typeid
    Is Modifierfalse
    Summarytrue
    4. MeasureReport.meta
    Definition

    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

    ShortMetadata about the resource
    Control0..1
    TypeMeta
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. MeasureReport.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. MeasureReport.language
    Definition

    The base language in which the resource is written.

    ShortLanguage of the resource content
    Comments

    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

    Control0..1
    BindingThe codes SHOULD be taken from CommonLanguages
    (preferred to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. MeasureReport.text
    Definition

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortText summary of the resource, for human interpretation
    Comments

    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

    Control0..1
    TypeNarrative
    Is Modifierfalse
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. MeasureReport.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

    ShortContained, inline Resources
    Comments

    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

    Control0..*
    TypeResource
    Is Modifierfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    14. MeasureReport.extension
    Definition

    An Extension

    ShortExtension
    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MeasureReport.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 16. MeasureReport.extension:clinicalDataCollectionDeadline
      Slice NameclinicalDataCollectionDeadline
      Definition

      This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer.

      ShortThis is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer and applies to the early-bird date if incentive were offered.
      Comments

      This is an extension to represent the clinical data collection deadline

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Risk Adjustment Clinical Data Collection Deadline) (Extension Type: date)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. MeasureReport.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      20. MeasureReport.identifier
      Definition

      A formal identifier that is used to identify this MeasureReport when it is represented in other formats or referenced in a specification, model, design or an instance.

      ShortAdditional identifier for the MeasureReport
      Comments

      Typically, this is used for identifiers that can go in an HL7 V3 II data type - e.g. to identify this {{title}} outside of FHIR, where the logical URL is not possible to use.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows externally provided and/or usable business identifiers to be easily associated with the module.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. MeasureReport.status
      Definition

      The MeasureReport status. No data will be available until the MeasureReport status is complete.

      Shortcomplete | pending | error
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from MeasureReportStatus
      (required to http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1)

      The status of the measure report.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. MeasureReport.type
      Definition

      The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

      ShortThe type code is fixed to 'individual' for a risk adjustment coding gap report
      Comments

      Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

      Control1..1
      This element is affected by the following invariants: mrp-1
      BindingThe codes SHALL be taken from MeasureReportType
      (required to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1)

      The type of the measure report.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Fixed Valueindividual
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. MeasureReport.measure
      Definition

      A reference to the Measure that was calculated to produce this report.

      ShortThis references a measure that represents a risk adjustment model, such as CMS-HCC V24.
      Control1..1
      Typecanonical(Risk Adjustment Model Measure)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. MeasureReport.subject
      Definition

      Optional subject identifying the individual or individuals the report is for.

      ShortWhat individual(s) the report is for
      Control1..1
      TypeReference(US Core Patient Profile)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. MeasureReport.date
      Definition

      This is the date when the risk adjustment coding gap reports were generated by payers' back end systems such as legacy system, FHIR server, risk adjustment engine. For example, a payer may generate risk adjustment coding gap reports for members quarterly or at a different frequency.

      ShortWhen the report was generated
      Control1..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MeasureReport.reporter
      Definition

      Organization that generated the MeasureReport

      ShortOrganization that generated the MeasureReport
      Control1..1
      TypeReference(US Core Organization Profile)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MeasureReport.period
      Definition

      The reporting period for which the report was calculated.

      ShortClinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes.
      Control1..1
      This element is affected by the following invariants: ra-1
      TypePeriod
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
      36. MeasureReport.period.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      38. MeasureReport.period.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MeasureReport.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 40. MeasureReport.period.start
        Definition

        The start of the period. The boundary is inclusive.

        ShortStarting time with inclusive boundary
        Comments

        If the low element is missing, the meaning is that the low boundary is not known.

        Control1..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MeasureReport.period.end
        Definition

        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        ShortEnd time with inclusive boundary, if not ongoing
        Comments

        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

        Control1..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MeasureReport.improvementNotation
        Definition

        Whether improvement in the measure is noted by an increase or decrease in the measure score.

