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Survey Results
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Survey Results

The Medicare Health Outcomes Survey (HOS) is an assessment of a Medicare Advantage Organization's (MAO) ability to maintain or improve the physical and mental health functioning of its Medicare beneficiaries over a two-year period, using the best available science in functional status and health outcomes measurement. Refer to the HOS and the Star Ratings page for information regarding the use of HOS in the Centers for Medicare & Medicaid Services' (CMS) performance assessment program.

The first cohort of baseline data was collected in 1998. Beginning in 2000, both a baseline cohort and a two-year follow up cohort were collected. During the most recent survey administration (2023 Round 26), Cohort 26 Baseline and Cohort 24 Follow Up data were collected. The most recently available results are from the 2023 Cohort 26 Baseline and the 2021-2023 Cohort 24 Performance Measurement, which combines data from the 2021 Cohort 24 Baseline and 2023 Cohort 24 Follow Up surveys.

  • The Program Timeline page provides information about the survey fielding schedule
  • The Data Dissemination page provides further information about the dissemination of survey results
  • The Star Ratings page provides the overall timeline for Medicare Part C Star Ratings data collection and posting of results

Calculating Performance Measurement Results

Cohort-specific performance measurement results are calculated after the administration of the follow up surveys for each cohort. Reponses from eligible seniors (age 65 or older) who had a physical component summary (PCS) score or mental component summary (MCS) score that could be calculated at baseline and were still enrolled in the same participating MAO at the time of the follow up sampling are included in the analytic sample and the performance measurement results.

A performance measurement data set is created by merging a completed cohort's baseline and follow up data. Death information is then incorporated into the performance measurement data set for baseline respondents who died between baseline and the two-year follow up. Details summarizing the eligible and ineligible beneficiaries in each completed cohort’s analytic sample are found in the document Medicare HOS Performance Measurement Distribution of Sample.

The HOS performance measurement results are computed using established case-mix/risk-adjustment models. Information about the case-mix specifications and national HOS results are available in the Sample Performance Measurement Report. Each MAO’s annual HOS Performance Measurement Report also provides national HOS results and MAO-specific results for each of the following longitudinal functional health measures:

  • Improving or Maintaining Physical Health display measure is the “Physical Health Percent Better or Same” result
  • Improving or Maintaining Mental Health display measure is the “Mental Health Percent Better or Same” result
  • Physical Functioning Activities of Daily Living display measure is the PFADL result (in development, with an overview available in Medicare HOS PFADL Change Measure)


Analyses of the two-year performance measurement data have demonstrated that, at the national level, there is significant variation among MAOs with respect to both physical and mental health outcomes. Research has identified differences in outcomes among specific groups of beneficiaries and potential opportunities to improve care.

For general status information, including response rates for the baseline and follow up cohorts administered and reported to date, view or download a copy of the Medicare HOS Survey Status Information (PDF). The list of participating MAOs from the most recently completed cohort is available here: Medicare HOS Status Information.

Beginning in measurement year 2022, CMS finalized updates to the case-mix specifications for the expected outcomes of the HOS performance measures derived from PCS and MCS (Federal Register 2021). The case mix specifications now reflect a single model for each outcome, using the Contract-Mean Imputation (CMI) method for covariates with missing data. Under the updated case-mix specifications, when an adjuster is missing for a member, it is replaced with the mean value for that adjuster for other members in the same contract with responses contributing to the PCS/MCS measures.

The following are tables of coefficients for cohorts using the CMI methodology. Contact HOS technical support at hos@hsag.com for tables of coefficients from earlier performance measurement cohorts.


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 This page was last modified on 10/22/2024

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