HL7 FHIR® Implementation Guide: Value Based Performance Reporting (VBPR), Edition 1 - US Realm

DESCRIPTION

A value-based contract is a written contractual agreement between parties in which the payment for health care goods and services is tied to predetermined, mutually agreed upon terms that are based on clinical circumstances, patient outcomes, financial benchmarks, and other specified measures of the appropriateness and effectiveness of the services rendered. With the shift from fee-for-service to value-based care, value-based contracts have emerged as a mechanism that payers may use to better align their contracting structures with broader changes in the health care system.

Standardization of payer/provider performance reporting for quality and risk contracts is crucial for health systems and other provider organizations to receive timely interim reports to track and manage their performance on value-based contracts during the term. This implementation guide standardizes the value-based performance reporting format and exchange methods between payers and providers.

See the specification at http://hl7.org/fhir/us/davinci-vbpr/STU1.1.0

ALTERNATIVE NAMES

HL7 FHIR® Implementation Guide: Value Based Performance Reporting (VBPR), Edition 1 - US Realm may also go by the following names or acronyms:

BENEFITS

• Standardizes the value-based performance report formats;
• Connect payer baseline reporting data with provider organization data at the population level;
• Provide the flexibility to compare interim progress at different times during the contract performance period, in addition to notifying providers of non-clinical pre-defined events that may have a direct effect on financial performance and ultimately success.

IMPLEMENTATIONS/CASE STUDIES

• Da Vinci;
• Da Vinci VBPR Reference Implementation

DEVELOPMENT BACKGROUND

This implementation guide is supported by the Da Vinci initiative which is a private effort to accelerate the adoption of Health Level Seven International Fast Healthcare Interoperability Resources (HL7® FHIR®) as the standard to support and integrate value-based care (VBC) data exchange across communities. Like all Da Vinci Implementation Guides, it follows the HL7 Da Vinci Guiding Principles for exchange of patient health information. As an HL7 FHIR Implementation Guide, changes to this specification are managed by the sponsoring Clinical Quality Information (CQI) Work Group and are incorporated as part of the standard balloting process.

RELATED DOCUMENTS

HL7 FHIR® Implementation Guide: Value Based Performance Reporting (VBPR), Edition 1 - US Realm

STU DOCUMENTS

HL7 FHIR® Implementation Guide: Value Based Performance Reporting (VBPR), Edition 1.1 - US Realm See the standard at http://hl7.org/fhir/us/davinci-vbpr/STU1.1.0.

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TOPICS

• Clinical Quality
• Financial Management

BALLOT TYPE

• STU

STATUS DATE

2024-06-17

RESPONSIBLE WORK GROUP

PRODUCT TYPE

• Implementation Guide

STAKEHOLDERS

• Clinical Decision Support Systems Vendors
• EHR, PHR Vendors
• Health Care IT Vendors
• Healthcare Institutions
• Payors
• Standards Development Organizations (SDOs)

FAMILY

• FHIR

CURRENT STATE

• Active

REALM

• US Realm