Updating HCBS Rates Using Cost Information from Cost Surveys and Other Sources

In a series of posts, Myers and Stauffer will highlight home and community-based services (HCBS) and rate setting methodologies that can have a tremendous impact on services with state programs. 

Collecting cost information from providers through a provider survey is a common approach to developing home and community-based services (HCBS) rates. States should make decisions about how they will use costs in a rate model and the preliminary design of that rate model, which will help identify potential sources of information (e.g., cost survey, nationally published data, or other state information) and the best way to obtain that data.

States should plan carefully and obtain information that will satisfy their objectives in rate assessment or rate development, while not creating overly burdensome requirements for providers. Cost data collection requires a commitment from both states and their providers.

In designing the cost survey, states should determine the appropriate balance of original data collection and reliance on existing data sources. For example, some states use the Bureau of Labor Statistics (BLS) publicly available wage data to determine salary costs. Others decide to collect salary information and supplement as needed or validate the collected data with BLS Information. Whatever the approach, it is important that states do not overburden providers.

The HCBS cost survey is an important tool for states in assessing current payment rates, developing new methodologies, and supporting changes to policies that promote access and quality of HCBS.

How We Can Help 

Myers and Stauffer is helping a number of clients implement HCBS cost surveys to support the evaluation of current rates and the development of new methodologies that can improve access and quality of services. We have a strong history of helping clients develop and design waivers, implement rate reimbursement structures, and conduct stakeholder engagement, all with the goal of strengthening HCBS programs. We work with our clients and stakeholders to create population or program-specific solutions that meet each state’s desired goals and outcomes.

We are known for our willingness and proficiency in supporting our clients through complex changes to programs, policy and reimbursement systems, and for our commitment to maintaining confidentiality throughout the planning and implementation processes. We have also been trusted to work with provider groups and associations in a variety of roles to evaluate various policy and reimbursement reforms and initiatives.