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Testing Experience & Functional Tools

The Centers for Medicare & Medicaid Services (CMS) Testing Experience and Functional Tools (TEFT) demonstration provided grants to nine states to test quality measurement tools and demonstrate e-health in Medicaid home and community-based services (HCBS). The TEFT grant program, spanning the demonstration period (2014-2018), field tested a cross-disability experience of care survey and a set of functional assessment items, demonstrated personal health records, and created an electronic long term services and supports (eLTSS) service plan standard.  

Based on the demonstration experience, CMS promotes the use of health information technology (IT) in Medicaid HCBS and, through TEFT, provides national measures and valuable feedback on how an eLTSS standard can advance CMS interoperability goals. Grantee states assisted with the design, testing, and validation of the four experience and testing tools. The resulting diversity in the state pilot activities provided CMS and states with information on the approaches that show promise in improving quality, service planning, or care coordination in HCBS programs.

Final Evaluation Report: Testing Experience and Functional Tools in Home and Community-Based Services

This report summarizes the program monitoring and evaluation over the course of the TEFT demonstration and lessons learned with CMS, states, federal partners, and contractors aimed to help states refine their TEFT demonstration activities. Rapid-cycle (quarterly) feedback on the experience of care survey, Functional Assessment Standardized Items (FASI), personal health records, and the eLTSS pilot test, has enabled states to see progress over time and support their planning and implementation efforts. The final evaluation report of the TEFT demonstration describes state grantee efforts to conduct on-the-ground testing of a new set of tools designed to increase the use of health IT in the HCBS system and improve quality measurement and service planning in Medicaid HCBS programs.

Home and Community-Based Services Systems Map Report

This report examines TEFT’s impact on state health IT systems and maps the changes made during the demonstration period that positively impacted Medicaid HCBS program operations through increasing the volume of information shared electronically between health IT systems and program stakeholders.

The CAHPS® Home- and Community-Based Services Survey (HCBS CAHPS) was developed through the TEFT demonstration as the Experience of Care (EoC) Survey, where grantee states piloted, tested and modified the initial EoC Survey resulting in obtaining the CAHPS® trademark and National Quality Forum (NQF) endorsement. The EoC Survey received the CAHPS® trademark in June 2016, and NQF endorsed 19 measures derived from the HCBS CAHPS® Survey in November 2016.

For more information about the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, a program of the U.S. Agency for Healthcare Research and Quality, please visit the U.S. Agency for Healthcare Research and Quality website.

For more details about the HCBS CAHPS® measures, go to NQF #2967 in the NQF Quality Positioning System.

State Participation in TEFT Demonstration, by Activity
StateTest Experience of Care SurveyTest FASIDemo PHRS&I Framework Participation# of Components
ArizonaXX  2
Louisiana*X   1
MarylandX XX3
New HampshireX   1

*Louisiana participated in round one EoC data collection.

PHR = personal health record

S&I Framework = Office of the National Coordinator for Health Information Technology's Standards and Interoperability (S&I) Framework