Da Vinci Value-Based Performance Reporting Implementation Guide
1.0.0 - STU1
Da Vinci Value-Based Performance Reporting Implementation Guide
1.0.0 - STU1
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
<MeasureReport xmlns="http://hl7.org/fhir">
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<valueMarkdown
value="This is an example Value-Based Performance MeasureReport for the *VBP MeasureReport* profile., which includes utilization and quality."/>
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value="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/vbp-performance-measurereport"/>
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<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MeasureReport</b><a name="vbp-measurereport102"> </a><a name="hcvbp-measurereport102"> </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 MeasureReport "vbp-measurereport102" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-vbp-performance-measurereport.html">Value-Based Performance MeasureReport</a></p></div><p><b>Measure Report Category</b>: Value-Based Performance <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-measurereport-category.html">Measure Report Category</a>#vbp)</span></p><p><b>status</b>: complete</p><p><b>type</b>: summary</p><p><b>measure</b>: <a href="Measure-vbp-measure02.html">Example Value-Based Contract - ABC Payer and EveryHospital</a></p><p><b>subject</b>: <span>: Every Hospital</span></p><p><b>date</b>: 2022-12-31</p><p><b>reporter</b>: <a href="Organization-vbp-payer01.html">Organization/vbp-payer01</a> "ABC Payer"</p><p><b>period</b>: 2022-10-01 --> 2022-12-31</p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ubip-group-01</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: 250 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: In patient admission <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#inpatient-admission)</span></p><p><b>measureScore</b>: 400 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ubip-group-02</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: 180 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: In patient acute <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#inpatient-acute)</span></p><p><b>measureScore</b>: 350 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ubip-group-03</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: 51 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: Readmission <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#readmission)</span></p><p><b>measureScore</b>: 120 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ubip-group-04</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: 350 per 100<span style="background: LightGoldenRodYellow"> (Details: UCUM code /100 = '/100')</span></p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: ED visit <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#ed-visit)</span></p><p><b>measureScore</b>: 300 /100<span style="background: LightGoldenRodYellow"> (Details: UCUM code /100 = '/100')</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ubip-group-05</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: 51 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: Skilled Nursing Facility admission <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#snf-admission)</span></p><p><b>measureScore</b>: 50 /10*3<span style="background: LightGoldenRodYellow"> (Details: UCUM code /10*3 = '/10*3')</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ubip-group-06</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: 22 d<span style="background: LightGoldenRodYellow"> (Details: UCUM code d = 'd')</span></p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: Skilled Nursing Facility average length of stay <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#snf-avg-los)</span></p><p><b>measureScore</b>: 15 d<span style="background: LightGoldenRodYellow"> (Details: UCUM code d = 'd')</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>ssq-group-starscore</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><p><b>code</b>: Weighted average star <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#weighted-avg-star)</span></p><p><b>measureScore</b>: 2.5</p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>financial-group-01</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: <span title="US Dollar">$800.00</span> (USD)</p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: Total medical expense PMPM <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#med-cost-pmpm)</span></p><p><b>measureScore</b>: </p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>financial-group-02</blockquote><blockquote><p><b>Payment Stream</b></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Utilization incentive payment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-payment-stream.html">Payment Stream Codes</a>#ubip)</span></p></blockquote><blockquote><p><b>Baseline</b></p><blockquote><p><b>url</b></p><a href="StructureDefinition-baseline.html">Baseline</a></blockquote><p><b>value</b>: <span title="US Dollar">$800.00</span> (USD)</p><blockquote><p><b>url</b></p><code>period</code></blockquote><p><b>value</b>: 2021-01-01 --> 2021-12-31</p></blockquote><p><b>code</b>: Total medical expense PMPM <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-vbp-performance-metric.html">Performance Metric Codes</a>#ibnr-pmpm)</span></p><p><b>measureScore</b>: </p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href="MeasureReport-quality-measurereport11.html">MeasureReport/quality-measurereport11</a></li><li><a href="MeasureReport-quality-measurereport12.html">MeasureReport/quality-measurereport12</a></li><li><a href="MeasureReport-quality-measurereport13.html">MeasureReport/quality-measurereport13</a></li><li><a href="MeasureReport-quality-measurereport14.html">MeasureReport/quality-measurereport14</a></li><li><a href="MeasureReport-quality-measurereport15.html">MeasureReport/quality-measurereport15</a></li></ul></div>
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<coding>
<system
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<code value="vbp"/>
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<status value="complete"/>
<type value="summary"/>
<measure
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<subject>
<extension
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<valueReference>🔗
<reference value="Organization/vbp-provider02"/>
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<display value="Every Hospital"/>
</subject>
<date value="2022-12-31"/>
<reporter>🔗
<reference value="Organization/vbp-payer01"/>
