Medicare Health Outcomes Survey (HOS), 1998-2014 (ICPSR 23380)
Published: May 26, 2016
United States Department of Health and Human Services. Centers for Medicare and Medicaid Services
The Medicare Health Outcomes Survey (HOS) is the first patient reported health outcomes measure for the Medicare population in managed care settings. It is a continuous study that measures the physical and mental health and well-being of Medicare beneficiaries over a two-year period. Starting in 1998, a baseline survey was administered to a new cohort of respondents each year in the spring and a follow-up survey was conducted of those same respondents two years later. Cohorts 1-5 include the Baseline Data, the Follow-Up Data, and the Analytic Data file, which contains the merged Baseline and Follow-Up files along with supplemental variables. Beginning with Cohort 6, the Follow-Up Data were included only in the Analytic file. The HOS consists of the SF-36 Health Survey, which yields physical and mental health summary measures, as well as questions on topics such as chronic medical conditions, activities of daily living (ADLs), depression, smoking, physical health symptoms, weight and height, and additional questions corresponding to HEDIS (Health Care Employer Data and Information Set) measures such as urinary incontinence in older adults, osteoporosis testing in older women, and fall risk management. In 2006, CMS implemented the Medicare HOS 2.0 for Medicare Advantage Organizations (MAOs) which evaluates physical and mental health status using the Veteran RAND 12-Item Health Survey (VR-12). The revised instrument contains questions that gather information for case-mix and risk-adjustment variables, and collects information on respondents' physical functioning, bodily pain, social functioning, mental health, vitality, general health, and how respondents' physical and emotional health affects their lives. The survey includes case-mix adjustment variables which may be used to adjust the survey response data for beneficiary characteristics that are known to be related to systematic biases in the way people respond to survey questions. Demographic information includes respondent's age, gender, race, education level, marital status, annual household income, and geographic region.
Smallest Geographic Unit
1998 -- 2014
Data Collection Notes
For the variables corresponding to the Healthy Days questions, NCQA allowed the vendors to enter invalid values into the database when respondents indicated a response of more than 30 days. However, values greater than 30 were excluded from all analyses involving the three healthy days questions in the reports.
For comprehensive information on the history and progress of the Medicare HOS Program, including the full spectrum of available data and reports, please visit the Medicare Health Outcomes Survey Web site.
The CASE_ID identifier assigned to a beneficiary in the analytic public use files does not correspond to any identifier that may be assigned to the same beneficiary in either a baseline public use file or other analytic public use files.
Any file names referenced in the user guides are not applicable to the ICPSR release of the data.
The HOS questionnaire contains multiple skip patterns. Caution should be exercised when examining selected questions that involve skip pattern responses. Please refer to the User Guide for additional information on skip patterns.
According to the principal investigators, the value "MM" in the survey mode variable, formerly known as survey round number, was not used consistently by the HOS survey vendors since telephone follow-up of incomplete mail surveys is often utilized, with a subsequent "MT" survey mode assignment.
Cohorts 1-5 contain the Baseline Data, the Follow-Up Data, and the Analytic Data file, which contains the merged Baseline and Follow-Up files along with supplemental variables. Beginning with Cohort 6, the Follow-Up Data were no longer produced separately and were included only in the Analytic Data file.
Demographic variables in the baseline survey (age, race, marital status, education level) were collapsed by the principal investigators to ensure the confidentiality of the respondents. Information on how to gain access to HOS nonidentifiable data, identifiable data, and limited data set files is available via the Centers for Medicare and Medicaid Services Web site.
Cohort 9 (2006-2008) only contains Baseline data at this time.
The HOS measure was administered to a randomly selected sample of individuals at baseline from each Managed Advantage Organization (MAO). From this sample, a Follow-Up cohort was identified of those who were eligible for re-measurement two years later. The sampling methodology was dependent upon the size of a plan's population and changed slightly each year. For information on the sample inclusion criteria, please refer to the User Guide for the specific cohort.
Medicare recipients in Medicare contract market areas in the 50 states, the District of Columbia, and the United States territories of Puerto Rico, Guam, and the Virgin Islands.
Unit(s) of Observation
Centers for Medicare and Medicaid Services (CMS) Monthly Report of Managed Care Health Plans
Centers for Medicare and Medicaid Services (CMS) Medicare Enrollment Database
administrative records data
Mode of Data Collection
Original Release Date
2016-05-26 Baseline and analytic data for cohorts 14 and 15 have been added to the collection and documentation was updated to account for title change.
2014-11-13 Baseline and analytic data for cohorts 10 through 13 have been added to the collection and documentation was updated to account for title change.
2009-07-22 ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:
- Checked for undocumented or out-of-range codes.
Data in this collection are available only to users at ICPSR member institutions.
This study is provided by ICPSR. ICPSR provides leadership and training in data access, curation, and methods of analysis for a diverse and expanding social science research community.