Measuring Outcomes of People with Disabilities in the US: Current Challenges and Opportunities


Over the past decade as a best practice and in compliance with federal and state HCBS policies, U.S. states are required to measure the impact of the services they provide to persons with disabilities as well as the quality of those supports. Measuring service quality and the outcomes of HCBS recipients has been approached in different ways across states and service providers. There are a variety of measurement tools currently being utilized to evaluate these outcomes. They vary significantly with respect to the approaches they take for data collection (e.g., who they interview) and their psychometric characteristics, including their reliability and validity.  Some of these tools are person-centered and focus on the individual’s desired life outcomes while others assess a standard set of outcomes prescribed by a state or provider. A number of tools focus on quality assurance, while others are centered on the personal outcomes people with disabilities experience that contribute to their quality of life. The purpose of this chapter is to outline the critical challenges in HCBS outcome measurement in the U.S. as they relate to both states and service providers as well as opportunities for improvements in the measurement of the quality of services and supports and the personal outcomes of people with disabilities. In the chapter the authors review different types of measurement instruments researchers, state programs and service providers in the US are currently using as well as discuss how these tools are utilized. Gaps in measuring outcomes for people with disabilities will then be addressed including the current lack of longitudinal outcome measurement systems. Recommendations will  be provided with respect to the development and use of measurement system that have the potential to effectively drive improvement in policy, service provision, and the outcomes of people with disabilities who rely on the human service system in the U.S.

Suggested Citation

Tichá, R., & Abery, B. (2021). Measuring outcomes of people with disabilities in the US: Current challenges and opportunities. In J. Šiška & J. Beadle-Brown (Eds.), The Development, Conceptualisation and Implementation of Quality in Disability Support Services (1st ed.). Retrieved from


Book Chapter 
Karolinum Press [Czech Republic]