Frequently Asked Questions about the Medicare HOS
Where can I obtain copies of the HOS survey questionnaire?
Copies of the HOS and HOS-Modified (HOS-M) survey instruments may be downloaded
from the Survey Instrument section of the HOSonline.org
(HOS) website. In addition, the HOS and HOS-M questionnaires may also be found
in the corresponding NCQA HEDIS®, Volume 6 Specifications for the Medicare Health Outcomes Survey
manuals, which may be purchased by calling the NCQA Customer Support Telephone Line
at 1-888-275-7585 or via NCQA's Secure Online Order Center (www.ncqa.org).
How will I know when the HOS reports are available?
The HOS program and administration timelines are posted on the HOS website on
the Program Timeline
and Program Overview sections to
provide a reasonable estimate of when the HOS reports will be completed and
ready for distribution each year. The approved users of the CMS Health Plan Management
System (HPMS) at your MAO will receive an announcement through HPMS of the
availability of the reports. If you do not have an HPMS User ID, you may contact
your organization's CMS Quality Point of Contact to access the reports. Private Fee-for-Service
(PFFS) plans and Regional Preferred Provider Organizations (RPPOs) are excluded
from any state or regional measures in the reports, although they are included in
the national HOS numbers.
How can MAOs obtain their HOS reports?
All HOS report distribution (HOS and HOS-M) occurs electronically
to participating Medicare Advantage Organizations (MAOs) and PACE
Organizations through HPMS. For individual MAOs and PACE Organizations
to access their HOS reports, an HPMS User ID is required. If you do
not have an HPMS User ID, you may contact your organization's CMS
Quality Point of Contact to obtain access to the reports. If assistance
is required regarding HPMS access, you may contact CMS via e-mail at
The most recent sample reports are available in the Overview portion
of the Publications section.
What does it mean if my MAO has been identified as an “outlier” in a HOS Performance
Outliers are MAOs that performed significantly better
(i.e., better than expected) or significantly worse
(i.e., worse than expected) when compared to the national average.
The national average is based on all MAOs that participated in
performance measurement. MAOs can be outliers on a measure of
physical health (which is based on death and the VR-12 Physical
Component Summary score), or on a measure of mental health
(which is based on the VR-12 Mental Component Summary score).
Additional information is available in the Methodology section
of the Performance Measurement report. A sample Performance
Measurement report is available for download from the Overview
part of the Publications section.
How are the performance measurement results calculated for the HOS Performance
Details of how the HOS Performance Measurement Results are calculated may be obtained
from Appendix 1 Calculations of Outcomes section of the Performance Measurement
Report. A self-paced training webinar on “Understanding the Medicare Health Outcomes
Survey (HOS) Performance Results Used in the MA Plan Ratings” is available in the
“Real World” Uses of HOS Data section of the website.
Where can I obtain ideas for quality improvement activities based upon the HOS
results for my MAO?
The Medicare HOS website contains a section entitled “Real
World” Uses of HOS Data to assist MAOs in obtaining ideas for quality improvement initiatives. The HOS
Publications section is an excellent source of journal articles and technical reports that use
HOS data. For example, the resource
“Opportunities for Improving Medicare HOS Results
through Practices in Quality Preventive Health Care for the Elderly” is
available to help MAOs develop and apply strategies that address the HOS items used in the
CMS Medicare Part C Star Ratings. The literature review “Functional Status in Older Adults: Intervention Strategies for Impacting Patient Outcomes” is
a synthesis of selected articles of functional status outcomes in older adults and is designed
to supplement the resource guide.
Is there any training available to assist MAOs in understanding how to use their
Four self-paced training webinars are available in the “Real World” Uses of
HOS Data section.
What HOS data sets are available to the MAOs?
- “Introduction to the Medicare Health Outcomes Survey (HOS)” is a basic training session that provides
an overview of the HOS; describes how MAOs may obtain HOS reports, data sets, and
Data User's Guides; and discusses additional available resources.
- “Getting the Most from Your Medicare Health Outcomes
Survey (HOS) Baseline Report” is an intermediate level training session that discusses
how to maximize the use of the HOS baseline report to provide information on the
health of beneficiaries and to develop chronic care improvement programs (CCIPs).
- “Using Your Medicare Health Outcomes Survey (HOS) Data” is an intermediate
training session that contains information on how MAOs may use their HOS data to assist
in quality improvement activities.
- “Understanding the Medicare Health Outcomes Survey
(HOS) Performance Results Used in the MA Plan Ratings” is an advanced training session
that describes the methodology used in calculating the performance measurement results.
The tutorial discusses the primary health outcomes collected from the survey, the
PCS and MCS scores, and how they are utilized to describe changes in the functional
status of MAO beneficiaries over a two-year period. It also discusses how the HOS
Survey results are utilized in the Medicare Star Ratings.
