HCBS News 2026Apr30

Medicaid Home Care Chartbook Shines Light on In-home Services

Focusing on a subset of Medicaid home and community-based services delivered in people’s homes, the Medicaid Home Care Chartbook provides analysis and data on recipients of Medicaid home care. Released by the Research Institute for Home Care in collaboration with the National Alliance for Care at Home, the chartbook provides information on percentages of recipients accessing home care through different payer models, eligibility pathways, and geographies. Authors include data on individuals enrolled in Medicaid Expansion with home care claims, noting that though this only accounts for 1.4% of the expansion population, new work requirements and eligibility review frequencies could threaten access to needed in-home care. For providers and advocates in Medicaid home care, the brief offers data specifically limited to services provided in participant homes, when compared with other available analysis. The chartbook highlights the prevalence of home care utilization across eligibility pathways and offers estimates of coverage losses based on new HR 1 policies. The full chartbook is available here.

CMS Posts HCBS Quality Measure Set for 2028 State Reporting

Available in the Federal Register prior to the official posting on April 28, the Centers for Medicare and Medicaid Services (CMS) posted the Medicaid Program; 2028 Medicaid Home and Community-Based Services Quality Measure Set. The posting announces a 30-day public comment period on the set and proposes mandatory state adoption of the home and community-based services quality measure set, with reporting to commence on July 9, 2028, for 25% of measures. The remaining measures will be rolled in with 50% of measures being reported on by 2030, and full reporting necessary by 2032. The proposal by CMS to mandate quality measures in HCBS comes at a time when all additional transparency into service delivery and program integrity will support states’ policy decisions in light of ongoing scrutiny to fraud and program abuse. Measures will be reported on the aggregate, though stratified by participant age and wavier categories. Reponses will be based on surveys of participants’ abilities to access services, timeliness of service availability post enrollment, ability to access broader community supports, and amend service needs. Further analysis of the proposal is forthcoming as LeadingAge anticipates commenting on the proposal.