Home and Community-Based Services (HCBS) Quality Measure Set (QMS)
The Home and Community-Based Services (HCBS) Quality Measure Set (QMS) is a set of nationally standardized quality measures for Medicaid-funded HCBS. It is intended to promote more common and consistent use within and across states of nationally standardized quality measures in HCBS programs, create opportunities for CMS and states to have comparative quality data on HCBS programs, drive improvement in quality of care and outcomes for people receiving HCBS, and support states’ efforts to reduce disparities in their HCBS programs. On July 21st, 2022, CMS issued a State Medicaid Director Letter to release the first official version of the HCBS QMS. On April 11, 2024, CMS issued a CMCS informational bulletin to update the HCBS QMS for 2024, with the following changes:
• Fee-for-service (FFS) versions of six managed long-term services and supports (MLTSS) measures have been added to the HCBS QMS. As a result, seven of the eight MLTSS measures (MLTSS-1, MLTSS-2, MLTSS-3, MLTSS-4, MLTSS-6, MLTSS-7, and MLTSS-8) have been updated to reflect a cross-delivery system focus. Additional information about the LTSS measures is available on Medicaid.gov.
• The Flu Vaccinations for Adults Ages 18-64 measure, which has been retired by its measure steward (National Committee for Quality Assurance (NCQA)), has been removed from the HCBS QMS.
On April 11, 2024, CMS also released a CMCS informational bulletin that describes the HCBS QMS reporting requirements for Money Follows the Person grant recipients.
The Ensuring Access to Medicaid Services final rule (Access rule, CMS 2442-F), published in May 2024, requires states to report every other year, beginning in 2028, on the HCBS QMS. The Access rule also sets requirements for CMS to develop and update the HCBS QMS through a process that will allow for public input and comment, including through the Federal Register. As required by the Access rule, CMS will update the HCBS QMS no more frequently than every other year with the exception of annual technical updates and corrections. CMS will establish the measure set required under the Access rule no later than December 31, 2026.
CMS has developed Measure Summaries for the measures in the HCBS QMS as a resource for states. The Measure Summaries include technical specifications, links to testing reports, and information about the measures’ alignment with the CMS Meaningful Measures Initiative, CMS Measures Management System Blueprint measure criteria, section 1915(c) waiver assurances and sub-assurances, and health equity variables.
CMS is available to provide technical assistance to states on the implementation of the measure set. Questions or requests for technical assistance related to the measure set can be directed to HCBSQuality@cms.hhs.gov. Additional guidance on how states can use the measure set to meet federal reporting requirements for HCBS programs, such as required reporting on section 1915(c) waiver assurances and sub-assurances, is forthcoming.