This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v2.0.0-ballot: STU2 (v2.0.0) Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Change Log

The Risk Adjustment Implementation Guide was developed under the Davinci Project

Version 2.0.0-ballot

• The 2.0.0-ballot includes the following changes to support new functionalities:
  • The Guidance page in STU1 is now broken into two pages, General Guidance and Report Generation, with new content
  • New pages: Report Generation, Report Query, Remediation, and Report Annotation
  • New profiles and extensions, see Profiles
• It also introduces Digital Condition Category as DRAFT content for review:
  • New page: Digital Condition Category(dCC)
  • New operation: $ra.evaluate-measure

Trackers Applied for 2.0.0-ballot

1. Applied: Add “data collection period” to Glossary (FHIR-37672)
2. Applied: Corrected CMS-HCC model to HHS-HCC model (FHIR-37745)
3. Applied: Corrected Category misspelling (FHIR-38205)
4. Applied: Corrected Condition misspelling in Suspect Type Value Set (FHIR-38206)
5. Applied: Corrected Venn Diagram misspelling in DCC cntent page (FHIR-39300)
6. Applied: Make “Example CMS Hierarchical Condition Category Value Set” a true sample (FHIR-39371)
7. Applied: Remove “Code System” and “Value Set” from names and titles of code system and value set (FHIR-39374)

version 1.0.0

Ballot Comments Applied: Summary (Jira Issue)

1. Applied: Bind example value sets where ever possible instead of creating complicated element definitions (FHIR-34774)
2. Applied: Missing Must Support, $report comment, & extension comment (FHIR-35139)
3. Applied: Clarify provider-driven v. payer-driven approach to coding gaps (FHIR-35324)
4. Applied: Keep group.population and group.stratifier in as optional (FHIR-35221)
5. Applied: “Hierarchical Condition Categories (HCCs) with less severe HCCs superseded (ignored) if evidence of higher severity HCCs is present” statement is not accurate description. (FHIR-34773)
6. Applied: Group usage in bundles missing from guidance (FHIR-34710)
7. Applied: Over-specific precondition for patient resource logical id (FHIR-34708)
8. Applied: Cardinality confusion for MeasureReport.group.code (FHIR-34711)
9. Applied: extracted diagnosis data element missing background (FHIR-34696)
10. Applied: Figure 1-2 Workflow for Medicare Advantage Population, Phase One misses the preceding step where provider sends initial diagnostic/condition codes before risk coding report is generated. (FHIR-34778)
11. Applied: plural possessive (FHIR-34695)
12. Applied: actor names (FHIR-34698)
13. Applied: Typo in Intro (FHIR-34501)

Other Changes Applied: Summary (Jira Issue)

1. Applied: Remove extension-reporterGroup extension from RA Coding Gap MeasureReport (FHIR-36850)
2. Applied: Noted several errors in example data (FHIR-35773)
3. Applied: US Core 3.1.1 Alignment (FHIR-35924)
4. Applied: Add language to acknowledge physician burden reduction (FHIR-35323)
5. Applied: Correct MeasureReport.group.stratifier.code cardinality due to error in base resource (FHIR-36053)
6. Applied: Title for HCC 18 should be “Diabetes with chronic complications” not “Diabetes without complications” (FHIR-35774)
7. Applied: Add more details to the description of the evaluatedResource element (FHIR-35980)
8. Applied: Change to Condition Category (CC) gap instead of HCC gap in SuspectType definitions (FHIR-36024)
9. Applied: Typo in 1.4 Scope text (FHIR-35971)
10. Applied: Example MeasureReport01 Group vs EvaluatedResources Data Conflict (FHIR-37345)
11. Applied: Example MeasureReport01 HCC Code Consistency (FHIR-37348)
12. Applied: Example MeasureReport04 HCC Code Consistency (FHIR-37351)
13. Applied: Example MeasureReport06 Links Different Patient Than EvaluatedResource (FHIR-37354)
14. Applied: Example MeasureReport01 Group vs Condition Data Conflict (FHIR-37347)
15. Applied: Example MeasureReport02 Group vs Condition Data Conflict (FHIR-37350)
16. Applied: Example MeasureReport05 Encounter and Condition Link Consistency Issue (FHIR-37353)
17. Applied: Example MeasureReport04 Group-013 Condition May Not be Applicable (FHIR-37352)

Version 0.1.0

Initial content for STU1 ballot.