CMS Releases Quality Measure Set to Improve Home, Community-Based Care

CMS has released a quality measure set for home- and community-based services (HCBS), aiming to promote consistent quality measurement and data collection in the Medicaid HCBS program and improve health outcomes for those receiving long-term services and supports (LTSS).

The quality measure set is also part of the agency’s initiative to advance health equity and reduce disparities in health outcomes among older adults and people with disabilities.

More than 7 million people across the country receive HCBS under Medicaid and Medicaid-funded HCBS accounts for $125 billion annually in state and federal spending, the press release stated.

CMS said it hopes the HCBS quality measure set will help promote consistent use of nationally standardized quality measures in HCBS programs within and across states.

“CMS is using every lever available to protect and expand coverage for all people eligible for Medicaid. We are working to expand their access to care across settings — including in the setting of their choice,” CMS Administrator Chiquita Brooks-LaSure said in the press release.

“Today’s announcement provides states with tools to better understand and compare health outcomes across groups receiving home- and community-based services. The use of consistent quality measures across the country is another step toward reducing health disparities and ensuring that people with disabilities, and older adults enrolled in Medicaid, have access to and receive high-quality services in the community.”

The HCBS quality measure set, the purpose of the set, the measure selection criteria, and considerations for implementation are included in a State Medicaid Director Letter (SMDL). The set consists of voluntary measures that address HCBS quality and outcomes in three areas: access, rebalancing, and community integration.

Some of the measures include the percentage of people who feel safe around their support staff, the percentage of people who know how to manage their chronic conditions, HCBS CAHPS Personal Safety and Respect Composite Measure, and HCBS CAHPS Community Inclusion and Empowerment Composite Measure.

CMS encouraged states to use the SMDL information to assess and improve the quality and outcomes of their HCBS programs. The agency plans to update the set in the future to include measures that address gaps identified as the measure development advances.

The creation of the HCBS quality measure set is just one part of the strategy to improve Medicaid quality, CMS said.

“CMS is committed to supporting states as they measure quality, close quality gaps, and drive high-quality outcomes across their Medicaid programs,” the press release stated.