Da Vinci Risk Based Contract Member Identification FHIR IG Proposal
This page documents a Pending 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 reuse the existing US Core Patient profile and bulk data to support patient inclusion in a risk based contract or create such a patient in the PM/EHR if the patient does already exist and the PM/EHR has the capability.
Content location
https://github.com/HL7/davinci-rbc
Proposed IG realm and code
us/DaVinci-RBC
Maintenance Plan
Da Vinci project intends to provide ongoing support of this implementation guide
Short Description
Enable systems to exchange a roster of patients for inclusion in a risk based contract
Long Description
The implementation guide will define how to use the bulk data IG for payers and providers to synchronize data from practice management and EHRs, and to enable providers and payer organization to validate enrollment in Value-Based Care (VBC) programs at the point of care and for population level program management.
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) BCBS Michigan | |
| 3) United Healthcare | |
| 4) BCBS Florida | |
| 5) Humana |
Content sources
Requirements are drawn from payer organizations as part of the Da Vinci initiative
Example Scenarios
A payer may provide a roster of patients to a clinical system to notify patient enrollment
An EHR may provide 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 HRex implementation guide for the automated exchange of information between a payer and provider using standard profiles and constraints on existing exchange methods, including Bulk Data.
Timelines
Tentative Connectathon in December and/or January.
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