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

On July 21, the Centers for Medicare & Medicaid Services (CMS) announced it will release its first-ever home- and community-Based Services (HCBS) quality measure set to promote consistent quality measurement within and across state Medicaid HCBS programs. The measure set is intended to provide insight into the quality of HCBS programs and enable states to measure and improve health outcomes for people relying on long-term services and support (LTSS) in Medicaid.

The release of this voluntary measure set is also a critical step to promoting health equity among the millions of older adults and people with disabilities who need LTSS because of disabling conditions and chronic illnesses.

Nationally, over 7 million people receive HCBS under Medicaid, and Medicaid-funded HCBS accounts for $125 billion annually in state and federal spending. Implementation of the HCBS quality measure set will create opportunities for CMS and states to promote more consistent use, within and across states, of nationally standardized quality measures in HCBS programs to promote health equity and reduce disparities in health outcomes among this population.

“We understand these measures will not affect all private home care providers,” said Private Duty Home Care at NAHC Executive Director Kristen Wheeler. However, it is critically important that we monitor this as it unfolds. The letter sent to State Medicaid Directors by CMS states that the use of this measure set is voluntary by states to start, but adds that CMS plans to incorporate the use of the measure set into the reporting requirements for specific authorities and programs, including the Money Follows the Person (MFP) program and future section 1115 demonstrations that include HCBS. Further guidance has been promised and we will share that information as it becomes available.”

The HCBS quality measure set is included in a State Medicaid Director Letter (SMDL) that also describes the purpose of the measure set, the measure selection criteria, and considerations for implementation. CMS strongly encourages states to use this information to assess and improve quality and outcomes in their HCBS programs. CMS expects to update the measure set in the future, including adding newly developed measures that address measure gaps, as the field of HCBS measure development advances.

CMS hopes the HCBS quality measure set will 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 a 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.”

Read the (SMDL) on the HCBS quality measure set HERE.