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Last Updated: 2026-03-01
Status: ✅ Complete
Spec: PM-25 Value-Based Payment & APM Tracking
Constitution Reference: Section 1.2 (Core Independence), Section 1.3 (Integration Patterns)
Overview
PM-25 adds value-based payment (VBP) and alternative payment model (APM) tracking: programs, quality measures, performance levels, and incentive payments. It integrates with PM-11 (analytics/dashboards), CL-10 (outcomes data for measure numerators/denominators), CL-15 (quality measures and reporting), and PM-02/PM-01 (member/patient attribution).Integration Points (from spec)
| Dependency | Pattern | Purpose | Status |
|---|---|---|---|
| PM-11 | Data (same core) | VBP analytics, incentive forecasting, performance dashboards | 📋 Planned |
| CL-10 | Platform / Data | Outcomes data for measure numerators/denominators; gap identification | 📋 Planned |
| CL-15 | Platform / Data | Quality measures and reporting; gap identification | 📋 Planned |
| PM-02 / PM-01 | Data (same core) | Member/patient attribution for cost and measure denominators | 📋 Planned |
Data Source Tables (PM-25)
| Table | Key Columns | Used By |
|---|---|---|
pm_vbp_programs | organization_id, payer_id, contract_type, measurement_period, status, deleted_at | Program list, filters |
pm_vbp_measures | program_id, measure_id, measure_name, numerator, denominator, rate, benchmark, performance_level | Rate calculation, performance reporting |
pm_vbp_incentive_payments | program_id, payment_period, earned_amount, paid_amount, status | Incentive tracking, PM-11 reports |
Platform Layer Usage
- PM-11: Reads
pm_vbp_*tables for VBP widgets, incentive forecasting, and gap reports. No new event contracts; same-core data access. - CL-10 / CL-15: Gap identification (patients due for measures) may consume outcomes and quality data via platform integration layer or shared reporting; exact contract TBD in implementation (see spec Clarifications C-1, C-2).
- Permissions:
pm.vbp.view,pm.vbp.managegate UI; RLS enforces tenant isolation.
Event / API Contracts
- PM-11: Data only; no new events. Dashboard queries pm_vbp_*.
- CL-10 / CL-15: Integration for gap identification to be documented when implementation approach is chosen (manual list vs attribution table vs shared reporting layer).
Integration Matrix
| From | To | Pattern | Status | Doc |
|---|---|---|---|---|
| PM (PM-25) | PM-11 | Data (same core) | 📋 Planned | This doc |
| PM (PM-25) | CL-10, CL-15 | Platform / Data (gap identification) | 📋 Planned | This doc |
| PM (PM-25) | PM-02, PM-01 | Data (same core, attribution) | 📋 Planned | This doc |