Strengthen Person & Family Engagement as Partners in their Care

VISIT THE PILLAR: State Health System Performance

National Context

The Centers for Medicare and Medicaid Services organizes measures in the state health system performance pillar of the Scorecard using the domains defined in the Meaningful Measures initiative. The initiative identifies the highest priority areas for quality measurement and improvement. The measures in this domain focus on engaging Medicaid and Children's Health Insurance Program (CHIP) beneficiaries as partners in their care, which helps ensure that they are making informed decisions about their care. Informed decisions can lead to improved satisfaction with care and quality of life for beneficiaries and their families.

State Use of Experience of Care Surveys for Beneficiaries Using Long-Term Services and Supports

This measure reports on states’ use of three experience of care surveys administered to long-term services and support (LTSS) beneficiaries. Surveys included in the count are:

CAHPS Home and Community-Based Services Survey (HCBS CAHPS)
HCBS CAHPS is a cross-disability survey of HCBS beneficiaries’ experience receiving LTSS. The survey is designed to facilitate comparisons across state Medicaid HCBS programs that target adults with disabilities, including frail elderly, individuals with physical disabilities, persons with developmental or intellectual disabilities, those with acquired brain injury and persons with severe mental illness. Please refer to CAHPS Home and Community-Based Services Survey for more information.
National Core Indicators (NCI) In-Person Survey
NCI is a collaborative effort by developmental disability agencies to gather a standard set of performance and outcome measures on individuals with intellectual or developmental disabilities. Please refer to National Core Indicators for more information.
National Core Indicators for Aging and Disabilities (NCI-AD)
NCI-AD is a collaborative effort by state Medicaid, aging, and disability agencies to gather a standard set of performance and outcome measures on older adults and individuals with physical disabilities. Please refer to National Core Indicators Aging and Disabilities for more information.

Administration of the three surveys is voluntary. States vary in how often they administer surveys and the proportion of the LTSS population covered by surveys. The count below includes surveys administered since 2017. States may also use other surveys to understand the experiences of their LTSS beneficiaries.

51 states reporting, median rate of 2 patient experience surveys.

State Health System Performance

State Use Experience �of Care Surveys for Beneficiaries Using Long-Term Services and SupportsUS Map with the categories and values. Described in the table below.

State	Count of Surveys
Alabama	2
Alaska	0
Arizona	2
Arkansas	1
California	1
Colorado	2
Connecticut	2
Delaware	2
Florida	2
Georgia	2
Hawaii	1
Idaho	1
Illinois	2
Indiana	2
Iowa	1
Kansas	3
Kentucky	1
Louisiana	1
Maine	1
Maryland	1
Massachusetts	1
Michigan	1
Minnesota	2
Mississippi	3
Missouri	2
Montana	1
Nebraska	2
Nevada	2
New Hampshire	1
New Jersey	3
New Mexico	1
New York	1
North Carolina	1
North Dakota	1
Ohio	2
Oklahoma	1
Oregon	2
Pennsylvania	2
Rhode Island	1
South Carolina	1
South Dakota	2
Tennessee	2
Texas	2
Utah	2
Vermont	2
Virginia	1
Washington	2
Washington, D.C.	1
West Virginia	2
Wisconsin	2
Wyoming	1

Source: Data on states’ HCBS CAHPS administration status come from the AARP Public Policy Institute (PPI) and National Association of States United for Aging and Disabilities (NASUAD), “Long-Term Services and Supports Economic Survey” (unpublished, Washington, DC: AARP PPI and NASUAD, 2018) and were verified by the Centers for Medicare & Medicaid Services (CMS). Data reflect administration between 2017 and 2019. Data on states’ NCI administration come from NCI administrative records and reflect administration during the 2017-2018 and 2018-2019 reporting cycles. Data on states’ NCI-AD administration come from NCI-AD administrative records and reflect administration during the 2017-2018 and 2018-2019 reporting cycles.