Da Vinci Value-Based Performance Reporting Implementation Guide
1.0.0-ballot - ballot United States of America flag

This page is part of the Da Vinci Value-Based Performance Reporting Implementation Guide (v1.0.0-ballot: STU1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Example MeasureReport: vbp-measurereport101

Generated Narrative: MeasureReport

Resource MeasureReport "vbp-measurereport101"

Profile: Value-Based Performance MeasureReport

Paid Through Date: 2022-12-31

status: complete

type: summary

measure: Example Value-Based Contract - ABC Payer and GoodHealth

subject: : Good Health Clinic

date: 2023-01-15

reporter: Organization/vbp-payer01 "ABC Payer"

period: 2022-01-01 --> 2022-12-31

group

id

ccf-group-01

Payment Stream

url

type

value: Care coordination fee (Payment Stream Codes#ccf)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Care coordination fee (Performance Metric Codes#ccf)

measureScore:

stratifier

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

group

id

ssq-group-starscore

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Weighted average star (Performance Metric Codes#weighted-avg-star)

measureScore: 3.8

group

id

ssq-group-01

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Member months (Performance Metric Codes#member-months)

measureScore: 300

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 100

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 50

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 50

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 200

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 150

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 50

group

id

ssq-group-02

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Average risk score (Performance Metric Codes#avg-risk-score)

measureScore: 0.7

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 0.8

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 0.9

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 1

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 1.1

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 1.2

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 1.3

group

id

ssq-group-03

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Total revenue (Performance Metric Codes#revenue)

measureScore: 10000

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 6000

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 3000

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 3000

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 4000

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 2000

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 2000

group

id

ssq-group-04

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Revenue PMPM (Performance Metric Codes#revenue-pmpm)

measureScore: 33

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 60

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 60

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 60

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 20

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 13

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 40

group

id

ssq-group-05

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Medical pharmacy cost (Performance Metric Codes#med-rx-cost)

measureScore: 9000

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 5000

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 3000

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 2000

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 4000

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 2000

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 3000

group

id

ssq-group-06

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Medical pharmacy cost PMPM (Performance Metric Codes#med-rx-cost-pmpm)

measureScore: 30

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 50

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 60

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 40

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 20

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 13

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 60

group

id

ssq-group-07

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Medical cost fund (Performance Metric Codes#med-cost-fund)

measureScore: 90 % (Details: UCUM code % = '%')

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 83.3 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 100 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 66.7 % (Details: UCUM code % = '%')

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 100 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 100 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 150 % (Details: UCUM code % = '%')

group

id

ssq-group-08

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Medical cost target (Performance Metric Codes#med-cost-target)

measureScore: 85 % (Details: UCUM code % = '%')

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 85 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 85 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 85 % (Details: UCUM code % = '%')

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 85 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 85 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 85 % (Details: UCUM code % = '%')

group

id

ssq-group-09

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Medical pharmacy cost target (Performance Metric Codes#med-rx-cost-target)

measureScore: 8500

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 5100

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 2550

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 2550

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 3400

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 1700

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 1700

group

id

ssq-group-10

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Variance cost (Performance Metric Codes#variance-cost)

measureScore: -500

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 100

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 450

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 550

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: -600

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: -300

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: -1300

group

id

ssq-group-11

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Average risk score market (Performance Metric Codes#avg-risk-score-market)

measureScore: 0.7

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 0.71

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 0.72

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 0.72

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 0.71

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 0.7

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 0.69

group

id

ssq-group-12

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Market average revenue PMPM (Performance Metric Codes#avg-revenue-pmpm-market)

measureScore: 35

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 40

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 32

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 36

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 50

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 29

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 30

group

id

ssq-group-13

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Market average medical pharmacy cost PMPM (Performance Metric Codes#avg-med-rx-cost-pmpm-market)

measureScore: 94.3 % (Details: UCUM code % = '%')

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 102.5 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 109.4 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 83.3 % (Details: UCUM code % = '%')

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 70 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 103.4 % (Details: UCUM code % = '%')

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 110 % (Details: UCUM code % = '%')

group

id

ssq-group-14

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Care coordination fee (Performance Metric Codes#ccf)

measureScore: 1500

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 500

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 250

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 250

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 1000

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 750

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 250

group

id

ssq-group-15

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Qulaity payment chronic (Performance Metric Codes#quality-pmt-chronic)

measureScore: 11900

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 3966.67

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 1983.33

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 1983.33

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 7933.33

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 5950

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 1983.33

group

id

ssq-group-16

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Qulaity payment office visit (Performance Metric Codes#quality-pmt-office-visit)

measureScore: 300

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 100

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 50

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 50

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: 200

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: 150

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 50

group

id

ssq-group-17

Payment Stream

url

type

value: Shared savings gated on quality (Payment Stream Codes#ssq)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Shared saving deficit (Performance Metric Codes#shared-saving-deficit)

measureScore: -400

stratifier

stratum

value: health maintenance organization policy (ActCode#HMO)

measureScore: 50

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: -360

stratum

component

code: Coverage type (LOINC#87520-3)

value: health maintenance organization policy (ActCode#HMO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: 275

stratum

value: preferred provider organization policy (ActCode#PPO)

measureScore: -480

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 1 ()

measureScore: -240

stratum

component

code: Coverage type (LOINC#87520-3)

value: preferred provider organization policy (ActCode#PPO)

component

code: location (ActCode#LOC)

value: Region 2 ()

measureScore: -1040

group

id

qip-group-01

Payment Stream

url

type

value: Quality incentive payment (Payment Stream Codes#qip)

url

incentive

value: Annual office visit (Incentive Payment Codes#annual-visit)

