As changes to the Medicare system shift their focus from fee for service (FFS) models to value-based programs utilizing incentive payments for quality of care, providers need to learn how to operate within this system. Not only will fulfilling the scoring metrics result in positive scores,  but it also contributes to a better patient experience. The  Centers for Medicare and Medicaid Services (CMS) programs reward providers based on performance metrics and reviews, so payment models, incentive payments, and reimbursements depend on provider performance

For providers enrolled in the Medicare Advantage (MA) plan,  CMS runs periodic assessments of provider performance and awards payments, contracts, and bonuses based on these results. Raising your health outcomes survey (HOS) score is one way to help your plan stand out when employers, facilities, and patients are shopping for providers. 

What is HOS?

The health outcomes survey (HOS) is a CMS initiative aimed at improving patient satisfaction and outcomes. This survey scores providers based on patient-reported outcomes to determine which providers are most optimally meeting the needs of those they serve. The HOS covers core metrics related to patient health care and wellbeing and assesses how well primary care and other providers meet those needs and how those results contribute to improved patient health outcomes. 

Who Answers the HOS Survey?

Each year, CMS chooses, at random, a sample of people with Medicare to survey. They draw this sample pool from those covered through a care organization enrolled in a Medicare Advantage plan with a minimum of 500 enrollees. They survey the sampled participants and then follow up with that cohort after two years. 

According to “For data collection years 1998-2006, the [Medicare Advantage Organization] MAO sample size was one thousand. Effective 2007, the MAO sample size was increased to twelve hundred. Since 2019, MAOs can request a survey sample larger than the standard sample of 1,200.”

CMS chooses different cohorts to survey at yearly intervals, covering a certain percentage of Medicare recipients each time. Each year, a new sample cohort is chosen at random. The 2022 HOS will occur beginning in July and is scheduled to be completed by October 2022. There is still time to make a positive impression on your clients and improve their outcomes before this year’s survey is administered.

How is the HOS Sample Chosen? 

CMS chooses each set of survey participants at random throughout the United States. With 1,200 respondents per annual survey, it is likely that at least one of them will be surveyed in the near future about the quality of care they received through your programs.

Each yearly sample cohort is re-surveyed after two years to measure patient outcomes and satisfaction trends. The answers to these questions help form the scores given to providers and help future patients evaluate plans and providers before enrollment. 

What Metrics Does the HOS Measure?

The goal of the HOS is to gather valid, reliable, and clinically meaningful data about the Medicare Advantage (MA) program. Three of the main categories include: Management of Urinary Incontinence in Older Adults, Physical Activity in Older Adults, and Fall Risk Management. Providers that successfully address these issues for their patients have a much better chance of garnering a positive score from the assessment survey. 

Management of Urinary Incontinence

Strength training can be very effective in preventing urinary incontinence episodes. Pelvic floor exercises are the first line of defense to address urinary incontinence, which can improve quality of life, prolong independence, and prevent feelings of isolation. A fitness program like Peerfit Move can help older adults stay active, allow them to feel more socially connected, and remain continent longer. These improved outcomes will raise your HOS score.

Physical Activity in Older Adults

A sedentary lifestyle has long been known to decrease quality of life and increase the risk of many health problems. Regular, moderate exercise improves cardiovascular function, enhances mood, and helps maintain mobility as you age. A health plan that encourages older adults to stay active through programs like Peerfit Move  will score higher on the HOS survey. Quality health care plans can also cover physical therapy programs to improve a patient’s health status.

Fall Risk Management

More than one-quarter of those 65 or older will experience a fall each year. Approximately one in five falls will result in a serious injury, and more than 800,000 patients are hospitalized per year due to a fall injury. The most common injuries resulting from a fall are head injuries and hip fractures. Even when they don’t result in an injury, falls make the person affected afraid to fall again. Fear of falling restricts physical activity and makes a patient less likely to retain independence. 

By providing access to a structured routine of physical activity that increases strength and balance through a program like Peerfit Move, patients can achieve great confidence in their mobility and remain more independent for longer. Preventing falls can reduce the incidence of hip arthroscopy, a common procedure to address hip fractures – most of which are performed as a result from falls. 

How Can Peerfit Move Help You Raise Your HOS Score?

With a comprehensive fitness program, you can help patients gain strength, improve balance, and regain mobility. In the elderly, increased physical fitness can reduce the risk of falls, decrease the instance of urinary incontinence, and improve their overall quality of life. Regular, moderate exercise has many health benefits including a positive effect on mood and a greater sense of independence. 

Falls are a significant factor in improving quality of life. About 36 million falls are reported among older adults each year, resulting in $50 billion annually. Fear of a fall may make the elderly afraid to move around more than minimally necessary, reducing their sense of independence and quality of life. Programs like Peerfit Move can give the elderly the confidence to stay active and retain their independence. By addressing the three main areas of concern addressed by the HOS, Peerfit Move can help you raise your score through improving health outcomes for your enrollees.

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