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TitleThe Medicare Health Outcome Survey (HOS) Quality Assurance Guidelines and Technical
LanguageEnglish
File Size1.8 MB
Total Pages191
Table of Contents
                            Medicare Health Outcomes Survey (HOS)
	Quality Assurance Guidelines and Technical Specifications V2.0
	Medicare HOS Table of Contents
	I. Reader’s Guide
	II. Introduction and Overview
	III. Program Requirements
	IV. Sampling
	V. Communications and Technical Support
	VI. Data Collection Protocol
	VII. Data Coding and Preparation
	VIII. Data Submission
	IX. Data Analysis and Public Reporting
	X. Quality Oversight
	XI. Discrepancy Reports
	Appendix A: HOS 2016 Minimum Business Requirements
	Appendix B: Model Quality Assurance Plan
	Appendix C: Frequently Asked Questions for Customer Support
	Appendix D: HOS 2016 Sample File Layout and Survey File Record Layout
	Appendix E: HOS 2016 Questionnaire and Mailing Materials
	Appendix F: HOS 2016 Telephone Script
	Appendix G: Discrepancy Report Form
	Appendix H: Acronyms and Abbreviations
                        
Document Text Contents
Page 1

Medicare Health Outcomes Survey

(HOS)




Quality Assurance Guidelines

and Technical Specifications







Version 2.0

January 2016

Page 95

Appendix A: Minimum Business Requirements February 2016

Centers for Medicare & Medicaid Services A-3
Medicare HOS Quality Assurance Guidelines and Technical Specifications V2.0

Criteria Survey Vendor Requirements

through each stage of the protocol through the use of a unique de-

identified member identification number and interim disposition

codes. This electronic management system should also prevent

duplicative records.

 A secure work environment for receiving, processing and storing
hardcopy and electronic versions of questionnaires and sample files that

protects the confidentiality of survey response data and personal

identifying information.

 Prepare and submit data via secure methods (HIPAA compliant).

Approved Use of

Subcontractors

(Subject to

Approval)

 CMS must approve subcontractors as part of the survey vendor approval
process at the time of application.

 Subcontractors must meet the criteria outlined for the survey
administration activities the subcontractors will be performing.

 Subcontracting of data file preparation and submission is not allowed.

 Subcontractors added after the application process are subject to
approval by CMS. Survey vendors must inform the HOS Project Team

of new subcontractor(s) as soon as possible.

Mode

Administration
 Responsible for printing, assembling and mailing survey materials in

accordance with the Medicare HOS Quality Assurance Guidelines and

Technical Specifications V2.0.

 Responsible for programming electronic telephone interviewing systems
in accordance with the Medicare HOS Quality Assurance Guidelines and

Technical Specifications V2.0.

 Comply with all quality oversight requirements described in the Medicare
HOS Quality Assurance Guidelines and Technical Specifications V2.0,

including submitting sample mail materials and telephone interviewing

screen shots to Project Team for review prior to survey administration.

 Demonstrate ability to collect and accurately process and code survey
data through all phases of survey administration.

 Demonstrate ability to adhere to the survey administration timeline.

Sampling

Experience
 Not applicable for HOS.

Data Submission  Follow all data preparation and submission rules as specified in the
Medicare HOS Quality Assurance Guidelines and Technical

Specifications V2.0.

 Submit data electronically in specified format outlined in the Medicare
HOS Quality Assurance Guidelines and Technical Specifications V2.0.

 Must be authorized by a health plan prior to submission of data.

 Work with the HOS Project Team to resolve data and data file
submission problems.

 Execute business associate agreement with MAO and receive annual
authorization from MAO to collect data on their behalf and submit to

CMS.

 Submit revised data files as requested by the HOS Project Team within

Page 96

Appendix A: Minimum Business Requirements February 2016

Centers for Medicare & Medicaid Services A-4
Medicare HOS Quality Assurance Guidelines and Technical Specifications V2.0

Criteria Survey Vendor Requirements

the specified timeframe.

Data Security  Established electronic security procedures related to access levels,
passwords and firewalls as required by HIPAA.

 Perform regularly scheduled data back-up and off-site redundancy
procedures that adequately safeguard system data.

 Required encryption protocols, if applicable, must be utilized for
transmitting data files.

 Established procedures for identifying and reporting breaches of
confidential data.

 Experience preparing and submitting data via secure methods (HIPAA
compliant).

 Ensure the CMS Data Use Agreement (DUA) is kept up to date and that
all CMS requirements are followed, including documenting all

subcontractors.

 Follow HIPAA compliant procedures.
Data Retention  Capacity to retain all data files (electronic or paper) for a minimum of

three years, or as otherwise specified by the Medicare HOS Quality

Assurance Guidelines and Technical Specifications V2.0.

 Store returned paper questionnaires in a secure and environmentally safe
location until December 31 of the following survey administration year

or as otherwise specified by the Medicare HOS Quality Assurance

Guidelines and Technical Specifications V2.0.

Confidentiality  Data files (electronic or paper) must be stored securely and confidentially
in accordance with the Medicare HOS Quality Assurance Guidelines and

Technical Specifications V2.0.

 Ensure confidentiality of sampled members’ identifying information
during each phase of the survey process. Only contract-level data may be

shared with MAOs as specified in the Medicare HOS Quality Assurance

Guidelines and Technical Specifications V2.0 (i.e., no member-level or

member identifying information can be shared with MAOs).

 Obtain signed confidentiality agreements from staff and subcontractors.
 Ensure compliance with all applicable HIPAA Security and Privacy

Rules in conducting all survey administration and data collection

activities.

Technical

Assistance/

Customer Support

 Establish toll-free customer support telephone lines with live operator
Monday through Friday from 9:00 a.m. to 8:00 p.m. (survey vendor local

time) to accommodate both Spanish and English inquiries starting at the

beginning of the survey fielding period and continuing through the

duration of survey fielding.

 If administering the HOS survey in Chinese, accommodate telephone
inquiries from Chinese-speaking survey participants.

Page 191

Appendix H: Acronyms and Abbreviations February 2016



Centers for Medicare & Medicaid Services H-2
Medicare HOS Quality Assurance Guidelines and Technical Specifications V2.0

Acronym/Abbreviation Term

PII Personally Identifiable Information
PHQ Patient Health Questionnaire
PROMIS Patient Reported Outcomes Measurement Information System
QA Quality Assurance
QAG Medicare HOS Quality Assurance Guidelines and Technical

Specifications
QAP Quality Assurance Plan
QI Quality Improvement
RTF Rich Text Format
SMS Survey Management System
SNP Special Needs Plan
TIFF Tagged Image File Format
USPS United States Postal Service
VR-12 Veterans RAND 12-Item Health Survey
WORM Write Once Read Many

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