Medicaid Gears Up 2028 Quality Checks for Home Care
Published Date: 4/28/2026
Notice
Summary
Starting in 2028, Medicaid will update the quality checks for Home and Community-Based Services (HCBS) to make sure people get better care no matter where they live. States will have to collect and share new kinds of data, including differences between rural and urban areas, to help improve services. Everyone’s invited to share their thoughts by May 28, 2026, so these changes work best for all.
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Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
States Must Report HCBS Measures
If you get Medicaid home and community-based services (HCBS), your State must start reporting required HCBS quality measures every other year beginning July 9, 2028. States must also set performance targets for mandatory measures and describe the quality improvement strategies they will use.
Disparities Data Must Be Phased In
States must begin providing stratified HCBS measure data by factors like race, ethnicity, sex, age, rural/urban status, disability, and language. The phase-in requires stratified reporting for 25% of measures by July 9, 2028; 50% by July 9, 2030; and 100% by July 9, 2032.
2028 Measure Set: 23 Measures Proposed
CMS is proposing a 2028 HCBS Quality Measure Set that would include 23 mandatory measures (2 assessment/case management, 3 administrative, and 18 participant-reported survey measures). States would not necessarily report all 23 measures; each State is expected to report between 9 and 19 measures depending on which experience-of-care surveys it uses, and CMS may report the three administrative measures on a State's behalf using T-MSIS data.
Some Survey Measures Not Mandatory in 2028
CMS is not proposing two participant-reported measures as mandatory in 2028: HCBS CAHPS 'Planning Your Time and Activities' composite and Personal Outcome Measures (POM) 'People Live in Integrated Environments.' CMS also expects to propose removing POM from the 2030 measure set.
Children and Youth Measures Planned Later
The notice states there is a lack of proposed HCBS measures for children and youth and that CMS is working to address this gap and expects to propose measures focused on children and youth in the future.
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