Service Period: 2022-01-01 --> 2022-11-30

Paid Through Date: 2022-12-31

code: Average members with office visit (Performance Metric Codes#avg-member-office-visit)

measureScore: 87 % (Details: UCUM code % = '%')

group

id

qip-group-02

Payment Stream

url

type

value: Quality incentive payment (Payment Stream Codes#qip)

url

incentive

value: Chronic care management incentive program (Incentive Payment Codes#chronic-care-mgmt)

Service Period: 2022-01-01 --> 2022-09-30

Paid Through Date: 2022-09-30

code: Eligible member (Performance Metric Codes#eligible-member)

measureScore: 500

stratifier

code: Condition count (Performance Metric Codes#condition-count)

stratum

value: 1 (LOINC#LA6112-2)

measureScore: 100

stratum

value: 2 (LOINC#LA6113-0)

measureScore: 200

stratum

value: 3 (LOINC#LA6114-8)

measureScore: 50

stratum

value: 4 (LOINC#LA6115-5)

measureScore: 50

stratum

value: 5+ (LOINC#LA10137-0)

measureScore: 100

group

id

qip-group-03

Payment Stream

url

type

value: Quality incentive payment (Payment Stream Codes#qip)

url

incentive

value: Chronic care management incentive program (Incentive Payment Codes#chronic-care-mgmt)

Service Period: 2022-01-01 --> 2022-09-30

Paid Through Date: 2022-09-30

code: 1 gap closed (Performance Metric Codes#1-gap-closed)

measureScore: 100

stratifier

code: Condition count (Performance Metric Codes#condition-count)

stratum

value: 1 (LOINC#LA6112-2)

measureScore: 20

stratum

value: 2 (LOINC#LA6113-0)

measureScore: 30

stratum

value: 3 (LOINC#LA6114-8)

measureScore: 20

stratum

value: 4 (LOINC#LA6115-5)

measureScore: 10

stratum

value: 5+ (LOINC#LA10137-0)

measureScore: 20

group

id

qip-group-04

Payment Stream

url

type

value: Quality incentive payment (Payment Stream Codes#qip)

url

incentive

value: Chronic care management incentive program (Incentive Payment Codes#chronic-care-mgmt)

Service Period: 2022-01-01 --> 2022-09-30

Paid Through Date: 2022-09-30

code: 2 gap closed (Performance Metric Codes#2-gap-closed)

measureScore: 0

stratifier

code: Condition count (Performance Metric Codes#condition-count)

stratum

value: 1 (LOINC#LA6112-2)

measureScore: 0

stratum

value: 2 (LOINC#LA6113-0)

measureScore: 0

stratum

value: 3 (LOINC#LA6114-8)

measureScore: 0

stratum

value: 4 (LOINC#LA6115-5)

measureScore: 0

stratum

value: 5+ (LOINC#LA10137-0)

measureScore: 0

group

id

qip-group-05

Payment Stream

url

type

value: Quality incentive payment (Payment Stream Codes#qip)

url

incentive

value: Chronic care management incentive program (Incentive Payment Codes#chronic-care-mgmt)

Service Period: 2022-01-01 --> 2022-09-30

Paid Through Date: 2022-09-30

code: Interim payment rate (Performance Metric Codes#interim-pmt-rate)

stratifier

code: Condition count (Performance Metric Codes#condition-count)

stratum

value: 1 (LOINC#LA6112-2)

measureScore: 20

stratum

value: 2 (LOINC#LA6113-0)

measureScore: 50

stratum

value: 3 (LOINC#LA6114-8)

measureScore: 100

stratum

value: 4 (LOINC#LA6115-5)

measureScore: 200

stratum

value: 5+ (LOINC#LA10137-0)

measureScore: 300

group

id

qip-group-06

Payment Stream

url

type

value: Quality incentive payment (Payment Stream Codes#qip)

url

incentive

value: Chronic care management incentive program (Incentive Payment Codes#chronic-care-mgmt)

Service Period: 2022-01-01 --> 2022-09-30

Paid Through Date: 2022-09-30

code: Earned incentive (Performance Metric Codes#earned-incentive)

measureScore: 11900

stratifier

code: Condition count (Performance Metric Codes#condition-count)

stratum

value: 1 (LOINC#LA6112-2)

measureScore: 400

stratum

value: 2 (LOINC#LA6113-0)

measureScore: 1500

stratum

value: 3 (LOINC#LA6114-8)

measureScore: 2000

stratum

value: 4 (LOINC#LA6115-5)

measureScore: 2000

stratum

value: 5+ (LOINC#LA10137-0)

measureScore: 6000

evaluatedResource: