# CQM Risk Adjustment - Quality Measure Implementation Guide v2.0.0-ballot

## Extension: CQM Risk Adjustment 

A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.

**Context of Use**

**Usage info**

**Usages:**

* Use this Extension: [CQM Computable Measure](StructureDefinition-cqm-computablemeasure.md)
* Examples for this Extension: [MultiRateExample](Measure-MultiRateExample-FHIR.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.uv.cqm|current/StructureDefinition/cqm-riskAdjustment)

### Formal Views of Extension Content

 [Description Differentials, Snapshots, and other representations](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](../StructureDefinition-cqm-riskAdjustment.csv), [Excel](../StructureDefinition-cqm-riskAdjustment.xlsx), [Schematron](../StructureDefinition-cqm-riskAdjustment.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "cqm-riskAdjustment",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cqi"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 4,
    "_valueInteger" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/uv/cqm/ImplementationGuide/hl7.fhir.uv.cqm"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/uv/cqm/ImplementationGuide/hl7.fhir.uv.cqm"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.61.42.26"
  }],
  "version" : "1.0.0",
  "name" : "CQMRiskAdjustment",
  "title" : "CQM Risk Adjustment",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-04-07T02:06:45+10:00",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cqi"
    }]
  }],
  "description" : "A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  }],
  "kind" : "complex-type",
  "abstract" : false,
  "context" : [{
    "type" : "element",
    "expression" : "Measure.group"
  }],
  "type" : "Extension",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Extension",
      "path" : "Extension",
      "short" : "How risk adjustment is applied for this measure",
      "definition" : "A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.",
      "comment" : "Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.",
      "min" : 0,
      "max" : "1"
    },
    {
      "id" : "Extension.url",
      "path" : "Extension.url",
      "type" : [{
        "code" : "uri"
      }],
      "fixedUri" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment"
    },
    {
      "id" : "Extension.value[x]",
      "path" : "Extension.value[x]",
      "type" : [{
        "code" : "string"
      }]
    }]
  }
}

```
