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Welcome to the Medicare Health Outcomes Survey (HOS) Website

The Medicare HOS was the first patient-reported outcomes measure used in Medicare managed care. The goal of the Centers for Medicare & Medicaid Services (CMS) 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 people with Medicare 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 people with Medicare 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. During the most recent HOS administration (2023 Round 26), Cohort 26 was surveyed and Cohort 24 was resurveyed using HOS 3.0. For data collection years 1998-2006, the standard MAO baseline sample size was one thousand. In 2007, the standard sample size was increased to twelve hundred. Since 2019, MAOs can request oversampling if the contract's enrollment permits a sample size larger than the standard sample of 1,200.

Information for People with Medicare and their Families

If you have questions or concerns about the HOS or HOS-Modified (HOS-M), you may contact CMS at 1-800-MEDICARE or the survey organization CMS is working with directly. More information about the survey, including contact information for CMS and each survey vendor, is available under the Information for People with Medicare and Their Families page.

What's New on the Medicare HOS

  • 2021-2023 Cohort 24 Performance Measurement Data Available. As announced in the Health Plan Management System (HPMS) memo dated August 1, 2024, the data and accompanying Data Users Guide (DUG) are available to participating MAOs. MAOs may request their data by contacting Medicare HOS Information and Technical Support at hos@hsag.com. The data will be distributed via electronic secure file transfer. When data are available, the designated data recipient will receive an email from the hosdata@hsag.com mailbox containing instructions and a link to the Secure File Manager facility. The DUG may also be downloaded from the Data Users Guides section.

  • 2021-2023 Cohort 24 Performance Measurement Reports Available. The HOS reports were made available to participating MAOs via HPMS on August 1, 2024. The contract-level summary data file distributed with each MAO report includes results for two HOS functional health measures and the Physical Functioning Activities of Daily Living (PFADL) measure. MAOs may ask their CMS Quality Point of Contact to download the HOS reports and the summary data or contact CMS at hpms_access@cms.hhs.gov 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.

  • 2023 Round 26 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 1, 2024. 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 hpms_access@cms.hhs.gov for help with HPMS access. A Sample HEDIS HOS Report with actual national HEDIS HOS data is available under the Sample Reports section.

  • HOS Quality Assurance Guidelines and Technical Specifications (QAG). The HOS 2024 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 and Methodology sections.

  • HOS-M QAG Addendum. The HOS-M 2024 QAG Addendum is now available. The publication details the requirements, protocols, and procedures for the HOS-M survey administration for Programs of All-Inclusive Care for the Elderly (PACE) organizations. The HOS-M QAG is available under the HOS-M page and the Methodology section.

  • Fully Integrated Dual Eligible (FIDE) Special Needs Plan (SNP) QAG Addendum. The HOS/HOS-M FIDE SNP 2024 QAG Addendum is now available. The publication details the requirements, HOS and HOS-M protocols, and procedures for the FIDE SNP survey administration. The FIDE SNP QAG is available under the HOS-M page and the Methodology section.

  • HOS 2024 Survey Vendor Training Slides and HOS-M 2024 Vendor Training Slides. The HOS and HOS-M 2024 survey vendor training took place in May 2024. The presentation slides are posted under the Survey Administration section.

  • 2024 Medicare HOS and HOS-Modified Approved Survey Vendor Lists Available. Final approval of the survey vendors was contingent on successfully completing the survey vendor training in Spring 2024. The lists of approved survey vendors are available in the HOS Survey Vendors and the HOS-M Survey Vendors sections.

  • Memo on Staff Involvement in Medicare HOS-M. The memo was released on March 18, 2024, detailing the extent to which HOS-M PACE staff and caregivers can participate in the HOS-M survey, and outlining permissible and non-permissible activities by program staff. The memo is posted under the Survey Administration section and may be accessed there.

  • HOS 2024 Administration Memo and HOS Exclusion MemoThe memos were released on March 18, 2024 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 2024. Both memos are posted under the Survey Administration section and may be accessed there.

  • HOS-M 2024 Survey Administration Memo. The memo was released on February 26, 2024 detailing the HOS-M plan reporting requirements, contracting with a CMS-approved survey vendor, sampling process, survey administration, contracts required to report HOS-M, and administration changes in 2024. The memo is posted under the Survey Administration section and may be accessed there.

  • HOS and HOS-M FIDE SNP Participation for Frailty Memo. The memo was released on February 7, 2024 detailing the application process and requirements for participation in the 2024 HOS and HOS-M to support the calculation of frailty scores for 2025 payments. The memo is posted under the Survey Administration section and may be accessed there.

For additional information about the availability of auxiliary aids and services, please visit the CMS Accessibility & Nondiscrimination for Individuals with Disabilities Notice.

 

This page was last modified on 08/14/2024

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