Proposed Methods for Developing and Testing Risk- and Reliability-Adjustment Models for HCBS Composite Measures

The purpose of this report is to describe the methods and processes to develop and test the risk-adjusted HCBS composite measures, with the ultimate goal of the finalized HCBS composites being to compare state-level rates for selected HCBS populations to relevant benchmarks. The HCBS composites are intended to assess the quality of care for HCBS recipients under a shared accountability framework: the measures profile the experience of the HCBS population and will reflect the care that all providers (not just HCBS providers) deliver. These comparisons are intended to guide HCBS quality improvement efforts led by HCBS stakeholders such as the Centers for Medicare & Medicaid Services and state Medicaid offices.