Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Continuous Quality Improvement: Discovery

10/29/2010

Discovery refers to the monitoring process states use to uncover deviations from program design in a timely fashion. Discovery allows states to know when program processes are not being followed and when the assurances (subassurances) are not being met. The discovery monitoring process requires a state to establish performance measures that enable it to assess whether--and the extent to which--it is complying with each of the Federal assurances.

In the waiver application, a state must specify one or more performance measures for each subassurance. In addition, it must provide information on (1) the data source(s) for each performance measure; (2) how the representativeness of the data will be ensured; (3) information on the party or parties responsible for collecting, reviewing, and using the data to manage the program; and (4) how frequently summary (i.e., aggregated) reports will be generated and reviewed.

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