Health Outcomes Survey: A look at patient-provider relationships

August 23, 2024

Health Outcomes Survey (HOS) season is here. Each year, we send the HOS to a random sampling of patients with Cigna HealthcareSM Medicare Advantage plans.

What is HOS and why does it matter?

The HOS is an important measuring stick for population health that runs from about July 22 to July 31 each year. In addition to measuring physical health, it:

  • Captures non-clinical factors that can impact your patients’ overall health: Mental, emotional, and social health, as well as physical capabilities and overall sense of well-being.
  • Provides a picture of the patient-provider relationship, patient experience, and opportunities to further engage patients and enhance that important connection.
  • Can help you to identify and close gaps in care.

HOS data helps the Centers for Medicare & Medicaid Services monitor health plan performance based on patient health outcomes. It also affects Star Quality Ratings that help Medicare beneficiaries choose a health plan.

Tips for driving success and patient engagement

You can positively impact HOS results by starting important conversations during office visits. During these conversations, ask questions, create recall, and encourage patients to take actions and engage in preventive health behaviors that align with key HOS measures.

EMPOWER yourself and your staff.

  • Educate yourself and your staff about the key HOS measures.
  • Use Cigna Healthcare tools such as Conversation Starters and questionnaires.
  • Encourage office staff to help patients complete the HOS.
  • Ask your provider performance enablement representative about additional tools and resources.

ENGAGE with patients at every visit.

  • Use every office visit, when appropriate, to ask patients about physical activity, depression, incontinence, and fall prevention.
  • Discuss prevention tactics, recommendations, and treatments.
  • Create recall about conversations by following up with patients after their visit.

ENCOURAGE patients to take a lead role.

  • Tell patients to be open and honest about their health.
  • Provide a questionnaire for patients to complete if they are embarrassed to talk openly.
  • Remind patients about the importance of filling out the HOS, if selected.
  • Suggest patients ask office staff for help completing the HOS.
HOS measureHOS QUESTIONS patients are asked (abridged)ACTIONS you can take
Improving and maintaining mental health and physical healthIn the past 12 months, did you talk with your provider about your mental health? For example, did your provider ask if you’re feeling depressed, having trouble sleeping, taking any medications, or seeing another provider to help you maintain your well-being?

Over the past two weeks, how often have you felt little interest or pleasure in doing things? Felt down, depressed, or hopeless?
In general, would you say your health is: Excellent, very good, good, fair, or poor?
Does your health now limit you in: Moderate activities or climbing stairs?
During the past four weeks, how much did pain interfere with your normal work?
Discuss physical and mental health.

Ask patient if they’ve felt down or depressed.

Refer patient to a mental health provider, if appropriate.

Offer activities to improve mental health, such as walks, socializing, crossword puzzles, going to a senior center, etc.

Ask patients what factors (such as pain) may be limiting their ability to complete daily activities.

Refer to a specialist, if appropriate.
Monitoring physical activityIn the past 12 months, did you talk with your provider about your level of exercise or physical activity? For example, did your provider ask if you exercise regularly?

Has your provider advised you to start, increase, or maintain your level of exercise or physical activity? For example, did your provider advise you to start taking the stairs, increase walking every day, or maintain your current exercise program?
Talk about the importance of exercise and physical activity.

Discuss how to start, increase, or maintain activity.

Refer patients with limited mobility or walking/balance issues to physical therapy to learn safe and effective exercises.
Improving bladder controlHave you talked with your provider about urine leakage?

Have you ever talked with your provider about ways to control leaking of urine, such as bladder training exercises, medication, and surgery?
Ask if bladder control is a problem and discuss when it has been a problem and what other symptoms may be accompanying it.

Discuss treatments for bladder control issues that may arise as patient ages, such as behavioral therapy, exercises, medications, medical devices, or surgery.

Provide educational brochures and materials, such as conversation starters.
Reducing fall riskIn the past 12 months, did you talk with your provider about falling or problems with balance or walking?

Has your provider done anything to help prevent falls or treat problems with balance or walking? Some things they might advise are to use a cane or walker.
Discuss balance problems, falls, difficulty walking, and other fall risks.

Suggest a cane or a walker.

Check blood pressure with patient standing, sitting, and reclining.

Suggest exercise or physical therapy.

Suggest vision/hearing test.

Perform bone density screening.

Provider resources and trainings

We have resources you can use to help facilitate important conversations and impact the HOS, from provider education to flyers that keep topics covered by HOS (such as physical and mental health, incontinence, and fall risk and prevention) top of mind with patients. The following resources can be found on the Cigna Healthcare Medicare Advantage Providers website (MedicareProviders.Cigna.com):

Additional provider toolkit items, including brochures and posters, are available by contacting your provider performance enablement representative.

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