Medicare Health Outcomes Survey (HOS)

This measure provides a general indication of how well a Medicare Advantage Organization (MAO) manages the physical and mental health of its members. The survey measures physical and mental health status at the beginning of a 2-year period and again at the end of the 2-year period, when a change score is calculated. Each member’s health status is categorized as “better than expected,” “the same as expected” or “worse than expected,” accounting for death and risk-adjustment factors. MAO-specific results are assigned as percentages of members whose health status was better, the same or worse than expected.

Why It Matters

This measure assesses a Medicare Advantage organization’s ability over time to maintain or improve the health status of its members. The measure is designed to quantify the physical and mental health of the Medicare population. HEDIS Medicare HOS is the primary health outcome measure for seniors enrolled in a Medicare health plan.

The measure is based on a random sample of individuals whose functional status is assessed at the beginning and end of a 2-year period. HOS also measures how well seniors are able to do basic activities of daily living (ADL), such as bathing and dressing, and whether or not they are getting help with things that might help or hurt their functioning, such as advice to reduce the risk of falling and encouragement to do regular physical activity. Researchers and clinicians use patient-based assessments like the VR-12:

• To look at the health of the general population.
• To evaluate treatment outcomes and procedures.
• To provide external performance measurement.

The functional status of the elderly normally declines over a two-year period. The measure considers expected decline and looks at whether the change in the physical and mental health status of each Medicare beneficiary surveyed was better, the same or worse than expected, accounting for risk-adjustment factors.

Results

Data not available to display at this time.