HOS is an outcomes measurement tool used for Medicare Advantage plans. The goal of the Medicare HOS program is to gather valid and reliable health status data in Medicare managed care plans for use in quality improvement activities, plan accountability, public reporting, and improving health. All managed care plans with Medicare Advantage (MA) contracts must participate.
The Medicare HOS instrument consists of:
- physical and mental health status
- case mix and risk adjustment purposes
- select HEDIS Effectiveness of Care measures
- questions added by CMS as required by the 1997 Balanced Budget Act
- revised questions on race, ethnicity, primary language, sex and disability status (Section 4302 of the Affordable Care Act)
The HOS RIF Data User Guide is accessed by the link under the "Data Documentatio" tab above. Please note that CMS will supply additional file specifications to researchers who request and are approved for the HOS RIF data.