OMB control number

Medicare Health Outcomes Survey Field Test (CMS-10861)

OMB 0938-1464 · HHS/CMS.

OMB 0938-1464

The Centers for Medicare & Medicaid Services (CMS) has fielded the Medicare Health Outcomes Survey (HOS) annually since 1998. The HOS is a national survey of Medicare managed care plan enrollees that provides data that permit the calculation of both longitudinal and cross-sectional measures of plan performance that are publicly reported to assist Medicare beneficiaries in making enrollment decisions. This request is to conduct a field test to evaluate potential new survey items, alternatives to existing survey content, and the effects of a web-based survey administration mode on response patterns and measure scores. CMS’s goal is a refined and shorter HOS survey instrument with new and methodologically simpler cross-sectional and longitudinal measures, expanded measurement of physical functioning and mental health, and the addition of survey items that support CMS’s efforts to measure and address health equity.

The latest form for Medicare Health Outcomes Survey Field Test (CMS-10861) expires 2027-12-31 and can be found here.

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