Health Outcome Surveys aka HOS is a patient-reported outcomes measure. It is a CMS survey (Centers for Medicare & Medicaid Services) that aims to obtain health status reports from people with Medicare. HOS is a part of an integrated system that focuses on activities to improve quality and establish accountability in Medicare-managed care. All Medicare Advantage (MA) must participate in and conduct the Health Outcome Survey.
The objective of the HOS is to collect clinically meaningful, reliable, and valid status data from the MA patients for the purpose of
To administer the Survey, an MA plan requires a CMS-approved survey vendor. The survey tests the plan’s ability in improving the physical and mental health of the patients. The survey helps in supporting the Medicare beneficiaries make informed decisions and choices regarding health care. The gathered health data increases the MA plan focus on wellness and health outcomes.
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The HOS is conducted on a random sample of Medicare beneficiaries. The sample is drawn from each one of the participating MA plans. This implies that a baseline survey is conducted on a group each year. Two years later another survey was conducted again on the same sample of respondents.
The difference in the status data for the period of two years shows if the physical and mental health of the members improved or worsened. The difference in the report is categorized as “better, same or worse than expected”.
The Technical Expert Panel which comprises individuals with expertise in the healthcare industry refines and develops the HOS. The analysts apply the recently gathered advances to summarize the physical and mental health outcomes of the patients. Also, apply suitable techniques for risk adjustment.
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There are fives Health Outcome Survey measures:
2 functional health measures + 3 HEDIS Effectiveness of Care
The survey questions concern patient-physician relations. It helps a physician identify the areas for improvement in the patient’s health outcomes. The surveys involve questions about overall physical and mental status. The patients are also asked if they had any discussion or received any counseling from the physician.
The five measures of Health Outcome Survey or HOS are
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You should ask questions if they suffered from physical pain. If they answer yes, follow it up with how it is affecting their ability to complete a normal physical activity that they do in their daily lives.
Identify ways to improve pain management so that your patient can achieve their recovery goal.
You can counsel them on physical therapy or rehab if required. Also, determine if your patient should consult with a pain specialist to achieve better health benefits.
Empathizing with the patients can make them comfortable to talk about their mental health.
You can discuss with them about going for therapy if required.
If they don’t want mental health counseling, offer other ideas such as: socialize, engage more with family, own a pet, volunteer work, meditation, etc.
Also, consider a hearing test. Loss of hearing can give a sense of isolation.
Offer patients suggestions for physical activity based on their capability.
A survey cannot provide you many insights about a patient’s activity level. So, discuss with them what physical activity they engage in and talk about the health benefits.
For a patient with limited mobility, suggest they learn less strenuous yet effective exercises.
The topic may be personal and people may not feel comfortable discussing it. However, you must communicate professionally and inform them that it is common as we grow old. Inform them of the treatments that can help with the issue.
You can also provide them with a brochure to make them comfortable about the sensitive topic before discussing it.
Review the medication and treatments given to the patients to check if any of that increases the chance of falling.
Suggest physical therapy and balance activities like yoga. Also, suggest patients use a walker or cane if required.
Discuss home safety and suggest installing handrails.
HOS 3.0 is the current version of the Health Outcome Survey. It includes Veterans RAND 12-item Health Survey or VR-12. It involves questions concerning HEDIS Effectiveness of Care measures along with Section 4302 of the Affordable care Act. It also includes other health questions such as limitations on ADL (activities of daily living), depression, chronic conditions, pain, and quality of sleep.
The HOS-M, i.e., Health Outcome Survey-Modified, is used to measure health problems for Medicare beneficiaries who are under the organizations of PACE, Program of All-inclusive care for the Elder.
The HOS and HOS-M surveys can be used for either of the following purposes
Several of the HOS, since 2012, measures have been included in the Star rating for MA quality bonus payments.
For the MA program in 2021 quality bonus payment, 2020 Medicare Part C Star Ratings will be used by CMS as the basis for the quality bonus payment.
To gather the measure two sets of HOS data will be used for the 2021 quality bonus program
Similarly, for the MA program in 2022 quality bonus payment CMS will use 2021 Medicare Part C Star Ratings as the basis for the quality bonus payment.
Medicare beneficiary is used to refer to an individual residing in the U.S., who is entitled to benefits under Medicare part A and enrolled under part B plan.
HEDIS: Healthcare Effectiveness Data and Information Set
HEDIS is a set of standardized performance measures. It is designed to provide information for comparison of health plan performance to consumers. Cancer, heart disease, diabetes, asthma, and smoking are some significant health issues that HEDIS measures relate to.
The five HOS measures consist of two functional health measures and three HEDIS Effectiveness of Care measures.