Brief Description of the MHOS Surveys
The Medicare Health Outcomes Survey (MHOS) is the first patient-based outcomes measure in Medicare managed care. It is a longitudinal, two-wave survey that assesses physical and mental functioning of beneficiaries, and includes additional information about functional status, smoking status and chronic medical conditions.
The HOS has been fielded nationally since 1998 as a Healthcare Effectiveness Data and Information Set (HEDIS®) effectiveness of care measure, and has been used to assess the functional health outcomes and health-related quality of life (HRQOL) of Medicare managed care beneficiaries. For the years 1998 - 2005 the HOS version 1.0 evaluated the physical and mental health status of the beneficiaries using a 36-item Health Survey. Physical health and mental health functioning were measured with the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, respectively, which were derived from the survey.
In 2006, CMS implemented the Medicare HOS 2.0. The HOS 2.0 evaluates the HRQOL of Medicare Advantage beneficiaries by measuring their physical and mental health status using the Veterans RAND 12-item Health Survey (VR-12). Use of this HOS 2.0 instrument reduces beneficiary burden while maintaining comparability of HOS results over time. The Physical Component Summary (PCS) and Mental Component Summary (MCS) have already been re-scored to be equivalent across the cohorts/years of data collection. For information on how to re-score the VR-12 scale items to make them comparable to the legacy SF-36 measures, see the SAS Program to Recode the 8 VR-12 Scales to Match SF-36 page.
The HOS is a self-administered, mailed survey with telephone follow-up. The protocol includes a mailed pre-notification postcard, a first mailing of the survey, a reminder/thank you postcard, a second mailing of the survey to people who did not respond initially, and up to six follow-up telephone calls to those individuals who did not respond to the second mailing.
For data collection years 1998 - 2006, a baseline survey was administered to 1,000 randomly selected Medicare managed care beneficiaries per plan, drawn from the entire United States. Effective 2007, the plan sample size was increased to twelve hundred. A follow-up survey is administered to the same cohort two years later if the beneficiaries are still enrolled in the health plan.
The linked SEER-MHOS data resource presently available includes eighteen cohorts of MHOS data (baseline and follow up) covering the data collection years of 1998 - 2017. Researchers can find more information about HOS at www.cms.gov/Research-Statistics-Data-and-Systems/Research/HOS/ and www.hosonline.org.
The Medicare HOS instruments for each year can be downloaded from the Medicare Health Outcomes Survey Web site.