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CMS Enhances Medicaid HCBS Quality Reporting in Money Follows the Person States

New Reporting Requirements Set to Elevate Home and Community-Based Services Quality

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March 13, 2024  – In a recent policy update, the Centers for Medicare & Medicaid Services (CMS) has announced new reporting requirements for the 41 states and territories benefiting from the Money Follows the Person (MFP) program. Under the new directive, MFP states are required to begin reporting on a subset of the Home and Community-Based Services (HCBS) Quality Measures Set released in July 2022. The move, set to start with data collection in 2025 and reporting in September 2026, marks a pivotal step towards enhancing the quality of Home and Community-Based Services (HCBS) for Medicaid beneficiaries.

The new HCBS Quality Measure Set was designed to standardize quality measurement within Medicaid HCBS programs nationwide. By providing a detailed view into the quality of HCBS programs, this set of measures aims to facilitate states in evaluating and advancing health outcomes for those utilizing long-term services and support (LTSS). Covering aspects from consumer access and state efforts to rebalance spending between institutional and community settings, to compliance with community integration requirements, the measures underscore a person-centered approach to care.

Comprising 48 measures sourced from various experience-of-care surveys, the set looks at: 

  • HCBS Consumer Assessment of Healthcare Providers and Systems® (HCBS CAHPS®) (8 measures)
  • National Core Indicators-Aging and Disabilities (NCI-AD) TM (18 measures)
  • National Core Indicators®-Intellectual and Developmental Disabilities (NCI®-IDD) (16 measures)
  • Personal Outcome Measures® (POM) (6 measures)

There is an additional 12 nationally standardized measures from other data sources. These measures span assessment, case management, claims, and encounter data, offering a multi-faceted view of HCBS quality.

Since the MFP program’s launch in 2007, states have been diligently reporting program participation and services data to CMS. Following the end of the formal MFP demonstration evaluation in September 2017, CMS has been encouraging states to collaborate with their Transformed Medicaid Statistical Information System (T-MSIS) teams for streamlined reporting, promoting the development of a unified national Medicaid data source.

Looking ahead, MFP-funded states are required to apply the HCBS Quality Measure Set across all their Medicaid HCBS programs, expanding beyond those merely enrolling MFP participants. This inclusive approach aims to elevate the quality and effectiveness of HCBS services, reflecting CMS’s commitment to improving the care and support provided to Medicaid beneficiaries. As these new reporting requirements roll out, states not yet conducting participant surveys will need to commence this process, with technical assistance available to ensure a smooth transition to these enhanced quality measurement standards. 

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