Medicare Health Outcomes
Survey Field Test (CMS-10861)
Revision of a currently approved collection
No
Regular
12/08/2025
Requested
Previously Approved
36 Months From Approved
03/31/2027
6,800
6,800
1,700
2,267
0
0
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.
PL:
Pub.L. 108 - 173 722(a)(3)(A)(i) Name of Law: Medicare
Prescription Dug, Improvement, and Modernization Act
US Code: 42
USC 422.162 Name of Law: Medicare Advantage Quality Rating
System
CMS has removed 16 items and
added two items from the field test questionnaires that were
previously approved. The average time to complete the HOS field
test instrument was decreased from 20 to 15 minutes. This change
decreased the annual burden by 566.67 hours from 2,266.67 hours to
1,700 hours.
$800,000
No
Yes
Yes
No
No
No
No
Stephan McKenzie 410 786-1943
stephan.mckenzie@cms.hhs.gov
No
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form CMS-10861 HOS Field Test
CMS-10861 - Supporting Statement B.docx
HOS Field Test