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<period>
<start value="2022-10-01"/>
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<text value="Utilization incentive payment"/>
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<code>
<coding>
<system
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<code value="inpatient-admission"/>
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<measureScore>
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<coding>
<system
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<code value="inpatient-acute"/>
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<measureScore>
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<coding>
<system
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<text value="Readmission"/>
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<measureScore>
<value value="120"/>
<system value="http://unitsofmeasure.org"/>
<code value="/10*3"/>
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<system
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<text value="Utilization incentive payment"/>
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<code>
<coding>
<system
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<code value="ed-visit"/>
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<text value="ED visit"/>
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<measureScore>
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<group id="ubip-group-05">
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<system
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<code>
<coding>
<system
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<code value="snf-admission"/>
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<text value="Skilled Nursing Facility admission"/>
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<measureScore>
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<system value="http://unitsofmeasure.org"/>
<code value="/10*3"/>
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<group id="ubip-group-06">
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<code>
<coding>
<system
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<code value="snf-avg-los"/>
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<text value="Skilled Nursing Facility average length of stay"/>
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<measureScore>
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<system value="http://unitsofmeasure.org"/>
<code value="d"/>
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</group>
<group id="ssq-group-starscore">
<extension
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<extension url="type">
<valueCodeableConcept>
<coding>
<system
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<text value="Shared savings gated on quality"/>
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<code>
<coding>
<system
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<code value="weighted-avg-star"/>
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<text value="Weighted average star"/>
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<measureScore>
<value value="2.5"/>
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<group id="financial-group-01">
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<valueCodeableConcept>
<coding>
<system
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<text value="Utilization incentive payment"/>
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<extension
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<extension url="baseline">
<valueMoney>
<value value="800"/>
<currency value="USD"/>
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<extension url="period">
<valuePeriod>
<start value="2021-01-01"/>
<end value="2021-12-31"/>
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<code>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric"/>
<code value="med-cost-pmpm"/>
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<text value="Total medical expense PMPM"/>
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<measureScore>
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<valueMoney>
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<group id="financial-group-02">
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<coding>
<system
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<text value="Utilization incentive payment"/>
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<extension
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<extension url="baseline">
<valueMoney>
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<currency value="USD"/>
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<extension url="period">
<valuePeriod>
<start value="2021-01-01"/>
<end value="2021-12-31"/>
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<code>
<coding>
<system
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<code value="ibnr-pmpm"/>
</coding>
<text value="Total medical expense PMPM"/>
</code>
<measureScore>
<extension
url="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/alternate-measurescore">
<valueMoney>
<value value="800"/>
<currency value="USD"/>
</valueMoney>
</extension>
</measureScore>
</group>
<evaluatedResource>🔗
<extension
url="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/group-reference">
<valueString value="ssq-group-starscore"/>
</extension>
<reference value="MeasureReport/quality-measurereport11"/>
</evaluatedResource>
<evaluatedResource>🔗
<extension
url="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/group-reference">
<valueString value="ssq-group-starscore"/>
</extension>
<reference value="MeasureReport/quality-measurereport12"/>
</evaluatedResource>
<evaluatedResource>🔗
<extension
url="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/group-reference">
<valueString value="ssq-group-starscore"/>
</extension>
<reference value="MeasureReport/quality-measurereport13"/>
</evaluatedResource>
<evaluatedResource>🔗
<extension
url="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/group-reference">
<valueString value="ssq-group-starscore"/>
</extension>
<reference value="MeasureReport/quality-measurereport14"/>
</evaluatedResource>
<evaluatedResource>🔗
<extension
url="http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/group-reference">
<valueString value="ssq-group-starscore"/>
</extension>
<reference value="MeasureReport/quality-measurereport15"/>
</evaluatedResource>
</MeasureReport>
IG © 2023+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.davinci-vbpr#1.0.0 based on FHIR 4.0.1. Generated 2024-05-10
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