HEDIS MY 2021 Volume 6 (epub)



In downloading HEDIS® Volume 6 (the “Product”), I certify that my organization and/or I will use the Product solely for one of the following purposes as related to CMS’s HEDIS Medicare Health Outcomes Survey (“HOS”) and/or Medicare Health Outcomes Survey-Modified (“HOS-M”) (individually, a “Survey” and collectively, the “Surveys”):

  • Internal, non-commercial informational (reference) purposes

  • Participating in or fielding the official CMS Survey

Survey use outside of the above permitted uses, including but not limited to fielding Survey questions outside the official CMS-sponsored HOS Program (e.g., health plan quality improvement surveys), or providing commercial services (e.g., offering products or services for a fee), requires submission of the HOS Survey Intake Form, stating the purpose which you are downloading the Surveys, a Survey Use Request Form, and signed Terms of Use, found on NCQA's HOS Webpage. Email the completed Survey Use Request Application and Terms of Use form to hos@ncqa.org. NCQA will let you know the status of the Survey Use Request Application within 10 business days.

Blackout Period

Survey vendors, health plans, or their agents are prohibited from administering any Survey questions to Medicare beneficiaries eight weeks before and during HOS administration.

Risks of Off-Cycle Surveys:

Surveys of Medicare beneficiaries that overlap with official CMS surveys could have a negative effect on how Medicare beneficiaries respond to the non-CMS as well as the CMS survey. Some Medicare beneficiaries may be confused by the similarities between the surveys which could result in even stronger negative effects.

Medicare beneficiaries who receive requests to participate in multiple off-cycle or overlapping surveys are likely to ignore one or more of those requests, putting all official Survey response rates at risk.

I acknowledge that any use outside the aforementioned categories, including but not limited to fielding of Survey questions outside the official CMS-sponsored HOS Program or commercial use of the Product, must be approved by NCQA and I must submit the HOS Survey Intake Form, complete a Survey Use Request Form, and acknowledge the Terms of Use, found on NCQA's HOS Webpage.

HEDIS Measurement Year (MY) 2021 Volume 6: Specifications for The Medicare Health Outcomes Survey

  View Table of Contents for this Publication

The Medicare Health Outcomes Survey (HOS) measure was developed to monitor and evaluate the quality of care and service provided to Medicare beneficiaries and grant them information that supports plan-to-plan comparison. This volume features details about the measure, the survey instrument and information that health plans and vendors need to report results.

This publication incorporates content from the Centers for Medicaid and Medicaid Services (CMS). For information about the availability of auxiliary aids and services, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.

HEDIS (The Healthcare Effectiveness Data and Information Set) is the gold standard in health care performance measurement, used by more than 90 percent of the nation's health plans and many leading employers and regulators. HEDIS is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience.

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