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  1. FHIR Specification Feedback
  2. FHIR-24827

Add InsurancePlan.parent for modeling hierarchical product families

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • STU3
    • Patient Administration
    • InsurancePlan
    • 8.30.4
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      Core Changes:

      • Rename InsurancePlan to InsuranceProduct
      • Move the .plan backbone element content into a new InsurancePlan resource
      • Add a 1..1 reference from the new InsurancePlan to InsuranceProduct
      • Coverage.insurancePlan will refer to InsurancePlan

       

      Additional Changes:

      • Update the diagrams and descriptions in the administrative module page to reflect the new structure

      Non-core spec changes:

      • When IGs update to R6, they'd need to review references (extensions) to InsurancePlan and may want to update to InsuranceProduct where appropriate

       

       

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      Core Changes: Rename InsurancePlan to InsuranceProduct Move the .plan backbone element content into a new InsurancePlan resource Add a 1..1 reference from the new InsurancePlan to InsuranceProduct Coverage.insurancePlan will refer to InsurancePlan   Additional Changes: Update the diagrams and descriptions in the administrative module page to reflect the new structure Non-core spec changes: When IGs update to R6, they'd need to review references (extensions) to InsurancePlan and may want to update to InsuranceProduct where appropriate    
    • Paul Knapp / Bob Dieterle : 19-0-2
    • Enhancement
    • Non-compatible

    Description

      During the September 2019 WGM we discussed the possibility of splitting this resource to have separate resources for plans and products (see minutes for details). As an alternative I propose adding a new InsurancePlan.parent element with cardinality 0..1 and type Reference(InsurancePlan). That would allow payers to construct flexible hierarchies of insurance offerings to suit their own business practices.

      The fundamental problem is that payers all have different practices and often use the same words to mean different things. But if we simply allow InsurancePlan to have parent/child relationships then payers can use InsurancePlan to model plans, products, brands, groups, or whatever else they use to organize and describe their offerings. That way we can sidestep the need to reconcile differences between payers and leave it to Implementation Guide authors to work out the details of how to map plans, products, groups, etc to InsurancePlan for their use cases.

      There will be several competing proposals for how to resolve this issue so we should discuss them all together before holding a vote on this one.

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            nradov Nick Radov
            Nick Radov
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              Updated:
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