Crosswalk

Attachment A_Crosswalk of Changes to HOS Proposed Questionnaire.pdf

Medicare Health Outcomes Survey (HOS) (CMS-10203)

Crosswalk

OMB: 0938-0701

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Attachment A: Crosswalk of Changes to HOS Proposed Questionnaire
2015 (old question)
51. Has your doctor or other health
provider done anything to help
prevent falls or treat problems
with balance or walking? Some
things they might do include:
• Suggest that you use a cane
or walker.
• Check your blood pressure
lying or standing.
• Suggest that you do an
exercise or physical therapy
program.
• Suggest a vision or hearing
testing.
1. Yes
2. No
3. I had no visits in the past 12
months

2018 (proposed new question)
Type of change
51. Has your doctor or other health
Revised question
provider done anything to help
wording
prevent falls or treat problems
with balance or walking? Some
things they might do include:
• Suggest that you use a cane
or walker.
• Suggest that you do an
exercise or physical
therapy program.
• Suggest a vision or hearing
test.
• Suggest you take vitamin D.
1. Yes
2. No
3. I had no visits in the past 12
months

Reason for change
HEDIS® item; NCQA revised the
survey question to align with
current USPSTF recommendations


File Typeapplication/pdf
File TitleAttachment A: Crosswalk of Changes to HOS Proposed Questionnaire
AuthorTony Yep
File Modified2017-03-14
File Created2017-03-14

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