“Real World” Uses of HOS Data
Since its inception in 1998, the HOS program has successfully gathered valid, reliable,
and clinically meaningful data which are used in a variety of "real world" settings,
including:
- CMS to assess the performance of MAOs and reward high performers.
The Centers for Medicare & Medicaid Services (CMS) calculates a performance
assessment ranking for Medicare Advantage Organizations (MAOs) based on the HOS
results, other survey results (e.g., CAHPS®), and additional process measures. CMS
uses this information to monitor and reward desired health plan performance. In
addition, CMS uses HOS data to calculate a frailty adjustor to set payment rates
for social health maintenance organizations (SHMOs) and special needs plans (SNPs).
The analysis of HOS data helps CMS to prioritize program areas for further investigation.
- Health researchers to advance the state-of-the-science in functional health
outcomes measurement, and quality improvement interventions and strategies.
Please visit the HOS Publications Page for information
on available manuals, peer-reviewed articles, and technical reports that have been
developed using HOS data.
- Managed care organizations, providers, and quality improvement organizations
to monitor and improve health care quality.
An MAO can use the HOS to review its performance and identify clinical areas for
special focus. A Quality Improvement Organization (QIO) can use the HOS to monitor,
assess, and promote quality improvement in the MA program.
Materials and webinars have been developed to assist MAOs and QIOs with their quality
improvement efforts.
MAO Resources for Best Practices and the CMS Medicare Star Ratings
The following guide is a resource to help Medicare Advantage Organizations (MAOs)
develop and apply strategies that address the Medicare Health Outcomes Survey (HOS)
items used in the CMS Medicare Part C Star Ratings. The guide includes an overview
of HOS, national performance results on HOS items included in the Medicare Star
Ratings, best practices in promoting quality preventive health care for the elderly,
and HOS resources available to MAOs. Section 1 discusses the prevalence of conditions
measured by the HOS items and provides a summary of national HOS results to highlight
opportunities for improvement and intervention strategies. Section 2 provides examples
of interventions that some MAOs have used to promote patient-physician communication,
screening services or maintenance of functional status among their members. Select
the link below to access the guide.
The following literature review is a synthesis of selected articles of functional
status outcomes in older adults and is designed to supplement the guide for MAOs
above entitled, “Opportunities for Improving Medicare HOS Results through Practices
in Quality Preventive Health Care for the Elderly.” The included outcomes target
short form assessments of health that span the physical to psychological from well
established questionnaires. In addition, outcome measures include activities of
daily living that capture functional limitations in Medicare Advantage recipients.
The articles were selected from the vantage point of interventions that could impact
on the functional status outcomes in elderly populations. The HOS includes the Veterans
RAND 12 Item Health Survey (VR-12) as the core measure for the physical (PCS) and
mental (MCS) summary scores. It also includes HEDIS® Effectiveness of Care Measures
for Management of Urinary Incontinence in Older Adults, Physical Activity in Older
Adults, Fall Risk Management and Osteoporosis Testing in Older Women. Select the
link below to access the literature review.
Self-Paced Training Webinars
The following Windows Media Video (.MP4 and .WMV) files require windows media software
to view the recorded HOS self-paced training presentations. If no WMV-supported
media player has been installed on your system, a media player may be downloaded
from this Windows Media Player link. The videos
provide closed captioning, which is not a default setting for the Windows Media
Player. To configure your Windows Media Player for closed captioning, see the instructions
following the webinar listings. The webinars are accessible by clicking on the Webinar
titles and are approximately 20 to 30 minutes in length.
2013
“Using Your Medicare Health Outcomes Survey (HOS) Data” is an intermediate
training session for MAOs and contains information on how HOS data may be used in
quality improvement activities. The tutorial gives information on how MAOs can identify
program priorities and assess the impact of interventions, and demonstrates the
advantages of linking the HOS data with internal MAO data.
For a closed-captioned version, configure your media player for closed captioning
(see instructions below), then click
here. If your system firewalls prevent the above from functioning properly,
click here to download
the video files in a ZIP format to your computer and follow these instructions:
after downloading, extract all three files to the same directory, then click on
the playlist file (ending with .mp4) to start the video file.
2012
“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.
For a closed-captioned version, configure your media player for closed captioning
(see instructions below), then click here. If your system firewalls prevent the above from functioning
properly, click here to download the video files to your computer and follow
these instructions: after downloading, extract all three files to the same directory,
then click on the playlist file (ending with .asx) to start the video file.
2011
“Getting the Most from Your Medicare Health Outcomes Survey (HOS) Baseline Report”
is an intermediate training session that illustrates how MAOs may use their baseline
HOS report and builds on information from the basic introductory tutorial. The session
discusses how to maximize the use of the HOS baseline report to provide information
on the health of your beneficiaries and to develop chronic care improvement programs
(CCIPs). The webinar is accessible by clicking on the Webinar title below.
For a closed-captioned version, configure your media player for closed captioning
(see instructions below), then click here.
If your system firewalls prevent the above from functioning properly, click here to download the video files to your computer and follow
these instructions: after downloading, extract all three files to the same directory,
then click on the playlist file (ending with .asx) to start the video file.
