Fielding of the 2016 HOS Administration for the Medicare HOS and HOS-M recently ended. Information about the 2016 HOS Administration protocols, questionnaires, and survey vendor notifications is available in the HEDIS® 2016, Volume 6: Specifications for the Medicare Health Outcome Survey in the Methodology section on the HOS website.

• 2015 Cohort 18 Baseline Reports
• 2013-2015 Cohort 16 HOS Performance Measurement Reports
• 2015 HOS-M Reports

Registered Health Plan Management System (HPMS) users should have access to these reports through the HPMS. If you require assistance about accessing reports in the HPMS, please contact CMS via email at [email protected]. Sample reports with hypothetical data compared to actual national benchmarks are also available on the HOS website.

• Data sets and accompanying Data User's Guides (DUGs) for HOS Cohorts 1-15
• Data sets and accompanying DUGs for 2007-2015 HOS-M

The DUG included with each data set provides detailed documentation about file construction and contents for the data set. In the DUG, you will find information on methodology and design, the survey instrument, data file characteristics, data file layout by position, annotated baseline surveys, and follow up surveys, when applicable. Contact the HOS team at [email protected] to request data for your MAO or Program of All-Inclusive Care for the Elderly (PACE) Organization. New this year, encrypted data will be distributed via secure file transfer, rather than by mailing physical media.

• Improving or Maintaining Physical Health 
• Improving or Maintaining Mental Health

• Monitoring Physical Activity 
• Reducing the Risk of Falling 

A recently completed study examined the properties of a potential measure of success in limiting weight gain in enrolled Medicare beneficiaries. The study, presented at the Academy Health meeting, described an estimate of the effect of loss-to-follow-up on the measure and assessed the need for case-mix adjustment. The study also assessed the construct validity and identified geographic and beneficiary characteristics associated with performance on the measure. Passing the unadjusted Limiting Gain in BMI measure translates into limiting weight gain over two years to about 6 pounds, depending on height. The single most important case-mix adjuster that predicted passing the measure was baseline weight status-- beneficiaries who were normal weight were at highest risk of weight gain whereas beneficiaries who were heaviest gained the least weight. The measure was also found to be significantly related to contemporaneous change in six physical health measures.

CMS and the National Cancer Institute (NCI) have established a partnership to improve the understanding of the health-related quality of life of cancer patients and survivors enrolled in Medicare Advantage health plans. The SEER-MHOS links cancer registry data from SEER to the Medicare Health Outcomes Survey, with health-related quality of life and other patient-reported outcomes. There are over 2.1 million individuals represented in MHOS, with over 126,000 linked to SEER. 

The data have been publicly accessible since 2011, and we recently received our 53rd unique data use agreement (DUA) application. Each DUA application is reviewed by both NCI and a designated SEER Principal Investigator. A total of 24 papers have been published using data from SEER-MHOS, and they are listed on the SEER-MHOS website. One study, led by Dr. Kelly Kenzik from the University of Alabama at Birmingham, identified chronic condition clusters pre- and post-cancer diagnosis, evaluated predictors of developing clusters post-diagnosis, and explored the impact of clusters on functional impairment in older cancer survivors.[1] Cardiovascular, musculoskeletal, metabolic, and major depressive disorder risk clusters were all identified, and cluster prevalence increased from pre- to post-cancer diagnosis. Functional impairment was more prevalent in defined clusters compared to survivors with ≥2 un-clustered conditions. 

In addition, NCI made some methodologic improvements to the SEER-MHOS data resource. Given the change in the HOS to using the VR-12 in 2006, NCI supported psychometric work by Boston University (HHSN261201400530P) to develop algorithms that bridge the eight scales (general health, physical functioning, physical roles, bodily pain, vitality, social functioning, emotional roles, and mental health) of the VR-12 with the eight scales of the SF-36®. These algorithms enable analyses to pool cohorts over the SF-36 and VR-12 eras to increase statistical power. A full technical report including the algorithms is available upon request, adapted scores are now available as part of the SEER-MHOS data resource, and a manuscript outlining the effort and related issues is currently under review.[2] 

Finally, NCI has received permission from CMS to begin exploratory work examining the Part D drug benefit claims for Medicare Advantage beneficiaries present in the SEER-MHOS data linkage who elected Part D coverage. Once the next linkage is complete, NCI will be examining patterns of medication therapy associated with self-reported pain and depressive symptoms among cancer survivors. 

[1] Kenzik K, Kent EE, Martin MY, Bhatia S, Pisu M. (2016). Chronic condition clusters and functional impairment in older cancer survivors: a population-based study. Journal of Cancer Survivorship. PMID: 27229869.   http://dx.doi.org/10.1007/s11764-016-0553-4

[2] Selim A, Rogers W, Qian S, Rothendler JA, Kent EE, Kazis LE. (Under Review). A New Algorithm to Build Bridges Between two Patient-Reported Health Outcome Instruments: The MOS SF-36® and the VR-12 Health Survey.

Some recent questions received by our Medicare HOS Information and Technical Support site include:

The HPMS users at your MAO or PACE Organization will receive an announcement of the availability of the reports. An HPMS User ID and password are required to access the HPMS. If further assistance is required regarding HPMS access, you may contact CMS via email at [email protected]. 

• Medicare Part C & D Star Ratings Technical Notes 
• Medicare Part C & D Display Measure Technical Notes