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

: Example Value-Based Contract - ABC Payer and GoodHealth - JSON Representation

Active as of 2024-05-10

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{
  "resourceType" : "Measure",
  "id" : "vbp-measure01",
  "meta" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/instance-name",
        "valueString" : "Payer"
      },
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/instance-description",
        "valueMarkdown" : "This is an example measure for the *VBP Measure* profile."
      }
    ],
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/vbp-measure"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Measure</b><a name=\"vbp-measure01\"> </a><a name=\"hcvbp-measure01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Measure &quot;vbp-measure01&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-vbp-measure.html\">Value-Based Performance Measure</a></p></div><p><b>Line of Business</b>: MEDICARE <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-SOPT.html\">Source of Payment Typology</a>#1)</span></p><blockquote><p><b>Program Model</b></p><blockquote><p><b>url</b></p><code>hcplan</code></blockquote><p><b>value</b>: Category 3A <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hcplan-framework.html\">HCPLAN Framework Categories Codes</a>#3A)</span></p><blockquote><p><b>url</b></p><code>cohort</code></blockquote><p><b>value</b>: HMO cohort <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-cohort.html\">Cohort Codes</a>#hmo)</span></p></blockquote><blockquote><p><b>Program Model</b></p><blockquote><p><b>url</b></p><code>hcplan</code></blockquote><p><b>value</b>: Category 3B <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hcplan-framework.html\">HCPLAN Framework Categories Codes</a>#3B)</span></p><blockquote><p><b>url</b></p><code>cohort</code></blockquote><p><b>value</b>: PPO cohort <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-cohort.html\">Cohort Codes</a>#ppo)</span></p></blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Shared savings gated on quality <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-payment-stream.html\">Payment Stream Codes</a>#ssq)</span></p></blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Care coordination fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-payment-stream.html\">Payment Stream Codes</a>#ccf)</span></p></blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Quality incentive payment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-payment-stream.html\">Payment Stream Codes</a>#qip)</span></p></blockquote><p><b>url</b>: <code>https://build.fhir.org/ig/HL7/davinci-vbpr/Measure-vbp-measure01</code></p><p><b>identifier</b>: <code>http://example.org/fhir/server</code>/ex-vbp-measure01\u00a0(use:\u00a0temp), <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-uri.html\" title=\"As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt \r\n\r\nThis oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: \r\n\r\nNote that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.30.29.1</p><p><b>version</b>: 1.0.0</p><p><b>name</b>: VbprMeasureExample01</p><p><b>title</b>: Example Value-Based Contract - ABC Payer and GoodHealth</p><p><b>status</b>: active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-05-10 01:08:13+0000</p><p><b>publisher</b>: HL7 International / Clinical Quality Information</p><p><b>contact</b>: HL7 International / Clinical Quality Information: <a href=\"http://www.hl7.org/Special/committees/cqi\">http://www.hl7.org/Special/committees/cqi</a></p><p><b>description</b>: Example Value-Based Contract between ABC Payer and GoodHealth</p><p><b>jurisdiction</b>: United States of America <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-ISO3166Part1.html\">ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code</a>#US)</span></p><p><b>effectivePeriod</b>: 2022-01-01 --&gt; 2024-12-31</p><h3>RelatedArtifacts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Type</b></td><td><b>Display</b></td><td><b>Resource</b></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Breast Cancer Screening</td><td><a href=\"http://hl7.org/fhir/us/cqfmeasures/STU3/Measure-measure-exm125-FHIR.html\">EXM125 - Breast Cancer Screening Measure</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Colorectal Cancer Screening</td><td><a href=\"http://hl7.org/fhir/us/cqfmeasures/STU3/Measure-measure-exm130-FHIR.html\">EXM130 - Colorectal Cancer Screening Measure</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Diabetes Care - Blood Sugar Controlled</td><td><a href=\"http://example.org/Measure/measure-diabetes-care-blood-sugar-controlled-FHIR\">http://example.org/Measure/measure-diabetes-care-blood-sugar-controlled-FHIR</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Diabetes Care - Eye Exam</td><td><a href=\"http://example.org/Measure/measure-diabetes-care-eye-exam-FHIR\">http://example.org/Measure/measure-diabetes-care-eye-exam-FHIR</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Medication Adherence for Cholesterol (Statins)</td><td><a href=\"http://example.org/Measure/measure-med-adherence-cholesterol-statins-FHIR\">http://example.org/Measure/measure-med-adherence-cholesterol-statins-FHIR</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Medication Adherence for Hypertension (RAS antagonists)</td><td><a href=\"http://example.org/Measure/measure-med-adherence-hypertension-FHIR\">http://example.org/Measure/measure-med-adherence-hypertension-FHIR</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Medication Adherence for Diabetes Medications</td><td><a href=\"http://example.org/Measure/measure-med-adherence-diabetes-meds-FHIR\">http://example.org/Measure/measure-med-adherence-diabetes-meds-FHIR</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Statin Therapy for Patients with Cardiovascular Disease</td><td><a href=\"http://example.org/Measure/measure-statin-therapy-cardiovascular-disease-FHIR\">http://example.org/Measure/measure-statin-therapy-cardiovascular-disease-FHIR</a></td></tr><tr><td style=\"display: none\">*</td><td>, </td><td>composed-of</td><td>Statin Use in Persons with Diabetes (SUPD)</td><td><a href=\"http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR\">http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR</a></td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/lob",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "https://nahdo.org/sopt",
