HEDIS Medicare Health Outcomes Survey

Under contract to CMS, NCQA supports the implementation of the HEDIS Medicare Health Outcomes Survey (HOS) and a modified HOS version, the Medicare Health Outcomes Survey – Modified (HOS-M).

The goal of the HOS is to gather valid, reliable, clinically meaningful data about the Medicare Advantage (MA) program. The data have many uses, such as informing and targeting quality improvement activities and resources, monitoring health plan performance and rewarding top-performing health plans, helping beneficiaries to make informed health care choices, and advancing the science of functional health outcomes measurement.

The current version of HOS, HOS 3.0, includes the Veterans RAND 12-Item Health Survey (VR-12), and questions that collect information for selected HEDIS Effectiveness of Care measures, Section 4302 of the Affordable Care Act (i.e., race, ethnicity, primary language, sex, and disability status), other health questions, including limitations on activities of daily living (ADL), pain, depression, sleep quality, and chronic conditions. The HOS-M is used to measure frailty for Medicare beneficiaries enrolled in Program of All-inclusive Care for the Elderly (PACE) organizations.

The HOS-M survey includes the VR-12, ADL questions, and other health questions about memory loss and difficulty controlling urination.

The HOS and HOS-M surveys are available in English, Spanish, Chinese, and Russian.

HEDIS Volume 6

HEDIS Volume 6 outlines the technical specifications for the HOS Survey. Volume 6 and other HEDIS publications are accessible from the NCQA store.

The use of the HOS survey contained in Volume 6 is subject to the same HOS Survey Use Application and HOS Survey Terms of Use when accessing Volume 6 for any purpose other than internal, non-commercial informational (reference) purposes, or for the purposes of participating in or being a survey vendor for CMS’s programmatic administration of the HOS.

Accessing and Using the Surveys

HOS 3.0, the historical versions of the survey (HOS 2.5, HOS 2.0, and HOS 1.0), and the HOS-M instruments are available for download. Click here to complete the Survey Intake Form and download the surveys. The HOS and HOS-M surveys are available for download immediately after submitting the intake form.

If you are a Medicare Advantage member and you lost or misplaced your survey, contact your survey vendor using the customer support number on your survey cover letter. Your survey vendor will send you a replacement mail survey or help you complete the survey by phone. If you do not know who your survey vendor is, please contact NCQA Customer Support at 1-888-275-7585.

The Surveys may be used for one of the following purposes:

  1. Reference or informational purposes, including by academic researchers
  2. Participating in or fielding the official CMS survey as a CMS-approved HOS or HOS-M survey vendor

For permitted uses, complete the Survey Intake Form to download the HOS and HOS-M surveys.

Survey use outside the purposes stated above purposes, including, but not limited to, fielding Survey questions outside the official CMS-sponsored HOS Program e.g., health plan quality improvement surveys) or providing commercial services (e.g., offering products or services for a fee), requires submission of the Survey Use Request Application, and Terms of Use.

Email the completed Survey Use Request Application and Terms of Use to hos@ncqa.org. NCQA will provide an approval decision within 10 business days of receiving a complete application.

Blackout Period

Survey vendors, health plans, or their agents are prohibited from administering any HOS and HOS-M survey questions to Medicare beneficiaries eight weeks before and during HOS administration. CMS also strongly discourages the fielding of non-CMS surveys to Medicare beneficiaries eight weeks before and during HOS administration.

Risks of Off-Cycle Surveys

Surveys of Medicare beneficiaries that use the same or similar questions as the official CMS surveys could have a negative effect on how Medicare beneficiaries respond to the non-CMS, as well as the CMS survey. Some Medicare beneficiaries may be confused by the similarities between the surveys which could result in even stronger negative effects.

Medicare beneficiaries who receive requests to participate in multiple off-cycle or overlapping surveys are likely to ignore one or more of those requests, putting all survey response rates at risk.

Intake Form

To access the HOS and HOS-M surveys, please fill out the following form:

If you are a Medicare Advantage member and you lost or misplaced your survey, contact your survey vendor using the customer support number on your survey cover letter. Your survey vendor will send you a replacement mail survey or help you complete the survey by phone. If you do not know who your survey vendor is, please contact NCQA Customer Support at 1-888-275-7585.

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