This is an example Value-Based Performance MeasureReport for the *VBP MeasureReport* profile., which includes examples for payment streams shared savings - gated on quality, care coordination fee, quality incentive payment for the chronic care management incentive program, quality incentive payment for the annual office visits, and quality measure performance.
Generated Narrative: MeasureReport vbp-measurereport101 Profile: Value-Based Performance MeasureReport Measure Report Category: Value-Based Performance status: Complete type: Summary measure: Example Value-Based Contract - ABC Payer and GoodHealth subject: Good Health Clinic date: 2023-01-15 reporter: Organization ABC Payer period: 2022-01-01 --> 2022-12-31 group id ccf-group-01 Payment Stream type: Care coordination fee Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Care coordination fee measureScore: stratifier stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 group id ssq-group-starscore Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Weighted average star measureScore: 3.8 group id ssq-group-01 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Member months measureScore: 300 stratifier stratum value: HMO cohort measureScore: 100 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 50 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 50 stratum value: PPO cohort measureScore: 200 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 150 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 50 group id ssq-group-02 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Average risk score measureScore: 0.7 stratifier stratum value: HMO cohort measureScore: 0.8 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 0.9 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 1 stratum value: PPO cohort measureScore: 1.1 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 1.2 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 1.3 group id ssq-group-03 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Total revenue measureScore: 10000 stratifier stratum value: HMO cohort measureScore: 6000 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 3000 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 3000 stratum value: PPO cohort measureScore: 4000 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 2000 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 2000 group id ssq-group-04 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Revenue PMPM measureScore: 33 stratifier stratum value: HMO cohort measureScore: 60 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 60 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 60 stratum value: PPO cohort measureScore: 20 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 13 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 40 group id ssq-group-05 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Medical pharmacy cost measureScore: 9000 stratifier stratum value: HMO cohort measureScore: 5000 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 3000 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 2000 stratum value: PPO cohort measureScore: 4000 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 2000 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 3000 group id ssq-group-06 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Medical pharmacy cost PMPM measureScore: 30 stratifier stratum value: HMO cohort measureScore: 50 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 60 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 40 stratum value: PPO cohort measureScore: 20 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 13 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 60 group id ssq-group-07 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Medical cost fund measureScore: 90 % (Details: UCUM code% = '%') stratifier stratum value: HMO cohort measureScore: 83.3 % (Details: UCUM code% = '%') stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 100 % (Details: UCUM code% = '%') stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 66.7 % (Details: UCUM code% = '%') stratum value: PPO cohort measureScore: 100 % (Details: UCUM code% = '%') stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 100 % (Details: UCUM code% = '%') stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 150 % (Details: UCUM code% = '%') group id ssq-group-08 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Medical cost target measureScore: 85 % (Details: UCUM code% = '%') stratifier stratum value: HMO cohort measureScore: 85 % (Details: UCUM code% = '%') stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 85 % (Details: UCUM code% = '%') stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 85 % (Details: UCUM code% = '%') stratum value: PPO cohort measureScore: 85 % (Details: UCUM code% = '%') stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 85 % (Details: UCUM code% = '%') stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 85 % (Details: UCUM code% = '%') group id ssq-group-09 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Medical pharmacy cost target measureScore: 8500 stratifier stratum value: HMO cohort measureScore: 5100 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 2550 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 2550 stratum value: PPO cohort measureScore: 3400 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 1700 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 1700 group id ssq-group-10 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Variance cost measureScore: -500 stratifier stratum value: HMO cohort measureScore: 100 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 450 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 550 stratum value: PPO cohort measureScore: -600 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: -300 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: -1300 group id ssq-group-11 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Average risk score market measureScore: 0.7 stratifier stratum value: HMO cohort measureScore: 0.71 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 0.72 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 0.72 stratum value: PPO cohort measureScore: 0.71 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 0.7 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 0.69 group id ssq-group-12 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Market average revenue PMPM measureScore: 35 stratifier stratum value: HMO cohort measureScore: 40 