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Health Outcomes Survey (HOS)

The Medicare Health Outcomes Survey (HOS) is the first patient reported outcomes measure used in Medicare managed care.  The goal of the Medicare HOS program is to gather valid, reliable, and clinically meaningful health status data in the Medicare Advantage (MA) program for use in quality improvement activities, pay for performance, program oversight, public reporting, and improving health.  All managed care organizations with MA contracts must participate.

A random sample of Medicare beneficiaries is drawn from each participating Medicare Advantage Organization and surveyed every spring (i.e., a baseline survey is administered to a new cohort, or group, each year). Two years later, these same respondents are surveyed again (i.e., follow up measurement). Prior to 2007, the plan sample size was one thousand.  Effective 2007, the plan sample size is increased to twelve hundred. Cohort One was surveyed in 1998 and was re-surveyed in 2000. During the most recent HOS administration in 2011, Cohort 14 was surveyed (baseline) and Cohort 12 re-surveyed (follow-up).

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the National Committee for Quality Assurance (NCQA), launched the Medicare HOS in 1998. The Medicare HOS is used as part of the effectiveness of care component of the Healthcare Effectiveness Data and Information Set (HEDIS®).  This measure was initially titled Health of Seniors, and was renamed the Medicare Health Outcomes Survey during the first year of implementation. This name change was intended to reflect the inclusion of people with Medicare who are disabled and under age 65 in the sampling methodology.

The HOS measure was developed under the guidance of a Technical Expert Panel comprised of individuals with specific expertise in the health care industry and outcomes measurement. The measure includes the most recent advances in summarizing physical and mental health outcomes results and appropriate risk adjustment techniques.  In addition to health outcomes measures, the HOS is used to collect the Urinary Incontinence in Older Adults, Physical Activity in Older Adults, Fall Risk Management, and Osteoporosis Testing in Older Women HEDIS® measures. 

For comprehensive information on the history and progress of the Medicare HOS program, including the full spectrum of available data and reports, please see the link to the Medicare Health Outcomes Survey web site in the Related Links Outside CMS below.  For information on how to gain access to HOS non-identifiable data, identifiable data, and limited data set files, please see the link to Files for Order in the Related Links inside CMS section below.

If you have any technical questions regarding the Medicare HOS, please feel free to contact the Medicare HOS Information and Technical Support Line at 1-888-880-0077 or e-mail (see the link in the Related Links Outside CMS section below).  To ask an HOS program or policy question, please see the Submit Feedback link at the bottom of the page.