DOI: 10.3886/icpsr23380.v2
title: Medicare Health Outcomes Survey (HOS), 1998-2014
title: Version 2

description: 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.
description: The data are not weighted.
description: 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..
description: Datasets: 
 
 DS0: Study-Level Files 
 DS1: Cohort 1 (1998-2000): Baseline Data 
 DS2: Cohort 1 (1998-2000): Follow-up Data 
 DS3: Cohort 1 (1998-2000): Analytic Data 
 DS4: Cohort 2 (1999-2001): Baseline Data 
 DS5: Cohort 2 (1999-2001): Follow-up Data 
 DS6: Cohort 2 (1999-2001): Analytic Data 
 DS7: Cohort 3 (2000-2002): Baseline Data 
 DS8: Cohort 3 (2000-2002): Follow-up Data 
 DS9: Cohort 3 (2000-2002): Analytic Data 
 DS10: Cohort 4 (2001-2003): Baseline Data 
 DS11: Cohort 4 (2001-2003): Follow-up Data 
 DS12: Cohort 4 (2001-2003): Analytic Data 
 DS13: Cohort 5 (2002-2004): Baseline Data 
 DS14: Cohort 5 (2002-2004): Follow-up Data 
 DS15: Cohort 5 (2002-2004): Analytic Data 
 DS16: Cohort 6 (2003-2005): Baseline Data 
 DS17: Cohort 6 (2003-2005): Analytic Data 
 DS18: Cohort 7 (2004-2006): Baseline Data 
 DS19: Cohort 7 (2004-2006): Analytic Data 
 DS20: Cohort 8 (2005-2007): Baseline Data 
 DS21: Cohort 8 (2005-2007): Analytic Data 
 DS22: Cohort 9 (2006-2008): Baseline Data 
 DS23: Cohort 10 (2007): Baseline Data 
 DS24: Cohort 10 (2007-2009): Analytic Data 
 DS25: Cohort 11 (2008): Baseline Data 
 DS26: Cohort 11 (2008-2010): Analytic Data 
 DS27: Cohort 12 (2009): Baseline Data 
 DS28: Cohort 12 (2009-2011): Analytic Data 
 DS29: Cohort 13 (2010): Baseline Data 
 DS30: Cohort 13 (2010-2012): Analytic Data 
 DS31: Cohort 14 (2011): Baseline Data 
 DS32: Cohort 14 (2011-2013): Analytic Data 
 DS33: Cohort 15 (2012): Baseline Data 
 DS34: Cohort 15 (2012-2014): Analytic Data
description: computer-assisted telephone interview (CATI), mail questionnaire 
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.
Cohort 9 (2006-2008) only contains Baseline data at this time.
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.
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.
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.
 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. 
 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. 
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.
description: 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. Smallest Geographic Unit: Region
description: 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.