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 32 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 36 stratum value: PPO cohort measureScore: 50 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 29 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 30 group id ssq-group-13 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Market average medical pharmacy cost PMPM measureScore: 94.3 % (Details: UCUM code% = '%') stratifier stratum value: HMO cohort measureScore: 102.5 % (Details: UCUM code% = '%') stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 109.4 % (Details: UCUM code% = '%') stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 83.3 % (Details: UCUM code% = '%') stratum value: PPO cohort measureScore: 70 % (Details: UCUM code% = '%') stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 103.4 % (Details: UCUM code% = '%') stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 110 % (Details: UCUM code% = '%') group id ssq-group-14 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Care coordination fee measureScore: 1500 stratifier stratum value: HMO cohort measureScore: 500 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 250 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 250 stratum value: PPO cohort measureScore: 1000 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 750 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 250 group id ssq-group-15 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Qulaity payment chronic measureScore: 11900 stratifier stratum value: HMO cohort measureScore: 3966.67 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 1983.33 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 1983.33 stratum value: PPO cohort measureScore: 7933.33 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 5950 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 1983.33 group id ssq-group-16 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Qulaity payment office visit measureScore: 300 stratifier stratum value: HMO cohort measureScore: 100 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: 50 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 50 stratum value: PPO cohort measureScore: 200 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: 150 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: 50 group id ssq-group-17 Payment Stream type: Shared savings gated on quality Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Shared saving deficit measureScore: -400 stratifier stratum value: HMO cohort measureScore: 50 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 1 measureScore: -360 stratum component code: Cohort value: HMO cohort component code: Facility value: Region 2 measureScore: 275 stratum value: PPO cohort measureScore: -480 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 1 measureScore: -240 stratum component code: Cohort value: PPO cohort component code: Facility value: Region 2 measureScore: -1040 group id qip-group-01 Payment Stream type: Quality incentive payment incentive: Annual office visit Service Period: 2022-01-01 --> 2022-11-30 Paid Through Date: 2022-12-31 code: Average members with office visit measureScore: 87 % (Details: UCUM code% = '%') group id qip-group-02 Payment Stream type: Quality incentive payment incentive: Chronic care management incentive program Service Period: 2022-01-01 --> 2022-09-30 Paid Through Date: 2022-09-30 code: Eligible member measureScore: 500 stratifier code: Condition count stratum value: 1 measureScore: 100 stratum value: 2 measureScore: 200 stratum value: 3 measureScore: 50 stratum value: 4 measureScore: 50 stratum value: 5+ measureScore: 100 group id qip-group-03 Payment Stream type: Quality incentive payment incentive: Chronic care management incentive program Service Period: 2022-01-01 --> 2022-09-30 Paid Through Date: 2022-09-30 code: 1 gap closed measureScore: 100 stratifier code: Condition count stratum value: 1 measureScore: 20 stratum value: 2 measureScore: 30 stratum value: 3 measureScore: 20 stratum value: 4 measureScore: 10 stratum value: 5+ measureScore: 20 group id qip-group-04 Payment Stream type: Quality incentive payment incentive: Chronic care management incentive program Service Period: 2022-01-01 --> 2022-09-30 Paid Through Date: 2022-09-30 code: 2 gap closed measureScore: 0 stratifier code: Condition count stratum value: 1 measureScore: 0 stratum value: 2 measureScore: 0 stratum value: 3 measureScore: 0 stratum value: 4 measureScore: 0 stratum value: 5+ measureScore: 0 group id qip-group-05 Payment Stream type: Quality incentive payment incentive: Chronic care management incentive program Service Period: 2022-01-01 --> 2022-09-30 Paid Through Date: 2022-09-30 code: Interim payment rate stratifier code: Condition count stratum value: 1 measureScore: 20 stratum value: 2 measureScore: 50 stratum value: 3 measureScore: 100 stratum value: 4 measureScore: 200 stratum value: 5+ measureScore: 300 group id qip-group-06 Payment Stream type: Quality incentive payment incentive: Chronic care management incentive program Service Period: 2022-01-01 --> 2022-09-30 Paid Through Date: 2022-09-30 code: Earned incentive measureScore: 11900 stratifier code: Condition count stratum value: 1 measureScore: 400 stratum value: 2 measureScore: 1500 stratum value: 3 measureScore: 2000 stratum value: 4 measureScore: 2000 stratum value: 5+ measureScore: 6000 evaluatedResource: MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://hl7.org/fhir/us/cqfmeasures/Measure/EXM125-FHIR|8.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,5,,,,; status = complete; type = summary; measure = http://hl7.org/fhir/us/cqfmeasures/Measure/EXM130-FHIR|8.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-diabetes-care-blood-sugar-controlled-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-diabetes-care-eye-exam-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-med-adherence-cholesterol-statins-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-med-adherence-hypertension-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-med-adherence-diabetes-meds-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-statin-therapy-cardiovascular-disease-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement MeasureReport: extension = Proportion,0,,,,; status = complete; type = summary; measure = http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR|1.0.000; date = 2023-01-15; period = 2022-01-01 --> 2022-11-30; improvementNotation = Increased score indicates improvement
Chronic care management incentive program