This wiki has undergone a migration to Confluence found Here
<meta name="googlebot" content="noindex">

Da Vinci Risk Based Contract Member Identification FHIR IG Proposal

From HL7Wiki
Jump to navigation Jump to search

Risk Based Contract Member Identification

Owning Workgroup

Financial Management

Committee Approval Date:


Publishing Lead

Nagesh (Dragon) Bashyam (

Contributing or Reviewing Work Groups

Attachments (Now PIE!)

FHIR Development Project Insight ID


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

Proposed IG realm and code


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.


Tentative Connectathon in December and/or January.

Submit for STU Ballot for 2020 Jan Ballot cycle

FMG Notes