The data files distributed to the MAOs are the analytic
data sets, which contain the data for a completed cohort
(combined baseline and two year follow up). These data sets
are available after the distribution of the Performance
Measurement Reports. Additional information about the
data sets that have been distributed to the MAOs, may
be found in the Data Dissemination
section on the HOS website.
How do I obtain the HOS data sets for my MAO?
An announcement of the availability of the new cohort
data is sent to the participating MAOs through the HPMS.
Contact the HOS team via email at firstname.lastname@example.org
to request your data. MAO data sets will be formatted as
Comma Separated Value (CSV) files that are accessible
with MS Excel. The data will be sent on CD to the designated
recipient (one per company) within approximately two to
three weeks of the request. Documentation for the data
file will be included on the CD. Data are encrypted in
a self-extracting file using the Pointsec Media Encryption
Technology. The recipient must call the HOS
team after the CD arrives to get the encryption password (1-888-880-0077).
How can QIOs obtain their state's reports?
The HOS reports for QIOs are distributed through the CMS
QualityNet application, as well as through the HPMS.
For those QIOs that do not have any participating MAOs
in their state, a sample state-level HOS report is
distributed to provide information about HOS activities.
The sample QIO report contains example state-level data
only; however, all references to the HOS Total reflect
actual national-level data.
What data sets are available to the QIOs?
Beneficiary level data files in a SAS® format are
provided to the QIOs following the distribution of
both Baseline and Performance Measurement Reports.
The QIOs receive state-level HOS data for all
MAOs within their state, including survey respondents,
non-respondents, and those identified as ineligible.
PFFS plans and RPPOs are excluded from the
QIO data files. SAS® is a registered trademark of
the SAS Institute Inc., Cary, NC.
What types of data sets are available to researchers?
Three basic types of data sets are available to researchers:
Public Use Files (PUFs), Limited Data Sets (LDS) and Research
Identifiable Files (RIFs). The PUFs have been constructed so
that all the beneficiary identifying information, including
the Medicare Health Insurance Claim (HIC) numbers, Social
Security Numbers (SSN), name and address fields have been
removed. In addition, some demographic fields such as race
and age are aggregated to prevent identification of any individuals.
There are two types of PUFs, baseline and analytic. Analytic PUFs contain a completed
cohort of data for all baseline respondents and are constructed to be self-contained
with a baseline and follow up component for each beneficiary's record. There
no field that allows identification of a particular individual across the cohorts
in the analytic PUFs. Baseline PUFs have been constructed with a unique anonymous
ID field that does allow identification of the same individual across multiple baseline
LDSs and RIFs are comprised of the entire national sample
for a given cohort (including both respondents and non-respondents),
and contain all of the HOS survey items, the physical and mental
health summary scores, as well as plan identifiers and additional
variables describing the plan's characteristics. They also contain
protected beneficiary-level health information such as date of birth.
However, there are differences between the two types of data sets.
For example, the specific direct person identifiers (i.e., name,
address, Medicare Health Insurance Claim [HIC] number, and Social
Security Number) are included in the RIFs and allow identification
of the same individual across multiple cohorts; however, these
identifiers are excluded in the LDSs. For more information, go
to the Research Data section.
How can I obtain the research files?
The PUFs are available for download on the HOS website.
A signed Data Use Agreement with CMS is required to obtain
either LDS or RIF data files. A small fee is assessed for
each cohort of data. The Research Data Assistance Center (ResDAC)
at the University of Minnesota is a CMS contractor that provides
assistance to academic, government and non-profit researchers
interested in using Medicare and/or Medicaid data. ResDAC is
available to assist in the completion and/or review of data
requisition forms for Medicare HOS research data files prior
to their submission to CMS. For additional information
and assistance with obtaining Medicare HOS LDS and RIF files, please visit the ResDAC Web page and select the Health Outcomes
Survey within the Data Availability Table link.
ResDAC may also be contacted by calling 1-888-9RESDAC (1-888-973-7322)
between the hours of 8:00 a.m. to 4:30 p.m. CST Monday
through Friday or by e-mailing email@example.com.
Where can I obtain information about the CMS Medicare Star Ratings?
For information about the HOS results included in the Medicare Star Ratings,
you may go to the HOS and the Star Ratings
section of the HOS website. Additional information is available on the CMS website at
For any questions related to Medicare Part C Star Ratings, you may send an e-mail inquiry
directly to PartCRatings@cms.hhs.gov. Medicare
Part D Star Ratings questions may be sent to PartDMetrics@cms.hhs.gov. Please be sure to include your MAO contract number
in the email, where applicable.