Influential Group Floats Ideas for Home Care Quality Measurement

The National Quality Forum (NQF) recently released an interim report to address performance measure gaps in home and community-based services (HCBS). The report reflects a two-year project to develop a conceptual framework for quality measurement.  

The Quality Forum is a nonprofit organization dedicated to proposing and endorsing gold-standard performance measures to gauge and improve U.S. health care.

NQF, under a contract with the Department of Health and Human Services, is convening a multistakeholder committee to develop recommendations to address gaps in how HCBS performance is measured. This work will identify high-leverage areas for performance measurement and recommend the development or refinement of measures. It is being undertaken in large part because the aging of the U.S. population makes these types of long-term services and supports increasingly vital, NQF states in its description of the project.


“In doing so, it will contemplate the range of populations that use or need HCBS, varied community settings, payers, delivery systems, and accountable entities,” NQF explains in the July 17 report.

The report outlines high-quality characteristics HCBS should embody, including that it “provides for a person-driven system that optimizes individual choice and control in the pursuit of self-identified goals (e.g.,employment, enjoying life).”

As part of its proposed conceptual framework, NQF offers these domains of HCBS quality measurement: workforce/providers; consumer voice; choice and control; human and legal rights; system performance; full community inclusion; caregiver support; effectiveness/quality of services; service delivery; equity; and health and well-being.


The report also lists proposed subdomains to assist with defining each domain’s scope and articulating ideas for measurement.

In the next phase of the project, the committee will review any currently available measures within each domain and elaborate on potential new measurement concepts for development, NQF says in the report. 

The report’s comment period runs through 6 p.m. EST Aug. 17.

 Access the report here.

Written by Cassandra Dowell

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