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Home and Community-Based Services (HCBS) Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Measures

CBE ID
2967
E&M Committee Rationale/Justification

Committee Final Vote: CBE #2967 – HCBS CAHPS contains 19 individual measures. Per the policy on Instrument-based Clinical Quality Measures the CBE does not endorse survey instruments. Rather, the CBE reviews and endorses measures derived from survey instruments in which survey assessments are aggregated to an accountable entity. Thus, each of the 19 measures derived from the HCBS CAPHS survey instrument is reviewed and endorsed separately.

The committee voted to endorse 17 of the 19 measures with conditions and did not reach consensus on two measures (#17 - Unmet need in toileting due to lack of help and #18 - Unmet need with household tasks due to lack of help), which resulted in endorsement being removed for those two measures. 

Condition: For each of the 17 measures that received an endorsed with conditions designation, the committee would like to see the following condition addressed when these measures are submitted for maintenance review:

  • The developer will explore methodological strategies (e.g., weighting, sampling) to ensure that responses are representative.

Endorsement Decisions:

  1. Scale Measure 1 - Staff are reliable and helpful: Endorsed with Conditions
  2. Scale Measure 2 - Staff listen and communicate well: Endorsed with Conditions
  3. Scale Measure 3 - Case manager is helpful: Endorsed with Conditions
  4. Scale Measure 4 - Choosing the services that matter to you: Endorsed with Conditions
  5. Scale Measure 5 - Transportation to medical appointments: Endorsed with Conditions
  6. Scale Measure 6 - Personal safety and respect: Endorsed with Conditions
  7. Scale Measure 7 - Planning your time and activities: Endorsed with Conditions
  8. Global Rating Measure 1 - Global rating of personal assistance and behavioral health staff: Endorsed with Conditions
  9. Global Rating Measure 2 - Global rating of homemaker: Endorsed with Conditions
  10. Global Rating Measure 3 - Global rating of case manager: Endorsed with Conditions
  11. Recommendation Measure 1 - Would recommend personal assistance/behavioral health staff to family and friends: Endorsed with Conditions
  12. Recommendation Measure 2 - Would recommend homemaker to family and friends: Endorsed with Conditions
  13. Recommendation Measure 3 - Would recommend case manager to family and friends: Endorsed with Conditions
  14. Unmet Needs Measure 1 - Unmet need in dressing/bathing due to lack of help: Endorsed with Conditions
  15. Unmet Needs Measure 2 - Unmet need in meal preparation/eating due to lack of help: Endorsed with Conditions
  16. Unmet Needs Measure 3 - Unmet need in medication administration due to lack of help: Endorsed with Conditions
  17. Unmet Needs Measure 4 - Unmet need in toileting due to lack of help: Endorsement Removed due to No Consensus
  18. Unmet Needs Measure 5 - Unmet need with household tasks due to lack of help: Endorsement Removed due to No Consensus
  19. Physical Safety Measure - Hit or hurt by staff: Endorsed with Conditions
1.0 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Spring 2029
1.6 Measure Description

The Home and Community-Based Services (HCBS) Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey consists of 19 measures that assess the experiences of Medicaid participants’ age 18 and older receiving long-term services and supports (LTSS). The measures report a case-mix adjusted top-box score. Measure scores are calculated based on participant responses to a cross-disability survey about their experiences with the LTSS they receive in the community, delivered through a Medicaid-funded HCBS program. The unit of analysis is the Medicaid entity (that is, states, HCBS program, or managed care plans [MCPs], depending on the state).

Measure Specs
General Information
1.7 Composite Measure
No
1.3 Electronic Clinical Quality Measure (eCQM)
1.8a Population or Geographic Area Level of Analysis
State
1.9 Care Setting
1.9b Other Care Setting
Home and community-based services
1.10 Measure Rationale

The information that is collected as part of the HCBS CAHPS Survey informs HCBS managed care plans and states about their performance on services that are highly valued by HCBS participants. The type of data that are collected when implementing the survey is not readily available through other measures and can be used to target areas of improvement where scores are lagging. As the measure becomes implemented HCBS plans and states will have the ability to monitor performance over time and base care interventions, in part, on the trends they see in responses.

1.20 Types of Data Sources
1.25 Data Source Details

Data are derived from participant responses to the HCBS CAHPS Survey, funded by the Centers for Medicare & Medicaid Services (CMS). The HCBS CAHPS instrument is available at https://www.medicaid.gov/medicaid/quality-of-care/quality-of-care-performance-measurement/cahps-home-and-community-based-services-survey/index.html