Da Vinci Value-Based Performance Reporting Implementation Guide
1.0.0 - STU1 United States of America flag

Da Vinci Value-Based Performance Reporting Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-vbpr/ and changes regularly. See the Directory of published versions

Resource Profile: Value-Based Performance MeasureReport

Official URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/vbp-performance-measurereport Version: 1.0.0
Active as of 2024-06-12 Computable Name: VbpMeasureReport
Other Identifiers: OID:2.16.840.1.113883.4.642.40.30.42.14

Value-Based Performance MeasureReport is a payer-generated performance report against the specific details (metrics) of a value-based contract (VBC) or a value-based purchasing (VBP) which may include financial, quality, utilization, etc. over a time period.

The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Value-Based Performance MeasureReport has the following mandatory elements

  1. A measurereport-category - with a fixed code vbp
  2. A status - status of this report
  3. A type - with a fixed value summary
  4. A measure - that references the Value-Based Performance Measure
  5. An orgSubject extention on subject - that references the organization the report is for
  6. A date
  7. A reporter - references the organization who is reporting the data
  8. A period - the performance period the report covers

Each Value-Based Performance MeasureReport should have the following elements

  1. Zero to many group - each group corresponds to a performance metric
    • If group is present, each group must have a group.code that represents the performance metric
  2. Zero to many evaluatedResource - references the VBP Quality MeasureReport profile

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from MeasureReport

NameFlagsCard.TypeDescription & Constraintsdoco
.. MeasureReport 0..* MeasureReport A value-based performance report
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... measurereport-category S 1..1 (Complex) What category is this measure report
URL: http://hl7.org/fhir/StructureDefinition/measurereport-category
..... value[x]
...... coding 1..1 Coding Code defined by a terminology system
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: vbp
... status S 1..1 code complete | pending | error
... type S 1..1 code individual | subject-list | summary | data-collection
Fixed Value: summary
... subject S 1..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | Group) What individual(s) the report is for
.... extension 1..* Extension Extension
.... Slices for extension Content/Rules for all slices
..... orgSubject S 1..1 Reference(US Core Organization Profile) What organization the report is for
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/organization-subject
... date S 1..1 dateTime When the report was generated
... reporter S 1..1 Reference(US Core Organization Profile) Who is reporting the data
... period S 1..1 Period What performance period the report covers
... improvementNotation 0..0
... group S 0..* BackboneElement Performance metrics in the report. Each group contains data for a performance metric.
.... id S 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... paymentStream S 0..* (Complex) The payment stream the performance metric is part of
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/payment-stream
..... servicePeriod S 0..1 Period The service period for the performance metric
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/service-period
..... paidThroughDate S 0..1 date Ending date of the pay cycle
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/paid-through-date
..... baseline S 0..1 (Complex) The baseline for the performance metric
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/baseline
.... code S 1..1 CodeableConcept Performance metric
Binding: Performance Metric (extensible)
.... measureScore 0..1 Quantity The performance metric value
..... Slices for extension Content/Rules for all slices
...... altMeasureScore S 0..1 boolean, decimal, integer, CodeableConcept, Money Additional data type choices for the value of the performance metric
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/alternate-measurescore
.... stratifier S 0..* BackboneElement Stratification results
..... code S 0..* CodeableConcept What stratifier of the group
Binding: Measure Stratifier Example (example)
..... stratum S 0..* BackboneElement Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
...... value S 0..1 CodeableConcept The stratum value, e.g. male
...... component
....... code S 1..1 CodeableConcept What stratifier component of the group
Binding: Measure Stratifier Example (example)
....... value S 1..1 CodeableConcept The stratum component value, e.g. male
...... measureScore S 0..1 Quantity Stratified performance metric value
....... Slices for extension Content/Rules for all slices
........ altMeasureScore S 0..1 boolean, decimal, integer, CodeableConcept, Money Additional data type choices for the stratified performance metric value
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/alternate-measurescore
... Slices for evaluatedResource S 0..* Reference(Resource) What data was used to calculate the performance metric(s)
Slice: Unordered, Open by type:reference
.... evaluatedResource:qualityReport 0..* Reference(VBP Quality MeasureReport) quality measure MeasureReport
..... Slices for extension Content/Rules for all slices
...... groupRef S 0..* string Reference a performance metric (MeasureReport.group.id) on this value-based performance report
URL: http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/group-reference

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MeasureReport.group.codeextensibleVbpPerformanceMetricsVS (a valid code from Performance Metric Codes)
http://hl7.org/fhir/us/davinci-vbpr/ValueSet/vbp-performance-metric
from this IG
MeasureReport.group.stratifier.codeexampleMeasureStratifierExampleVS (a valid code from Measure Stratifier Example Codes)
http://hl7.org/fhir/us/davinci-vbpr/ValueSet/measure-stratifier-example
from this IG
MeasureReport.group.stratifier.stratum.component.codeexampleMeasureStratifierExampleVS (a valid code from Measure Stratifier Example Codes)
http://hl7.org/fhir/us/davinci-vbpr/ValueSet/measure-stratifier-example
from this IG

 

Other representations of profile: CSV, Excel, Schematron