A value-based contract (VBC) is a written contractual agreement between parties in which the payment for health care goods and services is tied to predetermined, mutually agreed upon terms that are based on clinical circumstances, patient outcomes, financial benchmarks and other specified measures of the appropriateness and effectiveness of the services rendered. With the shift from fee for service to value-based care, value-based contracts (VBCs) have emerged as a mechanism that payers may use to better align their contracting structures with broader changes in the health care system. Standardization of payer/provider performance reporting for quality and risk contracts is crucial for health systems and other provider organizations to receive timely interim reports to track and manage their performance on value-based contracts during the term. Payer-generated VBC contract reports are crucial because payers are generally in the best position to be the arbiters in determining financial performance on risk contracts with health systems. Unfortunately, there is a lack of standardizations for reporting format, the process is usually resource intensive, not very scalable and data reconciliation process is complex. Payers are also facing challenges such as lacking common contract term definitions, for example Total Cost of Care could have many different calculations, retrieving data is time and resource intensive, data is error-prone based on human errors when entering reporting system, and applying rules across different line of business (i.e., PPO, HMO, Federal Employee Benefits). Project Scope and Deliverables: This project is supported by the Da Vinci Project and it aims to develop a FHIR implementation guide to support value-based care performance reporting for quality and risk contracts. Standardized bi-directional, FHIR-based communication will connect payer baseline reporting data with provider organization data at the population level. It will also provide the flexibility to compare interim progress at different times during the contract performance period, in addition to notifying providers of non-clinical pre-defined events that may have a direct effect on financial performance and ultimately success. Payers and providers need a standards-based methodology to calculate the quality and financial performance of a provider organization on a VBC including but not limited to these parameters: • Contract detail at a population level • Population pool funding • Expenditures (current and target) • Quality and risk (current and target) • Earnings • Performance and incentives The project team will select an initial set of various terms and measures for contract level financial metrics to use as demonstrations and examples of the underlying framework. Wherever applicable, this project will work with existing FHIR artifacts and utilize and reference prior work from, but not limited to, USCore, Da Vinci implementation guides such as Data Exchange for Quality Measure (DEQM), Risk Adjustment, Member Attribution (ATR), Clinical Data Exchange (CDex), Payer Data Exchange (PDex), Health Record Exchange (Hrex), etc.