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Survey Results

The Medicare Health Outcomes Survey (HOS) is an assessment of a Medicare Advantage Organization's (MAO) ability to maintain or improve the physical and mental health functioning of its Medicare beneficiaries over a two-year period, using the best available science in functional status and health outcomes measurement. Refer to the HOS and the Star Ratings page for information regarding the use of HOS in the Centers for Medicare & Medicaid Services' (CMS) performance assessment program.

The first cohort of baseline data was collected in 1998. Beginning in 2000, both a baseline cohort and a two-year follow up cohort were collected. During the most recent survey administration (2023 Round 26), Cohort 26 Baseline and Cohort 24 Follow Up data were collected. The most recently available results are from the 2022 Cohort 25 Baseline and the 2020-2022 Cohort 23 Performance Measurement, which combines data from the 2020 Cohort 23 Baseline and 2022 Cohort 23 Follow Up surveys.

• The Program Timeline page provides information about the survey fielding schedule
• The Data Dissemination page provides further information about the dissemination of survey results
• The Star Ratings page provides the overall timeline for Medicare Part C Star Ratings data collection and posting of results

For general status information, including response rates for the baseline and follow up cohorts administered and reported to date, view or download a copy of the Medicare HOS Survey Status Information (PDF). The list of participating MAOs from the most recently completed cohort is available here: MAO Performance Measurement Contract List (PDF).  

Performance Measurement Analytic Sample

Cohort-specific performance measurement results are calculated after the administration of each follow up cohort. Eligible seniors (age 65 or older) who had a physical component summary (PCS) score or mental component summary (MCS) score that could be calculated at baseline and were still enrolled in the same participating MAO at the time of the follow up sampling are included in performance measurement results.

For details summarizing the eligible and ineligible beneficiaries in each completed cohort, view or download a copy of the distribution of the Performance Measurement Analytic Sample Medicare HOS Performance Measurement Distribution of Sample (PDF). 

Calculating Performance Measurement Results

A performance measurement data set is created by merging a cohort's baseline and follow up data. Death information is then incorporated into the performance measurement data set for baseline respondents who died between baseline and the two-year follow up. The HOS performance measurement results are computed using rigorous case-mix/risk-adjustment models. Information about the case-mix specifications and national HOS results are available in the Sample Performance Measurement Report. In addition to the national HOS results, results from each of the three longitudinal functional health measures are reported in each MAO’s annual HOS Performance Measurement Report.

• Improving or Maintaining Physical Health display measure is the “Physical Health Percent Better or Same” result
• Improving or Maintaining Mental Health display measure is the “Mental Health Percent Better or Same” result
• Physical Functioning Activities of Daily Living display measure is the PFADL result (in development)
  

CMS updated the case-mix specifications in 2022 for the expected outcomes of the HOS performance measures derived from PCS and MCS. The case mix specifications reflect a single model for each outcome, using the Contract-Mean Imputation (CMI) method for covariates with missing data. The CMI method aligns with the updates finalized by CMS for the 2022 measurement year (Federal Register 2021). Under the updated case-mix specifications, when an adjuster is missing for a member, it is replaced with the mean value for that adjuster for other members in the same contract with responses contributing to the PCS/MCS measures.

Analyses of the two-year performance measurement data have demonstrated that at the national level there is significant variation among MAOs with respect to both physical and mental health outcomes. Research has identified differences in outcomes among specific groups of beneficiaries and potential opportunities to improve care.

The following documents provide additional information regarding performance measurement using the HOS:

• An overview of the sampling methodology and design, data collection, scoring, analysis, and national HOS results is found in the most recent Sample Performance Measurement Report (PDF)
• An overview of the Physical Functioning Activities of Daily Living (PFADL) longitudinal measure in development: Medicare HOS PFADL Change Measure (PDF)
• A table summarizing overall performance measurement results by cohort: Medicare HOS Performance Measurement Results (PDF) 
• The tables of case-mix coefficients from the most recent performance measurement analysis of the two functional health measures derived from PCS and MCS: Medicare HOS Performance Measurement Coefficient Tables (PDF)

 This page was last modified on 02/15/2024