        Shortincrease | decrease
        Comments

        This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.

        Control0..1
        BindingThe codes SHALL be taken from MeasureImprovementNotation
        (required to http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1)

        Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

        TypeCodeableConcept
        Is Modifiertrue because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. MeasureReport.group
        Definition

        Condition Categories and detailed information for the coding gap.

        ShortA group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
        Control0..*
        This element is affected by the following invariants: mrp-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MeasureReport.group.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control1..1
        Typestring
        Is Modifierfalse
        Must Supporttrue
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        50. MeasureReport.group.extension
        Definition

        An Extension

        ShortExtension
        Control1..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MeasureReport.group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 52. MeasureReport.group.extension:ccType
          Slice NameccType
          Definition

          Condition Category type, whether the CC gap is historic, suspected, or net-new

          ShortCondition Category type: historic|suspected|net-new
          Comments

          This extension is to represent risk adjustment Condition Category (CC) type

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Risk Adjustment Condition Category Type) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          54. MeasureReport.group.extension:dxCode
          Slice NamedxCode
          Definition

          Diagnosis code

          ShortDiagnosis code
          Comments

          Diagnosis codes such as ICD-10 for the diagnosis/condition that attributed to the Condition Category.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Diagnosis Code) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          56. MeasureReport.group.extension:evidenceStatus
          Slice NameevidenceStatus
          Definition

          Condition Category gap evidence status

          ShortThis is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|invalid-gap|pending.
          Comments

          This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, invalid-gap, or pending.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Evidence Status) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          58. MeasureReport.group.extension:evidenceStatusDate
          Slice NameevidenceStatusDate
          Definition

          When the evidence status changed to either closed-gap, open-gap, or pending.

          ShortWhen the evidence status was changed to either closed-gap, open-gap, or pending
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Risk Adjustment Evidence Status Date) (Extension Type: date)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          60. MeasureReport.group.extension:hierarchicalStatus
          Slice NamehierarchicalStatus
          Definition

          Hierarchies applied to a Condition Category (CC) status

          ShortHow hiearchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable
          Comments

          This extension hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Hierarchical Status) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          62. MeasureReport.group.extension:confidenceScale
          Slice NameconfidenceScale
          Definition

          Coding gap confidence scale

          ShortConfidence scale for a coding gap
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Confidence Scale) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          64. MeasureReport.group.extension:ccRemark
          Slice NameccRemark
          Definition

          Remark about a Condition Category

          ShortRemark added to a Condition Category
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Condition Category Remark) (Complex Extension)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          66. MeasureReport.group.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          68. MeasureReport.group.code
          Definition

          Condition Category (CC) code for a Risk Adjustment Model.

          ShortCondition Category (CC) code for a Risk Adjustment Model
          Control0..1
          BindingFor example codes, see Sample CMS Hierarchical Condition Category
          (example to http://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. MeasureReport.group.population
          Definition

          The populations that make up the population group, one for each type of population appropriate for the measure.

          ShortThe populations in the group
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. MeasureReport.group.population.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          74. MeasureReport.group.population.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          76. MeasureReport.group.population.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          78. MeasureReport.group.population.code
          Definition

          The type of the population.

          Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationType
          (extensible to http://hl7.org/fhir/ValueSet/measure-population)

          The type of population (e.g. initial, numerator, denominator, etc.).

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. MeasureReport.group.population.count
          Definition

          The number of members of the population.

          ShortSize of the population
          Control0..1
          Typeinteger
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. MeasureReport.group.population.subjectResults
          Definition

          This element refers to a List of subject level MeasureReport resources, one for each subject in this population.

          ShortFor subject-list reports, the subject results in this population
          Control0..1
          TypeReference(List)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. MeasureReport.group.measureScore
          Definition

          The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.

          ShortWhat score this group achieved
          Control0..1
          TypeQuantity
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. MeasureReport.group.stratifier
          Definition

          When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.

          ShortStratification results
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. MeasureReport.group.stratifier.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          90. MeasureReport.group.stratifier.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          92. MeasureReport.group.stratifier.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          94. MeasureReport.group.stratifier.code
          Definition

          The meaning of this stratifier, as defined in the measure definition.

          ShortWhat stratifier of the group
          Control0..1
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. MeasureReport.group.stratifier.stratum
          Definition

          This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.

          ShortStratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. MeasureReport.group.stratifier.stratum.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          100. MeasureReport.group.stratifier.stratum.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          102. MeasureReport.group.stratifier.stratum.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          104. MeasureReport.group.stratifier.stratum.value
          Definition

          The value for this stratum, expressed as a CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique.

          ShortThe stratum value, e.g. male
          Control0..1
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. MeasureReport.group.stratifier.stratum.component
          Definition

          A stratifier component value.

          ShortStratifier component values
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. MeasureReport.group.stratifier.stratum.component.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          110. MeasureReport.group.stratifier.stratum.component.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          112. MeasureReport.group.stratifier.stratum.component.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          114. MeasureReport.group.stratifier.stratum.component.code
          Definition

          The code for the stratum component value.

          ShortWhat stratifier component of the group
          Control1..1
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. MeasureReport.group.stratifier.stratum.component.value
          Definition

          The stratum component value.

          ShortThe stratum component value, e.g. male
          Control1..1
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. MeasureReport.group.stratifier.stratum.population
          Definition

          The populations that make up the stratum, one for each type of population appropriate to the measure.

          ShortPopulation results in this stratum
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. MeasureReport.group.stratifier.stratum.population.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          122. MeasureReport.group.stratifier.stratum.population.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          124. MeasureReport.group.stratifier.stratum.population.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          126. MeasureReport.group.stratifier.stratum.population.code
          Definition

          The type of the population.

          Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationType
          (extensible to http://hl7.org/fhir/ValueSet/measure-population)

          The type of population (e.g. initial, numerator, denominator, etc.).

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. MeasureReport.group.stratifier.stratum.population.count
          Definition

          The number of members of the population in this stratum.

          ShortSize of the population
          Control0..1
          Typeinteger
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          130. MeasureReport.group.stratifier.stratum.population.subjectResults
          Definition

          This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.

          ShortFor subject-list reports, the subject results in this population
          Control0..1
          TypeReference(List)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          132. MeasureReport.group.stratifier.stratum.measureScore
          Definition

          The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.

          ShortWhat score this stratum achieved
          Control0..1
          TypeQuantity
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. MeasureReport.evaluatedResource
          Definition

          An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of an Condition Category (CC) gap.

          ShortAn evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of a Condition Category (CC) gap.
          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          136. MeasureReport.evaluatedResource.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          138. MeasureReport.evaluatedResource.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MeasureReport.evaluatedResource.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 140. MeasureReport.evaluatedResource.extension:groupReference
            Slice NamegroupReference
            Definition

            This id references the MeasureReport.group.id, which allows linking a supporting resource to a specific Condition Categories coding gap.

            ShortThis references the MeasureReport.group.id.
            Comments

            This is an extension to reference a Condition Category (CC).

            Control0..*
            TypeExtension(Group Reference) (Extension Type: string)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            142. MeasureReport.evaluatedResource.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control0..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            144. MeasureReport.evaluatedResource.type
            Definition

            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

            ShortType the reference refers to (e.g. "Patient")
            Comments

            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from ResourceType
            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

            Aa resource (or, for logical models, the URI of the logical model).

            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. MeasureReport.evaluatedResource.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. MeasureReport.evaluatedResource.display
            Definition

            Plain text narrative that identifies the resource in addition to the resource reference.

            ShortText alternative for the resource
            Comments

            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))