Medicare Health Outcomes Survey

"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 MA Plans and reward high performers.

The Centers for Medicare & Medicaid Services (CMS) calculates a performance assessment ranking for Medicare Advantage (MA) Plans 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 MA Plan 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 MA Plans and QIOs with their quality improvement efforts.

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 MA Plans 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)

SF-36® Primer for the Medicare Health Outcomes Survey

This primer provides general information about the HOS, how it came to be, what its components are, how HOS data are collected and analyzed, and how HOS results have been used. Information on the construction, scoring, reliability, validity and interpretation of the SF-36® Health Survey is summarized. Multiple tables of normative data are included to allow health plans and others using the SF-36® to compare their data with reference norms for the Medicare managed care population, overall, and by categories such as age and gender. Examples of studies that demonstrate the impact of interventions such as disease management and geriatric assessment in improving or maintaining SF-36® scores are provided. Copies of the primer may be purchased via QualityMetric's Secure Online Order Center.

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 mode 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.



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