NCQA, in partnership with the Centers for Medicare and Medicaid Services, administers the HEDIS® Medicare Health Outcomes Survey. This measure is the first patient-based health outcome measure for the Medicare population in managed care settings. It was developed in 1997 as the Health of Seniors survey in response to the fast-growing number of Medicare beneficiaries receiving their health care through Medicare Advantage Organizations (MAOs). The survey was renamed the Medicare Health Outcomes Survey during the first year of implementation in 1998 to reflect the inclusion of Medicare beneficiaries who are disabled and under age 65.

The survey is administered to a random sample of 1,200 members from each MAO at the beginning (Baseline survey) and end (Follow-up survey) of a two-year period. Aged and disabled beneficiaries enrolled in an MAO are eligible for sampling. A new baseline sample is surveyed annually. For each member who completes a Baseline and Follow-up survey, a two-year change score is calculated and the member’s physical and mental health status are categorized as better, the same or worse than expected, taking into account risk adjustment factors. HOS results are assigned for each MAO based on the outcomes of members in that MAO. These MAO-specific results are assigned as percentages of respondents whose health status improved, declined or remained the same.

The goal of the HOS is to gather valid, reliable, clinically meaningful data that can be used to:

  • Target quality improvement activities and resources
  • Monitor health plan performance and reward top performing health plans
  • Inform beneficiaries' health care choices
  • Advance the science of functional health outcomes measurement, quality improvement interventions and strategies

Additional Information 

For current information on the progress of the HOS project, as well as Medicare HOS related data and reports: