Da Vinci Value-Based Performance Reporting Implementation Guide
1.1.0 - STU 1.1 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 1.1.0 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

ValueSet: Performance Metric

Official URL: http://hl7.org/fhir/us/davinci-vbpr/ValueSet/vbp-performance-metric Version: 1.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: VbpPerformanceMetricsVS
Other Identifiers: OID:2.16.840.1.113883.4.642.40.30.48.10

Type of value-based performance reporting performance metric.

References

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem Performance Metric Codes v1.1.0 (CodeSystem)

This value set contains 93 concepts

SystemCodeDisplay (en)JSONXML
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-risk-scoreAverage risk score
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-risk-score-marketMarket average risk score
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  capitationCapitation
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  capitation-pmpmCapitation per member per month
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  dental-capitationDental capitation
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  dental-capitation-pmpmDental capitation PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  reinsurance-capitationReinsurance capitation
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  reinsurance-capitation-pmpmReinsurance capitation PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  ccfCare coordination fee
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  goal-hcc-rafGoal HCC RAF
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  actual-hcc-rafActual HCC RAF
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  earnings-ccfEarnings CCF
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  performance-ccfPerformance CCF
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-upside-ccfPotential upside CCF
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-downside-ccfPotential downside CCF
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  earned-incentiveEarned incentive
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  earnings-qipEarnings QIP
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  performance-qipPerformance QIP
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-upside-qipPotential upside QIP
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-downside-qipPotential downside QIP
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  earnings-sslEarnings SSL
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  performance-sslperformance SSL
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-upside-sslPotential upside SSL
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-downside-sslpotential downside SSL
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  earnings-capEarnings capitated
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  performance-capPerformance capitated
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-upside-capPotential upside capitated
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  potential-downside-capPotential downside capitated
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  quality-gate-percentageQuality gate percentage
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  quality-gate-performance-percentageQuality gate performance percentage
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  interim-pmt-rateInterim payment rate
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  ibnr-pmpmIBNR PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-ibnrMedical IBNR
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  rx-ibnrPharmacy IBNR
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-rx-ibnrMedical pharmacy IBNR
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  revenueRevenue
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  revenue-pmpmRevenue PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-revenue-pmpm-marketMarket average revenue PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  cost-targetCost target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  admin-costAdministrative cost
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  rx-costPharmacy cost
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  rx-cost-targetPharmacy cost target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  rx-cost-pmpmPharmacy cost PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  rx-cost-pmpm-targetPharmacy cost PMPM target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-costMedical cost
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-cost-targetMedical cost target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-cost-pmpmMedical cost PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-cost-pmpm-targetMedical cost PMPM target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-cost-fundMedical cost fund
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-med-cost-fund-marketMarket average medical cost fund
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-rx-costMedical pharmacy cost
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-rx-cost-targetMedical pharmacy cost target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-rx-cost-pmpmMedical pharmacy cost PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-med-rx-cost-pmpm-marketMarket average medical pharmacy cost PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  variance-costVariance cost
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-loss-ratioMedical loss ratio
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-loss-ratio-targetMedical loss ratio target
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-expense-ratioMedical expense ratio
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-expense-ratio-pmpmMedical expense ratio PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  member-monthsMember months
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  med-member-monthsMedical member months
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  rx-member-monthsPharmacy member months
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  adjusted-paid-claimAdjusted paid claim
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  annual-care-visit-bonusAnnual care visit bonus
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-star-rating-bonusAverage star rating bonus
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-star-rating-improvement-bonusAverage star rating improvement bonus
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  quality-metric-performance-incentiveQuality metric performance incentive
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  quality-pmt-chronicQuality payment chronic disease management
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  quality-pmt-office-visitQuality payment annual office visit
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  shared-saving-deficitShared saving deficit
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  weighted-avg-starWeighted average star
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  condition-countCondition count
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  1-gap-closed1 gap closed
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  2-gap-closed2 gaps closed
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  paid-claimPaid claim
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  paid-claim-pmpmPaid claim PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  drg-expenseDRG expense
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  drg-expense-pmpmDRG expense PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  provider-quality-expense-pmpmProvider quality expense PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  subrogation-pmpmSubrogation PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-member-office-visitAverage members with office visit
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  ed-visitED visit
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  eligible-memberEligible members
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  inpatient-acuteInpatient acute
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  inpatient-admissionInpatient admission
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  nurse-hotlineNurse hotline
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  nurse-hotline-pmpmNurse hotline PMPM
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  snf-avg-losSkilled Nursing Facility average length of stay
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  readmissionReadmission
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  snf-admissionSkilled Nursing Facility admission
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  provider-quality-expenseProvider quality expense
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  subrogationSubrogation
http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric  avg-membershipAverage membership

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code