CMS Rolls Out First Home/Community-Based Services Measure Set

Nationally, more than 7 million people receive home- and community-based services (HCBS) under Medicaid, and Medicaid-funded HCBS accounts for $125 billion annually in state and federal spending. To promote consistent quality measurement within and across state Medicaid HCBS programs, the Centers for Medicare & Medicaid Services (CMS) has released the first-ever HCBS quality measure set.

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. CMS also called the release of this voluntary measure set 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. 

“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,” said CMS Administrator Chiquita Brooks-LaSure, in a statement. “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.”

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.       

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 said it 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.

The HCBS quality measure set is one piece of a larger Medicaid quality strategy. CMS said it is committed to supporting states as they measure quality, close quality gaps, and drive high-quality outcomes across their Medicaid programs.