“Introduction to the Medicare Health Outcomes Survey (HOS)” is a basic tutorial
that is appropriate for MAOs that are new to the HOS or those who want to obtain
an overview of the kinds of information that the HOS provides about the health of
beneficiaries. In addition, the training program provides some practical guidance
about how to obtain HOS reports and data.
For a closed-captioned version, configure your media player for closed captioning
(see instructions below), then click here.
If your system firewalls prevent the above from functioning properly, click here to download the video files to your computer and follow
these instructions: after downloading, extract all three files to the same directory,
then click on the playlist file (ending with .asx) to start the video file.
To configure your Windows Media Player for closed captioning, see instructions
below.
- Open Windows Media Player.
- If the menu bar with commands such as "File", "Play", and "Tools" is not visible
in the Windows Media Player window, press CTRL+M to open this menu bar.
- Open the Play menu, then point to Lyrics, Captions, and Subtitles.
- Enable the command that reads "On if Available" or "Captions."
- Open the Tools menu, then click Options.
- Go to the Security tab.
- Mark the "Show local captions when present" checkbox.
Medicare Advantage Quality Measurement & Performance Assessment Training Conference
On April 8-9, 2008, a two-day educational conference sponsored
by the Centers for Medicare & Medicaid Services (CMS) was conducted in Baltimore,
MD. The conference was designed to enhance participants' knowledge on various topics
pertaining to quality measurement and performance in Medicare Advantage. The presentation
slides from this conference are available in PowerPoint (.PPT) and Hypertext Markup
Language (.HTM) formats. Conference audio presentations are available in Windows
Media Player (.MP3) format, and written transcriptions for the audio presentations
are available in Portable Document File (.PDF) format.
Medicare Advantage Quality Measurement & Performance Assessment Training Conference
slides and transcripts are accessible by clicking on the PPT, HTM and PDF links
below. The MP3 files require a Windows Media Player to open, which may be downloaded
from this
Windows Media Player link.
April 8, 2008
Conference Overview – Samuel C. "Chris" Haffer, CMS; Audio/Transcript:
(MP3, 3.4 MB) (PDF, 14 KB)
Welcome and Introduction - Charlene Frizzera, CMS; Audio/Transcript:
(MP3, 3.3 MB) (PDF, 23 KB)
Morning Plenary Sessions
- A Decade of HEDIS: Celebrating Success and Shaping the Future – Margaret O'Kane,
NCQA; Slides: (PPT, 1.9 MB) (HTM, 3 KB) Audio/Transcript:
(MP3, 21.3 MB) (PDF, 85 KB)
- Measuring Quality & Performance in Medicare Advantage: Where We've Been, Where
We Are, and Where We're Going – Abby Block, CMS; Slides: (PPT, 1.5 MB) (HTM, 4 KB) Audio/Transcript: (MP3, 13.5) (PDF, 26 KB)
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Luncheon Keynote Address Quality Measurement in Action - Carolyn
Clancy, AHRQ; Slides: (PPT, 10.2 MB)
(HTM, 4 KB)
Audio/Transcript: (MP3, 23.5 MB) (PDF, 99 KB)
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Panel Sessions The Basics: CMS' MA Part C and Part D Reporting
Introduction CMS Panel Moderator – Sonya Bowen; Audio/Transcript: (MP3, 1.3 MB) (PDF, 10 KB)
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Afternoon Panel
1) HEDIS, Chronic Conditions QI Projects - Chris Eisenberg, CMS; Slides: (PPT, 58 KB) (HTM, 4 KB) Audio/Transcript: (MP3, 4.6 MB)
(PDF, 31 KB)
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Afternoon Panel
2) CAHPS – Elizabeth Goldstein, CMS; Slides:
(PPT, 214 KB)
(HTM, 4 KB) Audio/Transcript: (MP3, 5.4 MB)
(PDF, 22 KB)
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Afternoon Panel
3) Medicare HOS – Sonya Bowen, CMS; Slides: (PPT, 459 KB) (HTM, 4 KB)
Audio/Transcript: (MP3, 6.2 MB) (PDF, 30 KB)
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Afternoon Panel
4) MA Part D - Alice Lee-Martin, CMS; Slides: (PPT, 3.0 MB) (HTM, 4 KB) Audio/Transcript: (MP3, 5.5 MB)
(PDF, 32 KB)
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Afternoon Panel
5) MA Special Needs Plans – Philip Renner, NCQA; Slides: (PPT, 402 KB) (HTM, 3 KB) Audio/Transcript:
(MP3, 7.1 MB) (PDF, 36 KB)
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Question and Answer Session Audio/Transcript: (MP3, 4.4 MB)
(PDF, 19 KB)
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Reports from the Field: Using Data to Improve Quality and Performance
Introduction - Samuel C. "Chris" Haffer, CMS; Audio/Transcript: (MP3, 1 MB) (PDF, 10 KB)
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Field Report
1) Using Data to Improve Quality and Performance - Jennifer Clark, CMS Region IV;
Slides: (PPT, 616
KB) (HTM, 4 KB)
Audio/Transcript: (MP3, 9.5 MB)
(PDF, 43 KB)
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Field Report
2) HOS - Richard Hector, HSAG; Slides: (PPT, 575) (HTM, 4 KB) Audio/Transcript:
(MP3, 7.4 MB) (PDF, 37 KB)
