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Cutler, Disabilty and Aging


The Centers for Medicare and Medicaid Services (CMS) have contracted with the Muskie School of Public Service to develop a technical assistance guide for use by states and CMS regional offices to assess and improve the quality of home and community-based care (HCBC) to Medicaid beneficiaries. 1 The project will identify tools, measures, standards, and oversight mechanisms for performance measurement and quality improvement of long term care services delivered under federal and state-funded HCBC programs, exclusive of consumer-directed services. In addition to highlighting promising state practices, the project will describe the opportunities and challenges of applying advancements in the field of quality management, so broadly used in other sectors of health care, to improve the quality of HCBC services.

This paper reviews published literature and provides a summary of major CMS initiatives in the area of quality measurement and improvement over the last five years. In conducting this review, a wide lens was applied to identify quality strategies in settings of care and delivery systems both within and outside long term care. This paper will serve as background for a meeting with federal and state policymakers and quality experts to assess the relevance and limitations of identified methods to improve the quality of services and outcomes in HCBC programs. Based on findings from the meeting and additional structured interviews with stakeholders, a technical assistance guide will be prepared.

Funding Organization or Grant

This product was produced for the Centers for Medicare and Medicaid Services under Order No. CMS-01-00328.