Center for Medicare and Medicaid Services: Medicare Health Outcomes Survey

The Center for Medicare and Medicaid Services requires Medicare managed care plans (Medicare Advantage) to assess certain health outcomes of their member Medicare beneficiaries.  The Health Outcomes Survey (HOS) is used to survey a random sample of 1,200 Medicare beneficiaries from each Medicare Advantage organization annually.  The surveyed beneficiaries are surveyed again after two years.  The HOS uses patient-reported outcome (PRO) measures.  Annual versions of the survey instrument are available online.

Four HOS measures (two functional health measures and two HEDIS Effectiveness of Care measures) are currently included in the annual Medicare Part C Star Ratings (a fifth measure, improving bladder control, is under revision):

  • Improving or maintaining physical health (VR-12)
  • Improving or maintaining mental health (VR-12)
  • Monitoring physical activity (HEDIS)
  • Reducing the risk of falling (HEDIS)

The functional health measures are derived from the Veterans RAND 12-Item Health Survey (VR-12) portion of the HOS, which serves as the core measure for the physical component summary and mental component summary scores.  The Healthcare Effectiveness and Data and Information Set (HEDIS) measures are maintained by the National Committee for Quality Assurance (NCQA).

CMS currently contracts with NCQA to support the standardized administration of the HOS and HOS-Modified surveys, including the selection and training of the independent survey vendors. Medicare Advantage Organizations (MAOs) and Program of All-Inclusive Care for the Elderly (PACE) plans contract with the survey vendors to administer the surveys.

Here is the NCQA’s technical specifications for the 2015 HOS.

Link to Original Source

The technical specifications reference the availability of the HOS in Spanish and procedures for administering the HOS to individuals whose primary languages are either Spanish or Chinese.  It is not apparent what percentage of annual respondents actually respond in Spanish or Chinese.

This entry was posted in Health Care Reform, Health Care Reform: Quality Improvement, Patient-Centeredness. Bookmark the permalink.

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