In July 2022, the Centers for Medicare & Medicaid Services (CMS) released a home- and community-based services (HCBS) quality measure set—the first of its kind in the history of U.S. healthcare. This decision was made, in part, to improve health equity across the country for those seeking long-term services and supports (LTSS). Here, we examine the potential benefits of standardization, key takeaways from the HCBS quality measure set, and reactions from providers thus far.
Benefits Of Standardization
Currently, over 7 million people utilize Medicaid and Medicaid-funded accounts to access HCBS services. Nationally, this amounts to approximately $125 billion per year in state and federal spending. In an effort to meet its goal to provide “increased availability and provision of high-quality” HCBS services, CMS has stated the measure set will “promote health equity and reduce disparities in health outcomes” for older adults and people with disabilities.
According to CMS’s initial statement, the measure set – which is voluntary – will enable states to “better understand and compare health outcomes across groups receiving home- and community-based services.” In addition, CMS hopes national standardization will improve both consistency and quality in the use of HCBS across all states.
Reaction From Providers
Although provider groups have affirmed a commitment to the general effort to improve the quality of HCBS services, many feel a sense of frustration at the timing of the new quality measure set. Meredith Chillemi, Director of Medicaid and HCBS policy at LeadingAge, believes participation may be hindered by the ongoing stress of “longstanding, chronic underfunding…and the resulting workforce shortages — exacerbated by the pandemic.”
Other leaders in the industry have noted the need for adequate reimbursement for HCBS programs, plans for permanent funding, and long-term investment in training and recruitment to address workforce shortages.
To read the full CMS State Medicaid Director Letter regarding the HCBS quality measure set release, click here.