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Health Outcomes Survey (HOS)

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

About the survey: The HOS is administered annually to a random sample of Medicare beneficiaries drawn from each participating MA plan and surveyed in the 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). The baseline sample size is twelve hundred. Cohort 1 was surveyed in 1998 and was re-surveyed in 2000. During the 2016 HOS administration, Cohort 19 was surveyed (baseline) and Cohort 17 re-surveyed (follow-up).

The HOS was developed and continues to be refined under the guidance of a Technical Expert Panel comprised of individuals with specific expertise in the health care industry and outcomes measurement. HOS analysts apply 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 four HEDIS® effectiveness of care measures:  Management of Urinary Incontinence in Older Adults, Physical Activity in Older Adults, Fall Risk Management, and Osteoporosis Testing in Older Women.

Public reporting and policy relevance: CMS publicly reports aggregate results for participating MA contracts on the Medicare Plan Finder website (www.medicare.gov). Beneficiaries use HOS results to compare health plans. The public and research communities can use results to assess MA program performance, to monitor the health of the Medicare population and vulnerable subgroups, and to evaluate treatment outcomes and procedures. MA contracts use HOS results to identify areas for quality improvement, and Medicare administrators and policymakers rely on the measures to monitor MA plans. Since 2012, HOS measures have been included in the Star Ratings for MA Quality Bonus Payments. 

For comprehensive information about the Medicare Health Outcomes Survey program, please visit the CMS HOS website at http://hosonline.org. 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. For general and technical questions about the Medicare HOS, please contact HOS Information and Technical Support at hos@hcqis.org or (888) 880-0077. To ask a HOS program or policy question, please email hos@cms.hhs.gov.

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