Welcome to the Medicare Health Outcomes Survey (HOS) Website
The Medicare HOS is the first patient-reported outcomes measure used in Medicare managed care. The goal of the Medicare HOS program is to gather valid and reliable clinically meaningful data that have many uses, such as targeting quality improvement activities and resources; monitoring health plan performance and rewarding top-performing health plans; helping beneficiaries make informed health care choices; and advancing the science of functional health outcomes measurement. Managed care plans with Medicare Advantage (MA) contracts must participate.
Each year a random sample of Medicare beneficiaries is drawn and surveyed from each participating Medicare Advantage Organization (MAO) that has a minimum of 500 enrollees (i.e., a survey is administered to a different baseline cohort, or group, each year). Two years later, the baseline respondents are surveyed again (i.e., follow up measurement). Cohort 1 was surveyed in 1998 and was resurveyed in 2000. Cohort 2 was surveyed in 1999 and was resurveyed in 2001, and so on. During the most recent HOS administration (2020 Round 23), Cohort 23 was surveyed and Cohort 21 was resurveyed using HOS 3.0. For data collection years 1998-2006, the MAO sample size was one thousand. Effective 2007, the MAO sample size was increased to twelve hundred. Since 2019, MAOs can request a survey sample larger than the standard sample of 1,200.
What's New on the Medicare HOS
- Reporting Requirements for Healthcare Effectiveness Data and Information Set (HEDIS®) Measurement Year (MY) 2021, HOS, and CAHPS® Measures, and Information Regarding HOS and HOS-Modified (HOS-M) for Frailty. This Health Plan Management System (HPMS) memo was released on May 24, 2021. The memo provides information about the HEDIS, HOS, and CAHPS reporting requirements in 2022 and the timing of HOS and HOS-M survey administration. An update on the release schedule for information on using the HOS and HOS-M for FIDE SNP frailty measurement is also included in the memo.
- HOS Quality Assurance Guidelines and Technical Specifications (QAG).The HOS Quality Assurance Guidelines and Technical Specifications is now available. The publication details the requirements, protocols, and procedures for the HOS survey administration. The HOS QAG is available under the Survey Administration section and the Methodology section.
- HOS-M QAG Addendum. The HOS-M Quality Assurance Guidelines and Technical Specifications Addendum is now available. The publication details the requirements, protocols, and procedures for the HOS-M survey administration. The HOS-M QAG is available under the Methodology section.
- HOS 2021 New Survey Vendor Training Slides and HOS 2021 Survey Vendor Update Training Slides. The HOS 2021 survey vendor trainings for both new and returning HOS survey vendors took place in May 2021. The presentation slides have been are posted under the Survey Administration section and may be found there.
- 2021 Medicare HOS Centers for Medicare & Medicaid Services (CMS)-Approved Survey Vendors List. Final approval of the survey vendors was contingent on successful completion of HOS survey vendor training in May 2021. The list of approved survey vendors is posted under the Survey Vendor section and may be accessed there.
- Semi-annual HOS Newsletter. The Winter 2020-21 edition of the HOS Newsletter was released in March 2021. To sign up for email distribution, contact the HOS Information and Technical Support email (firstname.lastname@example.org).
- HOS 2021 Administration Memo and HOS Exclusion Memo. The memos were released on March 15, 2021 detailing the HOS plan reporting requirements, contracting with a CMS-approved survey vendor, sampling process, survey administration, requirements for HOS reporting, and exclusion criteria for MAOs not participating in 2021. Both memos are posted under the Survey Administration section and may be accessed there.
- HOS-M 2021 Survey Administration Memo. The memo was released on March 1, 2021 detailing the HOS-M plan reporting requirements, contracting with a CMS-approved survey vendor, sampling process, survey administration, and contracts required to report HOS-M. The memo is posted under the Survey Administration section and may be accessed there.
- Automated Process for Requesting HOS and HOS-M Fully Integrated Dual Eligible (FIDE) Special Needs Plan (SNP) Participation for Frailty. This HPMS memo was released on February 1, 2021 detailing the application process and requirements for participation in the 2021 HOS and HOS-M to support the calculation of frailty scores for 2022 payments. The new automated process is accessible via the HPMS. The memo is posted under the Survey Administration section and may be accessed there.
- Reporting Requirements for HEDIS® MY 2020, HOS, and CAHPS® Measures, and Information Regarding HOS and HOS-M for Frailty. This HPMS memo was released on September 8, 2020 via the HPMS and may be accessed there or here. The memo provides information about the HEDIS, HOS, and CAHPS reporting requirements in 2021, as well as the timing of HOS and HOS-M survey administration. An update on the timing for release of information on the HOS and HOS-M for FIDE SNPs that will be used for frailty consideration is also included in the memo.
- 2021 HOS and HOS-M Fielding Timeline. Administration of the 2021 HOS and HOS-M will take place from July to November 2021 in accordance with the 2021 HOS Program Timeline and HOS-M Program Timeline. More information about the timeline in 2021 can be found on the Program Timeline page.
- Regulatory Response to the COVID-19 PHE. CMS issued an Emergency Interim Final Rule that delayed Medicare HOS 2020 data collection until late summer 2020. The Interim Final Rule is available here: https://www.federalregister.gov/documents/2020/04/06/2020-06990/medicare-and-medicaid-programs-policy-and-regulatory-revisions-in-response-to-the-covid-19-public.
- REVISED Description of the Physical Functioning Activities of Daily Living (PFADL) Measure. The PFADL is a new longitudinal change measure derived from the Medicare HOS. The revised version includes updated methodology for the calculation of the measure.
For additional information about the availability of auxiliary aids and services, please visit the Centers for Medicare & Medicaid Services Nondiscrimination Notice and Notice of Availability of Auxiliary Aids and Services. Please also visit the Medicare Accessibility and Nondiscrimination Notice for CMS Accessible Communications.
This page was last modified on 06/29/2021
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