At the NASUAD HCBS conference earlier this month, representatives from the Centers for Medicare and Medicaid Services (CMS) announces that they will permit new performance-based options for paying for employment supports through 1915(c) HCBS waivers. The new payment structure would allow states to make milestone payments in addition to fee-for-service payments to reimburse providers when certain employment outcomes are achieved. Outcome payments must be based on a time-limited service that leads to a tangible outcome. Additionally, the payment must be based on the average amount of time it is expected to take to complete the service, based on actual verified data.
The presentation slides provided by CMS, which include information about the pay for performance option, are attached below. CMS has said that formal guidance will be issued in the near future.