MCKNIGHT: MACPAC: CMS should require states to report hourly wages to HCBS workers
In its March 2026 annual report to Congress, the Medicaid and CHIP Payment and Access Commission (MACPAC) recommended that the Centers for Medicare & Medicaid Services (CMS) require states to report hourly wages for home- and community-based services (HCBS) workers. This proposal aims to address critical data gaps that currently hinder states from setting effective reimbursement rates, which have contributed to high turnover rates of 40–60% and significant staffing shortages. By standardizing wage data for roles such as personal care and home health aides, MACPAC intends to provide a more accurate foundation for rate-setting that promotes workforce stability and improves access to care for the 2.5 million people relying on these Medicaid-funded services.
