Publications and Resources
Annually, a baseline report, a Healthcare Effectiveness Data and Information Set (HEDIS®) Health Outcomes Survey (HOS) Effectiveness of Care report (HEDIS HOS report), and a performance measurement report will be disseminated to each Medicare Advantage Organization (MAO) participating in the Medicare HOS. Each participating MAO will receive plan-specific baseline, HEDIS HOS, and/or performance measurement reports, which present results for their MAO, the state total, and the HOS national total.
- Beginning in 2013, each new MAO report file also includes a summary data file that contains contract-level responses to each HOS question, as well as demographic data related to the report.
- Beginning in 2014, the HOS summary measures from each report that are used in the Medicare Part C Star Ratings are added to the associated summary data file (e.g., the HOS functional health measures are included in the Performance Measurement Summary Data file). Beneficiary level data files are made available to MAOs only after each cohort is complete.
- Beginning in August 2014, with the advent of the regional Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs), HOS state-level reports and data are no longer distributed to the QIOs.
- Beginning in 2021, the HEDIS® Effectiveness of Care measures are included in the HEDIS HOS Report and Summary Data file. They were previously included in the Baseline Report and Summary Data file, where they can be found in past reports for the years 2014 through 2020.
The reports in the links below have been assembled to provide additional information on the Medicare HOS and to facilitate the use of the HOS data files produced by the Medicare HOS Program.
Medicare HOS Performance Measurement Results
2019-2021 HOS Sample Performance Measurement Report (PDF, 1.4 MB) 2022
After administration of each follow up cohort, a cohort-specific performance measurement report is produced. The performance measurement results describe change in health over time, which is characterized in terms of the direction and magnitude for a given respondent. These results account for demographic and health differences that may exist among members in the various MAOs. This sample MAO report contains example MAO-level data only; however, all references to the HOS Total reflect actual national-level data. The MAO Performance Measurement Contract List specifies the participating MAOs from the recently completed cohort.
After performance measurement reports have been distributed to the participating MAOs, beneficiary level performance measurement data are made available to the MAOs. In addition to the data files, each MAO is provided with a Data Users Guide (DUG) that describes the Medicare HOS file specifications and the appropriate use of Medicare HOS performance measurement data. Performance measurement DUGs are available for download.
HEDIS® HOS Effectiveness of Care Results
2021 HEDIS HOS Sample Report (PDF, 0.64 MB) 2022
HEDIS HOS reports present results using data for the baseline and follow up cohorts from the same measurement year (i.e., a round of data). The reports provide MAOs the opportunity to compare their HEDIS HOS results with their other HOS Performance Measurement results and Star Ratings. The HEDIS HOS results include MAO, state, region, and HOS national information on the following measures: Management of Urinary Incontinence in Older Adults (MUI), Physical Activity in Older Adults (PAO), and Fall Risk Management (FRM). Between 2012 and 2020, the Osteoporosis Testing in Older Women (OTO) measure was part of the Medicare Part C display measures on the Centers for Medicare & Medicaid Services (CMS) website. As of the 2021 HOS survey administration year, the OTO measure has been retired by the measure steward, National Committee for Quality Assurance (NCQA). OTO data are no longer available, and all references to the measure have been removed. The reports also include background information about the calculation of the HEDIS HOS measures. This sample MAO report contains example MAO-level data only; however, all references to the HOS Total reflect actual national-level data.
Medicare HOS Baseline Results
2021 HOS Sample Baseline Report (PDF, 1.4 MB) 2022
After the administration of each baseline cohort, a cohort-specific baseline report is produced. The baseline reports present physical component summary (PCS) and mental component summary scores (MCS). The scores are case-mix adjusted using demographics, chronic medical conditions, and HOS study design variables. The baseline reports also provide MAO, state, and HOS national information on the Centers for Disease Control and Prevention (CDC) Healthy Days Measures, additional health status indicators, and demographics. A section that relates the HOS measures to the CMS Medicare Star Ratings is included. This sample MAO report contains example MAO-level data only; however, all references to the HOS Total reflect actual national-level data.
Medicare HOS-Modified (HOS-M) Results
2021 HOS-M Sample Program of All-Inclusive Care for the Elderly (PACE) Report (PDF, 0.59 MB) 2022
After each yearly administration of the Medicare HOS-M, a plan specific report is produced for each PACE organization participating in the survey. The HOS-M report presents PCS and MCS scores, Activity of Daily Living (ADL) items, and selected health status measures, for the frail, elderly Medicare beneficiaries from each organization compared to the entire HOS-M sample. The Medicare HOS-M is an abbreviated version of the Medicare HOS that is administered to PACE Organizations. This sample PACE report contains example PACE data only; however, all references to the HOS-M Total reflect actual data for the entire HOS-M sample.
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This page was last modified on 12/19/2022
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