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Field Report
3) Using HOS to Inform QM - Eliot Fishman and Suzanne Tamang, MJHS; Slides: (PPT, 915 KB) (HTM, 3 KB) Audio/Transcript: (MP3, 8.6 MB)
(PDF, 36 KB)
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Field Report
4) MA QRO - Laura Stewart, Lumetra; Janice Acar, IPRO; Jody Jobeck, Delmarva; Slides:
(PPT,
485) (HTM,
4 KB) Audio/Transcript: (MP3, 10.2 MB)
(PDF, 25 KB)
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April 9, 2008
Introduction - Samuel C. "Chris" Haffer, CMS; Audio/Transcript:
(MP3, 912 KB) (PDF, 10 KB)
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Panel Discussion: Empowering a More Informed Consumer (Part C & D Report
Cards)
Audio/Transcript: (MP3,
21.4 MB) (PDF,
91 KB)
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Morning Panel
1) Consumer Testing of Part C and Part D – Elizabeth Goldstein, CMS; Slides: (PPT, 1.8 MB) (HTM, 4 KB)
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Morning Panel
2) Medicare Plan Ratings – Vikki Oates, CMS; Elizabeth Goldstein, CMS; Slides:
(PPT, 2.8 MB)
(HTM, 4 KB)
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Panel Discussion: Cutting Edge Research Findings from the Science of PM and
QI
Audio/Transcript: (MP3, 26.4 MB)
(PDF,
96 KB)
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Morning Panel
3) Findings from the 2007 Medicare CAHPS Survey - Marc Elliott, RAND Slides: (PPT, 106 KB) (HTM, 4 KB)
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Morning Panel
4) New Measures in HOS: Preventive Care and Vulnerability - Judy Ng, NCQA; Slides:
(PPT, 383 KB) (HTM, 3 KB)
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Morning Panel
5) Association of HEDIS Performance & Outcomes, Panel Moderator – Sarah Hudson
Scholle, NCQA; Slides: (PPT, 386 KB) (HTM, 3 KB)
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Keynote Address Aligning Incentives: Pay-for-Performance and Medicare
Advantage – Gail Wilensky, Project Hope;
Question and Answer Session – Audio/Transcript: (MP3, 5.6 MB)
(PDF, 17 KB)
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Recorded Webinars
The following WebEx Recording Format (.WRF) files require a WebEx Player in order
to view the recorded 2005 and 2006 HOS Webinar presentations. The player may be
downloaded from this
WebEx Player link. The WebEx (.WRF) files for each Webinar may be downloaded
from the links below. In addition, there are Portable Document Format (.PDF) files
of the slide presentations that are also available for download.
2006
"Enhancing the Use of HOS Data," two web conferences about the HOS program were
presented in 2006. Topics in the series included: how MAOs and QIOs can increase
the utilization of the information in their HOS reports; and using the HOS data
for research purposes. The seminar slides for each of the presentations are available
by clicking on the PDF link. Recorded presentations of the web conferences can also
be heard by clicking on the WRF link.
2005
HOS data applications were the subject of a series of web conferences entitled "The
Medicare Health Outcomes Survey: Data Driven Strategies for Quality Improvement"
presented by the Medicare Advantage (Quality Improvement Organization Support Center
[QIOSC]) in partnership with the Arizona and Florida Quality Improvement Organizations.
Topics included identifying strategies for managing chronic conditions and disease
management. The seminar slides for each of the presentations are available by clicking
on the PDF link. Recorded presentations of the web conferences can be heard by clicking
on the WRF link.
- Overview of the Medicare Health Outcomes Survey and Strategies For Using HOS Data
to Improve Quality: May 3, 2005 (PDF, 881 KB) (WRF, 8.47 MB)
- Using the Medicare HOS Data to Identify Strategies for Managing Chronic Conditions
and Using the Medicare HOS Data to Identify At Risk Beneficiaries: May 31, 2005
(PDF, 235 KB) (WRF, 4.49 MB)
- Using the Medicare HOS Data to Evaluate Disease Management Programs and Using the
Medicare HOS Data for the Pharmacy Management of Depression: June 28, 2005 (PDF, 254
KB) (WRF, 6.0 MB)
Medicare HOS Information Synthesis
This document reviews a number of interventions that have an effect on the overall
well-being and functional status of seniors. The intent of the review is to provide
direction in developing interventions that are relevant to the specific needs of
Medicare beneficiaries. This document is available for download Medicare HOS Information
Synthesis (PDF, 3.4 MB).
National Pilot Project on Depression
The National Pilot Project on Depression was a cooperative effort involving CMS,
six QIOs, and sixteen health plans, working to help primary care providers recognize
and treat depression in Medicare beneficiaries. HOS data were analyzed to establish
a profile of those at risk for depression. The results of this project can be used
as a model for developing risk profiles for other health conditions or outcomes
captured by the HOS data. Below are links to the Final Report and User's Guide for
this project.