Standardizing the measurement of the quality of home- and community-based services across payers and delivery systems is one step closer to reality with the release of a final set of recommendations from the National Quality Forum.

The report of NQF’s Measuring Home and Community-Based Services Quality project, conducted under contract from the Department of Health and Human Services, is the result of two years of work by a multi-stakeholder committee. Three interim reports previously had been released.

“With the ongoing effort to shift government funding from institutional to community-based settings and the increasing demand for [HCBS], it is important that we develop standardized measurement of the quality of these services,” Edwin Walker, acting administrator of the Administration for Community Living and assistant secretary on aging at HHS, said Wednesday. “We’re pleased with the progress on creating HCBS measures exemplified by this report and look forward to feedback from others, particularly as measures are tried and tested.”

The final report includes short-term recommendations for areas where quality measures already exist or measure concepts have been tested or could be tested, intermediate recommendations for existing measures or concepts that need further development, and long-term recommendations for areas that require more research because they lack measures and concepts. Additionally, the report identifies gaps in HCBS quality measurement, describes challenges in measuring HCBS quality and provides recommendations for prioritization in measurement.

The 11 domains mentioned:

  1. Service delivery and effectiveness
  2. Person-centered planning and coordination
  3. Choice and control
  4. Community inclusion
  5. Caregiver support
  6. Workforce
  7. Human and legal rights
  8. Equity
  9. Holistic health and functioning
  10. System performance and accountability
  11. Consumer leadership in system development

An appendix in the report cites the Center for Excellence in Assisted Living’s “Toolkit for Person-Centeredness in Assisted Living” as a measure concept source.