Headline

Guidance for health plans for improving quality of home- and community-based services (HCBS).

Context

The Centers for Medicare & Medicaid Services released the first HCBS quality measure set in July 2022, aiming to ensure consistent quality measurement across state Medicaid HCBS programs. HCBS encompasses services for older adults and people with disabilities to live in their homes rather than institutional settings. This brief reviews highlights from that measure set and explores other considerations for improving health plan quality.

Findings

This brief offers the following recommendations for health plans:

• Adopt health plan quality measures – includes an overview of and examples of measures in the HCBS quality measure set;
• Adopt operational protocols – includes an overview and examples of a Quality Rating System and other data types which can be used to monitor quality;
• Monitor and incentivize providers – includes provider-specific strategies, including licensure and certification processes, to monitor quality; and
• Employ incident reporting/management systems – reviews how incident reporting systems can support quality improvement.

Takeaways

Health plans can use this tool to improve HCBS as it provides several recommendations on monitoring quality.