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The Agency for Healthcare Research and Quality (AHRQ) released Assessing the Health and Welfare of the HCBS Population, a report on the development of outcome indicators to assess the "health and welfare" of recipients of Medicaid home and community-based services (HCBS). 

The report found that outcome indicators varied from state to state based on the state HCBS policies and service availability. More generous HCBS programs were consistently associated with lower rates of hospitalization.  

Most efforts around quality improvement and the HCBS population have focused on HCBS participants who receive 1915(c) waiver services and not on people who receive HCBS state plan services. Yet, half of HCBS participants use State plan services only. 

AHRQ recommends that future work needs to include quality improvement outcome indicators for state plan services.