Medicare Health Outcomes Survey Field Test

Problem

Administrators of the Medicare Health Outcomes Survey (HOS) want to know whether an online option could improve survey response rates.

HOS collects patient-reported outcomes from Medicare Advantage (MA) health plan enrollees. The goal of the survey is to measure how health plans maintain or improve beneficiaries’ health over time, and to provide objective and data-driven comparisons among MA contracts. Researchers and the public use the data to assess health plan performance and monitor health outcomes in the Medicare population. HOS measures are also included in the Star Ratings for MA Quality Bonus Payments, which help consumers evaluate and choose among MA plans when looking for coverage.

Currently, HOS collects survey responses through paper mailings with telephone follow-up. The National Committee for Quality Assurance (NCQA), which administers HOS on behalf of CMS, is investigating whether adding a web-based collection option can improve response rates and produce more representative data.

Solution

NORC is conducting a randomized field test to evaluate whether adding an online survey option to HOS improves response rates.

Under contract with NCQA, we are conducting all data collection activities for this field test. The study randomly assigns enrollees across approximately 50 MA contracts into two groups—one contacted by web, then mail, then phone, and one contacted by mail, then phone. We prepare and program survey materials for web, mail, and phone collection in English and Spanish. With 170 enrollees per group per contract, the test encompasses roughly 17,000 beneficiaries overall.

NORC conducts all aspects of data collection including respondent recruitment mailings, operating a help desk for participant inquiries, and providing status reports to NCQA. Interim and final data files—including contact outcomes and responses across all collection modes—are delivered to NCQA for analysis.

Result

NCQA and CMS will use the findings to determine whether to incorporate web-based collection into future rounds of HOS.

NORC will deliver data files encompassing contact outcomes and responses from all three collection modes, allowing NCQA and CMS to compare response patterns across the two groups.

NCQA and CMS will use these results to evaluate whether the web mode improves response rates and whether it introduces any measurement differences relative to the current survey process. The findings will directly inform decisions about incorporating web-based collection into future rounds of HOS.