Welcome to the Medicare Health Outcomes Survey (HOS) Website
The Medicare HOS was 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 people with Medicare 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 people with Medicare 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. During the most recent HOS administration (2022 Round 25), Cohort 25 was surveyed and Cohort 23 was resurveyed using HOS 3.0. For data collection years 1998-2006, the standard MAO baseline sample size was one thousand. In 2007, the standard sample size was increased to twelve hundred. Since 2019, MAOs can request oversampling if the contract's enrollment permits a sample size larger than the standard sample of 1,200.
Information for People with Medicare and Their Families
If you have questions or concerns about the HOS or HOS-M survey, you may contact CMS at 1-800-MEDICARE or the survey organization CMS is working with directly. Contact information for CMS and each survey vendor is posted under the HOS Survey Vendors and the HOS-M Survey Vendors sections.
What's New on the Medicare HOS
- 2020-2022 Cohort 23 Performance Measurement Data Available. As announced in the Health Plan Management System (HPMS) memo dated August 4, 2023, the data and accompanying Data Users Guide (DUG) are available to participating MAOs. MAOs may request their data by contacting Medicare HOS Information and Technical Support at hos@hsag.com. The data will be distributed via electronic secure file transfer. When data are available, the designated data recipient will receive an email from the hosdata@hsag.com mailbox containing instructions and a link to the Secure File Manager facility. The DUG may also be downloaded from the Data Users Guides section.
- 2020-2022 Cohort 23 Performance Measurement Reports Available. The HOS reports were made available to participating MAOs via HPMS on July 31, 2023. The contract-level summary data file distributed with each MAO report includes results for two HOS functional health measures and the Physical Functioning Activities of Daily Living (PFADL) measure. MAOs may ask their Centers for Medicare & Medicaid Services (CMS) Quality Point of Contact to download the HOS reports and the summary data or contact CMS at hpms_access@cms.hhs.gov for help with HPMS access. A Sample Performance Measurement Report with actual national HOS data is available under the Sample Reports section. The MAO Performance Measurement Contract List specifies the participating MAOs. The list is also available under the Survey Results section.
- 2022 Round 25 Healthcare Effectiveness Data and Information Set (HEDIS®) Effectiveness of Care Reports (HEDIS HOS Reports) Available. The HEDIS HOS reports were made available to participating MAOs via HPMS on July 31, 2023. The contract-level summary data for HEDIS HOS results are included with each MAO report. The HEDIS HOS Report includes results for the HEDIS HOS measures that are included in the Medicare Part C Star Ratings. MAOs may ask their CMS Quality Point of Contact to download the HOS reports and the summary data or contact CMS at hpms_access@cms.hhs.gov for help with HPMS access. A Sample HEDIS HOS Report with actual national HEDIS HOS data is available under the Sample Reports section.
- 2023 Medicare HOS and HOS-M Approved Survey Vendor Lists Available. Final approval of the survey vendors was contingent on successfully completing the survey vendor training in May 2023. The lists of approved survey vendors are posted under the HOS Survey Vendors and the HOS-M Survey Vendors sections.
- HOS Quality Assurance Guidelines and Technical Specifications (QAG). The HOS 2023 QAG 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 and Methodology sections.
- HOS-M QAG Addendum. The HOS-M 2023 QAG Addendum is now available. The publication details the requirements, protocols, and procedures for the HOS-M survey administration for PACE organizations. The HOS-M QAG is available under the HOS-M page and the Methodology section.
- Fully Integrated Dual Eligible (FIDE) Special Needs Plan (SNP) QAG Addendum. The HOS/HOS-M FIDE SNP 2023 QAG Addendum is now available. The publication details the requirements, HOS and HOS-M protocols, and procedures for the FIDE SNP survey administration. The FIDE SNP QAG is available under the HOS-M page and the Methodology section.
- HOS 2023 Survey Vendor Training Slides and HOS-M 2023 Vendor Training Slides. The HOS and HOS-M 2023 survey vendor training took place in May 2023. The presentation slides are posted under the Survey Administration section.
- Memo on Staff Involvement in Medicare HOS-M. The memo was released on March 13, 2023, detailing the extent to which HOS-M Programs of All-Inclusive Care for the Elderly (PACE) staff and caregivers can participate in the HOS-M survey, and outlining permissible and non-permissible activities by program staff. The memo is posted under the Survey Administration section and may be accessed there.
- HOS 2023 Administration Memo and HOS Exclusion Memo. The memos were released on March 13, 2023 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 2023. Both memos are posted under the Survey Administration section and may be accessed there.
- HOS-M 2023 Survey Administration Memo. The memo was released on February 27, 2023 detailing the HOS-M plan reporting requirements, contracting with a CMS-approved survey vendor, sampling process, survey administration, contracts required to report HOS-M, and administration changes in 2023. The memo is posted under the Survey Administration section and may be accessed there.
- HOS and HOS-M FIDE SNP Participation for Frailty Memo. The memo was released on February 6, 2023 detailing the application process and requirements for participation in the 2023 HOS and HOS-M to support the calculation of frailty scores for 2024 payments. The memo is posted under the Survey Administration section and may be accessed there.
- Reporting Requirements for HEDIS® Measurement Year (MY) 2023, HOS, and CAHPS® Measures, and Information Regarding HOS and HOS-M for Frailty. This Health Plan Management System (HPMS) memo was released on May 15, 2023. The memo provides information about the HEDIS, HOS, and CAHPS reporting requirements in 2024 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.
- Medicare HOS Outcomes Measures Moved to Display for 2022 and 2023 Star Ratings. This HPMS memo was released on August 5, 2021 by CMS. The memo states that the two HOS outcomes measures, Improving or Maintaining Physical Health and Improving or Maintaining Mental Health, will be moved to the display page on CMS.gov for the 2022 and 2023 Star Ratings. Due to the pervasive way in which the COVID-19 Public Health Emergency has impacted and will continue to impact the validity of these two HOS outcomes measures for the 2020 and 2021 follow-up measurement periods, the 2022 and 2023 Star Ratings will be calculated without the use of Improving or Maintaining Physical Health and Improving or Maintaining Mental Health.
For additional information about the availability of auxiliary aids and services, please visit the CMS Accessibility & Nondiscrimination for Individuals with Disabilities Notice.
This page was last modified on 08/21/2023
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