FHIR IG analytics| Package | hl7.fhir.us.davinci-vbpr |
| Resource Type | MeasureReport |
| Id | MeasureReport-vbp-measurereport101.json |
| FHIR Version | R4 |
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Note: links and images are rebased to the (stated) source
Generated Narrative: MeasureReport vbp-measurereport101
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-01Payment 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-starscorePayment 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-01Payment 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-02Payment 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-03Payment 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-04Payment 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-05Payment 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-06Payment 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-07Payment 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-08Payment 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-09Payment 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-10Payment 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-11Payment 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-12Payment 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-13Payment 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-14Payment 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-15Payment 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-16Payment 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-17Payment 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-01Payment 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-02Payment 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-03Payment 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-04Payment 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-05Payment 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-06Payment 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:
FHIR
FHIRsmith{
"resourceType": "MeasureReport",
"id": "vbp-measurereport101",
"meta": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/instance-name",
"valueString": "VBP MeasureReport Example 101"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/instance-description",
"valueMarkdown": "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."
}
],
"profile": [
"http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/vbp-performance-measurereport"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/measurereport-category",
"valueCodeableConcept": {
"coding": [
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"status": "complete",
"type": "summary",
"measure": "https://build.fhir.org/ig/HL7/davinci-vbpr/Measure-vbp-measure01",
"subject": {
"reference": "Group/goodhealth-group",
"display": "Good Health Clinic"
},
"date": "2023-01-15",
"reporter": {
"reference": "Organization/vbp-payer01"
},
"period": {
"start": "2022-01-01",
"end": "2022-12-31"
},
"group": [
{
"id": "ccf-group-01",
"extension": [
{
"extension": [
{
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"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"
},
{
"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/service-period",
"valuePeriod": {
"start": "2022-01-01",
"end": "2022-11-30"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/paid-through-date",
"valueDate": "2022-12-31"
}
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"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric",
"code": "ccf"
}
],
"text": "Care coordination fee"
},
"measureScore": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/alternate-measurescore",
"valueMoney": {
"value": 500,
"currency": "USD"
}
}
]
},
"stratifier": [
{
"stratum": [
{
"component": [
{
"code": {
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"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
"code": "cohort"
}
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},
"value": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-cohort",
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{
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"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
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},
"value": {
"text": "Region 1"
}
}
]
},
{
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},
"value": {
"coding": [
{
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}
]
}
},
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
"code": "facility"
}
]
},
"value": {
"text": "Region 2"
}
}
]
},
{
"component": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
"code": "cohort"
}
]
},
"value": {
"coding": [
{
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"code": "ppo"
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}
},
{
"code": {
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"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
"code": "facility"
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]
},
"value": {
"text": "Region 1"
}
}
]
},
{
"component": [
{
"code": {
"coding": [
{
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"code": "cohort"
}
]
},
"value": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-cohort",
"code": "ppo"
}
]
}
},
{
"code": {
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{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
"code": "facility"
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]
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"text": "Region 2"
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}
]
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]
},
{
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{
"extension": [
{
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"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/payment-stream",
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}
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],
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{
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{
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{
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{
"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/service-period",
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},
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"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/paid-through-date",
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],
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"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric",
"code": "member-months"
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],
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"value": 300
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{
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{
"value": {
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{
"component": [
{
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"value": {
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{
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{
"value": {
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}
},
{
"component": [
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"code": {
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{
"code": {
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"value": {
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},
{
"component": [
{
"code": {
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{
"code": {
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{
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{
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{
"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/service-period",
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{
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"code": "avg-risk-score"
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{
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"value": {
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{
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"code": {
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{
"value": {
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{
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{
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{
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],
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"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric",
"code": "revenue"
}
],
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"value": 10000
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{
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{
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"code": "ssq"
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{
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{
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{
"component": [
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"code": {
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"code": {
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"code": "facility"
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"value": {
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},
{
"component": [
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"code": {
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{
"code": {
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"code": "facility"
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]
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"value": {
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}
]
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]
},
{
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"code": "ssq"
}
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{
"url": "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/service-period",
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},
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],
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"coding": [
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"system": "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-performance-metric",
"code": "med-rx-cost"
}
],
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"value": 9000
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{
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"value": {
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{
"component": [
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