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
- 2018-2020 Cohort 21 Analytic Public Use File (PUF) and Data Users Guide (DUG) Available. The PUF may be downloaded from the Research Data Files section on the Data page. The DUG may be downloaded from the Data Users Guides section.
- Summer 2021 Semiannual HOS Newsletter Available. The Summer 2021 edition of the HOS Newsletter was released on August 20, 2021. To sign up for the email distribution, contact the HOS Information and Technical Support email (firstname.lastname@example.org).
- Medicare HOS Outcomes Measures Moved to Display for 2022 and 2023 Star Ratings. This Health Plan Management System (HPMS) memo was released on August 5, 2021 by the Centers for Medicare & Medicaid Services (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 (PHE) 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.
- 2018-2020 Cohort 21 Performance Measurement Data Available. As announced in an HPMS memo dated August 5, 2021, the data and accompanying DUG are available to participating MAOs. Participating MAOs may request their data by contacting Medicare HOS Information and Technical Support at email@example.com. The data will be distributed via electronic Secure File Transfer. Once available, the designated data recipient will receive an email from the firstname.lastname@example.org mailbox containing instructions and a link to the Secure File Manager facility. The DUG may also be downloaded under the Data Users Guides section.
- 2018-2020 Cohort 21 Performance Measurement Reports Available. The HOS reports were made available to participating MAOs via HPMS on August 5, 2021. The contract-level summary data file distributed with each MAO report includes results for two HOS functional health measures that are display measures in this year’s Part C Star Ratings and the Physical Functioning Activities of Daily Living (PFADL) display measure. MAOs may ask their CMS Quality Point of Contact to download the HOS reports and the summary data or contact CMS at email@example.com 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.
- 2020 Round 23 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 August 5, 2021. 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 firstname.lastname@example.org for help with HPMS access. A Sample HEDIS HOS Report with actual national HEDIS HOS data is available under the Sample Reports section.
- Reporting Requirements for HEDIS® Measurement Year (MY) 2021, HOS, and CAHPS® Measures, and Information Regarding HOS and HOS-Modified (HOS-M) for Frailty. This 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 Fully Integrated Dual Eligible (FIDE) Special Needs Plan (SNP) frailty measurement is also included in the memo.
- HOS Quality Assurance Guidelines and Technical Specifications (QAG).The HOS 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 section and the Methodology section.
- HOS-M QAG Addendum. The HOS-M QAG 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.
- 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 FIDE 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.
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 10/18/2021
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