            "code" : "1",
            "display" : "MEDICARE"
          }
        ],
        "text" : "MEDICARE"
      }
    },
    {
      "extension" : [
        {
          "url" : "hcplan",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework",
                "code" : "3A",
                "display" : "Category 3A"
              }
            ]
          }
        },
        {
          "url" : "cohort",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-cohort",
                "code" : "hmo",
                "display" : "HMO cohort"
              }
            ]
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/program-model"
    },
    {
      "extension" : [
        {
          "url" : "hcplan",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework",
                "code" : "3B",
                "display" : "Category 3B"
              }
            ]
          }
        },
        {
          "url" : "cohort",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-cohort",
                "code" : "ppo",
                "display" : "PPO cohort"
              }
            ]
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/program-model"
    },
    {
      "extension" : [
        {
          "url" : "type",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/payment-stream",
                "code" : "ssq"
              }
            ],
            "text" : "Shared savings gated on quality"
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/payment-stream"
    },
    {
      "extension" : [
        {
          "url" : "type",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/payment-stream",
                "code" : "ccf"
              }
            ],
            "text" : "Care coordination fee"
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/payment-stream"
    },
    {
      "extension" : [
        {
          "url" : "type",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/payment-stream",
                "code" : "qip"
              }
            ],
            "text" : "Quality incentive payment"
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/payment-stream"
    }
  ],
  "url" : "https://build.fhir.org/ig/HL7/davinci-vbpr/Measure-vbp-measure01",
  "identifier" : [
    {
      "use" : "temp",
      "system" : "http://example.org/fhir/server",
      "value" : "ex-vbp-measure01"
    },
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.30.29.1"
    }
  ],
  "version" : "1.0.0",
  "name" : "VbprMeasureExample01",
  "title" : "Example Value-Based Contract - ABC Payer and GoodHealth",
  "status" : "active",
  "experimental" : true,
  "date" : "2024-05-10T01:08:13+00:00",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "name" : "HL7 International / Clinical Quality Information",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "Example Value-Based Contract between ABC Payer and GoodHealth",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "effectivePeriod" : {
    "start" : "2022-01-01",
    "end" : "2024-12-31"
  },
  "relatedArtifact" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 1
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Breast Cancer Screening",
      "resource" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm125-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 3
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Colorectal Cancer Screening",
      "resource" : "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm130-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 3
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Diabetes Care - Blood Sugar Controlled",
      "resource" : "http://example.org/Measure/measure-diabetes-care-blood-sugar-controlled-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 3
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Diabetes Care - Eye Exam",
      "resource" : "http://example.org/Measure/measure-diabetes-care-eye-exam-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 3
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "reporting-only",
                "display" : "Reporting Only"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Medication Adherence for Cholesterol (Statins)",
      "resource" : "http://example.org/Measure/measure-med-adherence-cholesterol-statins-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 3
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Medication Adherence for Hypertension (RAS antagonists)",
      "resource" : "http://example.org/Measure/measure-med-adherence-hypertension-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 3
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Medication Adherence for Diabetes Medications",
      "resource" : "http://example.org/Measure/measure-med-adherence-diabetes-meds-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 1
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Statin Therapy for Patients with Cardiovascular Disease",
      "resource" : "http://example.org/Measure/measure-statin-therapy-cardiovascular-disease-FHIR"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight",
          "valueDecimal" : 1
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/contractual-status",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-contractual-status",
                "code" : "contractual",
                "display" : "Contractual"
              }
            ]
          }
        }
      ],
      "type" : "composed-of",
      "display" : "Statin Use in Persons with Diabetes (SUPD)",
      "resource" : "http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR"
    }
  ]
}