Da Vinci Value-Based Performance Reporting Implementation Guide
1.0.0 - STU1

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## ValueSet: HCPLAN Framework Categories

Official URL: http://hl7.org/fhir/us/davinci-vbpr/ValueSet/hcplan-framework | Version: 1.0.0
Active as of 2024-06-17 | Computable Name: HCPLANFrameworkVS
Other Identifiers: OID:2.16.840.1.113883.4.642.40.30.48.1

HCPLAN framework categories for value-based performance. HCPLAN framework represents payments from public and private payers to provider organizations.

References

- Program Model

### Logical Definition (CLD)

- Include all codes defined in `http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework`

### Expansion

Expansion based on codesystem HCPLAN Framework Categories Codes v1.0.0 (CodeSystem)

This value set contains 10 concepts

Code | System | Display | Definition
2A | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 2A | Foundational Payments for Infrastructure and Operations, e.g., care coordination fees and payments for HIT investments.
2B | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 2B | Pay for Reporting, e.g., bonuses for reporting data or penalies for not reporting data.
2C | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 2C | Pay-for-Performance, e.g., bonuses for quality performance.
3A | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 3A | APMs with Shared Savings, e.g., shared savings with upside risk only.
3B | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 3B | APMs with Shared Savings and Downside Risk, e.g., episode-based payments for procedures and comprehensive payments with upside and downside risk.
3N | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 3N | Risk Based Payments not linked to quality.
4A | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 4A | Condition-Specific Population-Based Payment, e.g., per member per month payments, payments for speciality services, such as oncology or mental health.
4B | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 4B | Comprehensive Population-Based Payment, e.g., global budgets or full/percent of premium payments.
4C | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 4C | Integrated Finance and Delivery System, e.g., global budgets or full/percent of premium payments in integrated systems.
4N | http://terminology.hl7.org/CodeSystem/hcp-lan-apm-framework | Category 4N | Capitated Payments not linked to quality.

Explanation of the columns that may appear on this page:

Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System | The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code | The code (used as the code in the resource instance)
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition | An explanation of the meaning of the concept
Comments | Additional notes about how to use the code