Da Vinci Risk Based Contract Member Identification FHIR IG Proposal
Contents
- 1 Risk Based Contract Member Identification
- 1.1 Owning Workgroup
- 1.2 Committee Approval Date:
- 1.3 Publishing Lead
- 1.4 Contributing or Reviewing Work Groups
- 1.5 FHIR Development Project Insight ID
- 1.6 Scope of coverage
- 1.7 Content location
- 1.8 Proposed IG realm and code
- 1.9 Maintenance Plan
- 1.10 Short Description
- 1.11 Long Description
- 1.12 Involved parties
- 1.13 Expected implementations
- 1.14 Content sources
- 1.15 Example Scenarios
- 1.16 IG Relationships
- 1.17 Timelines
- 1.18 FMG Notes
Risk Based Contract Member Identification
Owning Workgroup
Financial Management
Committee Approval Date:
TBD
Publishing Lead
Nagesh (Dragon) Bashyam (nagesh.bashyam@drajer.com)
Contributing or Reviewing Work Groups
Attachments (Now PIE!)
FHIR Development Project Insight ID
1517
Scope of coverage
The implementation guide will enable Payers and Providers to exchange Member Attribution Lists which are a necessity for Risk Based Contracts. The IG builds on US Core 3.1.0 and Bulk Data IG to enable the Member Attribution list data exchange.
Content location
https://github.com/hl7/davinci-atr
Proposed IG realm and code
us/DaVinci-ATR
Maintenance Plan
Da Vinci project intends to provide ongoing support of this implementation guide
Short Description
Enable Payers and Providers to exchange a roster of patients for inclusion in a risk based contract
Long Description
The implementation guide will define the mechanisms, resources, profiles and extensions required to exchange Member Attribution Lists. The Member Attribution Lists enable providers and payer organization to validate enrollment in Value-Based Care (VBC) programs and support reporting requirements and payment reconciliation.
Involved parties
This implementation guide has been developed by U.S. Payer organizations, providers, and EHR as part of the Da Vinci project.
Expected implementations
Da Vinci participants -
1) Cambia Healthcare Solutions | |
2) MultiCare | |
3) Providence | |
Content sources
Requirements are drawn from payer and provider organizations as part of the Da Vinci initiative
Example Scenarios
A payer may provide a roster of patients to a provider for a specific risk based contract.
A Provider organization may submit a roster of patients to a payer to confirm patient enrollment
IG Relationships
This project build on US Core 3.1.0 (based on R4) and the Bulk Data implementation guide for defining rosters and exchange roster information.
Timelines
Tentative Connectathon in December and/or January.
Submit for STU Ballot for 2020 Jan Ballot cycle