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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.

What's New on the Medicare HOS

  • New Memo for the HOS-Modified (HOS-M) 2021 Survey Administration. The memo was released on March 1, 2021 detailing the HOS-M plan reporting requirements, contracting with a Centers for Medicare and Medicaid Services (CMS)-approved survey vendor, sampling process, survey administration, and contracts required to report HOS-M. The memo has been posted under the Survey Administration section and may be accessed here.

  • The 2021 Medicare HOS Conditionally-Approved Survey Vendors List is Now Available. Final approval of the survey vendors is contingent on successfully completing HOS survey vendor training in May 2021. The list of conditionally-approved survey vendors has been posted under the Survey Vendors section.

  • New Memo on Automated Process for Requesting HOS and HOS-M Fully Integrated Dual Eligible (FIDE) Special Needs Plan (SNP) Participation for Frailty. The 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 Health Plan Management System (HPMS). The memo has been posted under the Survey Administration section and may be accessed here

  • Memo related to the Reporting Requirements for Healthcare Effectiveness Data and Information Set (HEDIS®) Measurement Year (MY) 2020, HOS, and CAHPS® Measures, and Information Regarding HOS and HOS-M for Frailty. The memo was released on September 8, 2020 via the HPMS and may be accessed there by HPMS users 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.

  • 2020 HOS and HOS-M Fielding Timeline. In response to the impact of the COVID-19 Public Health Emergency (PHE), administration of the 2020 HOS and HOS-M took place from August to November 2020 in accordance with the revised 2020 HOS Program Timeline and HOS-M Program Timeline. The memo and the updated HOS QAG Addendum provide more information about the survey. Preliminary information about the timeline in 2021 can be found on the Program Timeline page.

  • 2017-2019 Cohort 20 Analytic Public Use File (PUF) Available. The PUF may be downloaded from the Research Data Files section on the Data page. The Data Users Guide (DUG) may be downloaded from the Data Users Guides section.

  • Cohort 22 Baseline PUF Available. The PUF may be downloaded from the Research Data Files section on the Data page. The corresponding DUG may be downloaded from the Data Users Guides section.

  • 2017-2019 Cohort 20 Performance Measurement Data Available. The data and accompanying DUG were made available to participating MAOs for download following the CMS announcement to HPMS users on August 3, 2020. The data are distributed via electronic Secure File Transfer and participating MAOs may request their data by contacting the Medicare HOS Information and Technical Support email (hos@hsag.com). 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 link on the Data page.

  • 2017-2019 Cohort 20 Performance Measurement Reports Available. The HOS reports were made available to participating MAOs via the HPMS on August 3, 2020. The contract-level summary data file distributed with each MAO report includes results for two HOS functional health measures that are part of the Medicare Part C Star Ratings, and the new Physical Functioning Activities of Daily Living (PFADL) display measure. MAOs may contact 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 Performance Measurement Report with actual national HOS data is available in the Overview section on the Resources page. The MAO Performance Measurement Contract List specifies the participating MAOs. The list is also available on the Survey Results 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.

  • Summer/Fall 2020 Semi-annual HOS Newsletter Available. This edition of the HOS Newsletter was released in September 2020. You may contact the HOS Information and Technical Support email (hos@hsag.com) to sign up for the email distribution.

  • REVISED Description of the 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 03/01/2021

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